临床肝胆病杂志2025，Vol.41Issue(4)：650-660,11.DOI:10.12449/JCH250409
基于病证结合非酒精性脂肪性肝病湿浊内停证证候评价量表的初步构建
Construction of an evaluation scale for non-alcoholic fatty liver disease with internal retention of dampness and turbidity based on the method of combining disease and syndrome
摘要
Abstract
Objective To develop a scale for evaluating the syndrome of internal retention of dampness and turbidity in nonalcoholic fatty liver disease(NAFLD)that combines disease and syndrome and has the characteristics of traditional Chinese medicine(TCM).Methods An item pool was established for evaluating the syndrome of internal retention of dampness and turbidity in nonalcoholic fatty liver disease(NAFLD)with reference to the guideline for developing international scales.A clinical survey was conducted among the outpatients and inpatients who were diagnosed with NAFLD and had the syndrome of internal retention of dampness and turbidity in Department of Hepatology and Spleen-Stomach,The First Affiliated Hospital of Henan University of Chinese Medicine,from June to August,2023,and the items were screened based on the classical test theory and the item response theory.An expert questionnaire was developed,and expert discussions were conducted using the Delphi method to identify the items for evaluating the syndrome of internal retention of dampness and turbidity in NAFLD.Finally,the scale was given scientific scores.Results A preliminary item pool was established,with 16 primary items and 22 secondary items,and it was divided into the two dimensions of disease and syndrome type.Clinical pre-survey suggested to retain 9 primary items and 14 secondary items,while the Delphi expert questionnaire recommended to retain 11 primary items and 15 secondary items,and tongue manifestation and pulse manifestation were no longer used for assessing the severity of syndrome.After hierarchical analysis and scientific assignment of scores,the scale for evaluating the syndrome of internal retention of dampness and turbidity in NAFLD had a total score of 123 points and 9 important items,i.e.,discomfort in the hypochondrium,abdominal fullness and distension,obesity,heaviness of the head and body,loose stool,anorexia,coughing up phlegm,nausea with a tendency to vomit,and lethargy.Conclusion A preliminary scale is established for evaluating the syndrome of internal retention of dampness and turbidity in NAFLD,which fills the gap in this research field and provides a basis for further clinical application.关键词
非酒精性脂肪性肝病/湿浊内停证/个性量表/德尔菲技术/循证医学Key words
Non-alcoholic Fatty Liver Disease/Dampness-Turbidity Syndrome/Personality Inventory/Delphi Technique/Evidence-Based Medicine引用本文复制引用
周铖,杨金秋,刘通,李善政,刘彤,赵文霞..基于病证结合非酒精性脂肪性肝病湿浊内停证证候评价量表的初步构建[J].临床肝胆病杂志,2025,41(4):650-660,11.基金项目
国家自然科学基金面上项目(81473651) （81473651）
河南省中医药科学研究专项课题(2019JDZX2051,2019JDZX2012) （2019JDZX2051,2019JDZX2012）
河南省中医学"双一流"创建科学研究专项课题(HSRP-DFCTCM-2023-8-16) National Natural Science Foundation of China(81473651) （HSRP-DFCTCM-2023-8-16）
Special Project for Scientific Research on Traditional Chinese Medicine in Henan Province(2019JDZX2051,2019JDZX2012) （2019JDZX2051,2019JDZX2012）
Special Project for Scientific Research on the Creation of"Double First-class"Traditional Chinese Medicine in Henan Province(HSRP-DFCTCM-2023-8-16) （HSRP-DFCTCM-2023-8-16）
