The Development Of "Main Symptom Scale Of Atopic Dermatitis" And The Initial Evaluation Of Its Reliability, Validity, Responsibility

Speciality:Orthopedics of TCM(Integrative Traditional and Western Medicine)Author:Chujun HuangTutor:Professor Chen DacanBackground:Atopic dermatitis is a common,complex disease that frequently follows a chronic,relapsing course.It is characterized by dryness of the skin, pruritus and involvement of the skin flexures.The disease can impact the quality of life of patients and families to a significant degree.The incidence showed a rising trend in China.Also more and more studies have shown the efficacy of Chinese medicine in the treatment of AD.Chinese medicine can not only release the symptoms,but can also improve the quality of life.The accurate differentiation plays an important roll in Traditional Chinese Medicine(TCM).And the Syndrome differentiation is based on the patient' s complaint which is called "main symptom".In terms of comparing the main symptom,we could also evaluate the effectiveness of the treatment.So the main symptom can on one hand be one of the measurement of the patient' status, and on the other hand,it can be an evaluation of the changes of the status.A number of outcome measurements for AD have been published in clinical research.But so far,few of measurement which covers the main symptom and the diagnosis of TCM could be found.The diagnosis of TCM as an soft target is similar to the PRO(patient report outcome),we can use the international evaluation method of scale which has been developed sophisticated and widely accepted to develop a new evaluation.So the main symptom could be a complementary assessment of the clinical evaluation system in AD.Intent:Tentatively set the "Main Symptom scale of Atopic Dermatitis" and evaluate the scale' s reliability,validity and responsibility.In order to provides the evaluation for the effectiveness of TCM in Atopic dermatitis. Method:In this study,based on the theory of main symptom,we performed a research of ancient and modern literatures of AD,then organized,summarized,filtrated and statistic the main symptoms,tentatively set the "Main Symptom scale of Atopic Dermatitis" which combined the characteristics of AD.Then we made a cross-sectional survey among 40 patients,to evaluate the feasibility, reliability,validity and responsibility of the scale.Result:The "Main Symptom scale of Atopic Dermatitis" contains 13 items;The response and completion rate of the scale were 93.3%and 95.2%, respectively;The test-retest correlation coefficient,Cronbach' s Alpha coefficient and split-half reliability coefficient of the scale were 0.984, 0.885 and 0.923,respectively;The KMO is 0.736,and Bartlett's Test of Sphericity is 375.87,P＜0.001;Three factors were extracted according to the factor analysis,the cumulative contribution rate of factors is 62.251%; The Pearson' s correlation coefficient with SCORAD was 0.454,P＜0.05;After intervention by the treatment,the total scores of the main symptoms and the degree of the most upset symptom were better than three weeks ago in the responsibility analysis,P＜0.05;The standardized effect size and the standardized response mean were 0.74 and 0.78,respectively.Conclusion:The "Main Symptom scale of Atopic Dermatitis"(MSSAD) was made on the basis of general international development principle of PRO.The properties of MSSAD are acceptable,It can be used extensively into the clinical practice of TCM in the future.