证候疗效评价中症状量化赋值权重确定方法初探

王静 1，2，吴萍 1，曲丽娜 1，韩东彦 1

1.中国中医科学院广安门医院，北京 100053；2.中国人民大学统计学院，北京 100872摘要：目的 探讨证候疗效评价中，对症状进行量化赋值时，专家调查产生的权重与目前常用权重的异同。方法 通过专家问卷调查，将回收问卷的数据用SPSS11.5软件进行分析。对于各个症状权重是否相同这类2个选项的问题，计算给出“是”和“否”回答的专家的频数及频率；对于权重具体是多少这类开放性问题，先罗列出专家给出的每个权重值，然后计算认可每个权重值的专家的频数及频率，并选择频数最大的权重值作为该症状的权重来确定证候疗效评价中症状量化赋值的权重，并将得到的权重与目前常用的权重进行比较。结果 在

主症整体所占权重、次症整体所占权重方面，2种方法产生的权重非常接近；关于各个主症和次症的权重是否相同，绝大多数专家认为应该是不同的，而目前通常的做法是赋予相同的权重。结论 症状量化赋值时，并非每个主症和次症同等重要，因此，对各个主症和次症赋予相同权重的做法有待商榷。关键词：证候；疗效评价；症状；权重

DOI：10.3969/j.issn.1005-5304.2017.10.003

中图分类号：R2-05 文献标识码：A 文章编号：1005-5304(2017)10-0010-04

Primary Study on Symmetric Quantitative Assignment Weight Determination Method in Syndrome Evaluation

WANG Jing1,2, WU Ping1, QU Li-na1, HAN Dong-yan1 (1. Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China; 2. School of Statistics, Renmin University of China, Beijing 100872, China)

Abstract: Objective To explore the expert survey of the weight and the current common weight of the similarities and differences in the quantitative analysis of the symptoms in syndrome evaluation. Methods Through the expert questionnaire survey, the data of the questionnaire were analyzed by SPSS11.5 software. For the question of whether the weight of each symptom was the same, the frequency of the experts who gave “yes” and “no” was calculated. For the weight of the specific number of such openness, the weight given by the experts was listed firstly, and then the weight of frequency of each expert was calculated, and the frequency of the largest weight was selected as the weight of the symptoms to determine the weight of the syndrome quantification assignment in the evaluation of the efficacy of the syndrome, and to compare the obtained weight with the current weight. Results The weight of the two methods is very close in the weight of the primary symptom and the weight of secondary symptom. But as for whether the weight of the primary symptom and secondary symptom is the same, the majority of the experts think that it should be different, and the current usual practice is to give the same weight. Conclusion During the weight determination, not every primary symptom or secondary symptom is the same important. Therefore, the practice of giving the same weight to evry primary symptom and secondary symptom is questionable.

Key words: syndrome evaluation; symptom; weight

证候疗效是中医药疗效的特色和优势，是中医药临床疗效评价的重要内容。在进行证候疗效评价时，需要对证候诊断标准的每一个症状进行量化，这就涉

及症状量化赋值的权重问题[1]。由于证候的诊断一般通过确立主症和次症实现，所以，症状量化时需对主症和次症分别赋值。目前中医药领域的研究对症状进行量化赋值时，通常对主症和次症采用不同的权重，主症的权重大于次症，但对于主症及次症的各个症

状，则分别赋予同样的权重[2]。主症通常分为无、轻、中和重4个等级，进行量化时，或用0、1、2、3 分，或用 0、2、4、6 分，或用 0、3、6、9 分，还有的用