結合病患自述結果發展華人兒童中醫體質量表之可行性初探

A Pilot Feasibility Study on the Integration of the Patient-Reported Outcome to the Development of Body Constitution of Chinese Medicine Scale Among Chinese Pediatric Population

黃千容(Chian-Rung Huang) ； 李竹青(Zhuqing Li) ； 賴琬郁(Wan-Yu Lai) ； 黃韻婷(Wendy Wong) ； 顏宏融(Hung-Rong Yen)

《台灣中醫兒童暨青少年科醫學會雜誌》 1卷1期 (2021/06) Pp. 11-24

https://doi.org/10.29620/JTCMACA.202106_1(1).0002

摘要

以往中醫體質研究主要以成人為對象，但是目前對於兒童中醫體質分類仍沒有統一的標準。臨床上，病患自述結果是一種健康自我效能的評估，直接反應來自病人所獲得的健康狀況自述報告。本研究目的在於探討華人中醫兒童體質量表發展的可行性，透過文獻搜尋歸納彙整目前兒童中醫體質研究的現況，進一步透過專家共識德爾菲法，探討結合病患自述結果的概念建立適用於華人兒童中醫體質量表的可行性。本研究首先歸納分析《中國期刊全文數據庫》的兒童中醫體質研究，主要分成兩大類，第一類是針對特定年齡與對象進行體質調查，歸納出體質類型及其指標。第二類是專家以中醫基礎為理論，透過臨床觀察的經驗較主觀地總結出兒童體質分型。接著我們在2019年8月到2020年7月期間，透過專家訪談共識法，總共訪談8位臺中、香港及北京的中西醫兒科臨床醫師及中醫體質學專家學者。其共識結果認為中醫兒科學術界應該要為華人兒童設計專屬的中醫體質量表，並結合病患自述結果的概念。然而，在年齡層的區分、過敏體質及血瘀體質是否應列入問卷的選項、多久需要做一次體質問卷、家長或陪同者是否應參與兒童體質問卷的作答等，都是尚未達成共識的部分，有待未來持續探討。綜合本研究發現華人兒童中醫體質量表的發展有其必要性，如果能結合病患自述報告與中醫體質的華人兒童中醫體質量表，將有助於兒童中醫體質學的發展。

關鍵字

兒童 ； 中醫體質 ； 文獻回顧 ； 德爾菲法 ； 病患自述結果

並列摘要

In the past, the traditional Chinese medicine (TCM) body constitution has been developed in adult population. However, there is a lack of a standard for pediatric TCM constitution classification at present. Clinically, patient-reported outcome (PRO) is a direct measurement from the patient's self-report of health status. The purpose of this study is to investigate the feasibility of establishing the TCM body constitution scale among the Chinese pediatric population. We first reviewed and summarized previous literatures, followed by collecting the consensus from a Delphi Expert Panel about the feasibility of integration of the concept of PRO into TCM body constitution among the Chinese pediatric population. Summarizing the literatures documented in China Integrated Knowledge Resources Database, we found that studies in TCM pediatric constitution could be classified into two categories. One of them is surveys on a specific age group and population to summarize the different types and index items. The other one is based on the expert's clinical subjective observation and TCM theories to summarize the different types of TCM pediatric constitution. Next, we interviewed experienced TCM and western pediatricians and TCM constitution experts from Taichung, Hong Kong, and Beijing from August 2019 to July 2020 by Delphi individual interviews. The consensus of TCM pediatric academic society was reached to establish a TCM constitution scale for the Chinese pediatric population by integrating the concept of PRO. However, the opinions on the stratification of age, frequency of conducting the questionnaire, the inclusion of allergy and blood stasis constitutions or the inclusion of parents' response were diversified and consensus could not be reached. Future studies need to explore the needs from pediatric subjects. In summary, the present study found that it is necessary to develop a TCM constitution scale among the Chinese pediatric population by integrating the concept of PRO. This will further promote the development of TCM pediatric body constitution theory.

並列關鍵字

pediatrics ； traditional Chinese medicine ； body constitution ； literature reviews ； Delphi method ； patient-reported outcome