Preliminary Development Of Rating Scales For Excessive Rise Of Liver-Yang And Damp-Heat In Liver And Gallbladder Syndrome

OBJECTIVE To develop specific Rating scales for Excessive Rise of Liver-Yang syndrome and Damp-Heat in Liver and Gallbladder syndrome and offer effective instruments for collecting clinical data and assessing the therapeutic effectiveness of the syndromes.METHODS Adhere to the methods and theory of life quality scale of WHO and scale of psychology and according to relative researches ,we established the two scales through studying of the documents ,reviewing the large scale investigation of clinical epidemiology of Liver syndrome, discussion of the experts in TCM, item study and experienced selection. Through the test of 98 patients with type of Excessive Rise of Liver -Yang and 30 patients with deficiency of the Liver and kidney Yin ,We evaluated the reliability ,validity and responsibility of the scale for Excessive Rise of Liver-Yang syndrome.Also through the test of 100 patients with type of Damp-Heat in Liver and Gallbladder and 30 patients with spleen-stomach damp-heat syndrome, We evaluated the reliability,Validity, and Responsibility of the scale for Damp-Heat in Liver and Gallbladder syndrome.RESULTS An 14-item Scale for Excessive Rise of Liver - Yang syndrome (ERLYS), including two domains(deficiency of Yin, and Excessive Rise of Yang) was developed and showed good reliability and validity. The alternate form reliability coefficients of the scale for Excessive Rise of Yang, deficiency of Yin and the overall scales were 0.973,0.952 and 0.976 respectively. The Cronbach's Alpha coefficients were 0.8992,0.8123 and 0.8925 respectively .The split-half reliability coefficients were 0.8588,0.7823 and 0.8632 respectively. Two common factors were extracted according to the conceptual model and explaining 56.121% variance. The structure of the ERLYS was similar to the theory construction. The scale can differentiate different syndromes and can detect the statistical significance changes between the first measurement and the second one; An 13-item Self-Rating Scale for Damp-Heat in Liver and Gallbladder syndrome (DHLGS), was developed and showed good reliability and validity. The alternate form reliability coefficient of DHLGS was 0.985, The split-half reliability coefficient was 0.876. The Cronbach's Alpha coefficient was 0.861. Two common factors were extracted through Exploratory principal component analysis and explaining 51.897% variance. The structure of DHLGS was similar to the theory construction. There was a very significant difference between the results of DHLGS obtained from the two syndromes (t =2.586, P =0.011). The results of DHLGS obtained from patients with Damp-Heat in Liver and Gallbladder before and after therapy were significantly different (t=14.630, P<0.01).CONCLUSION Both ERLYS and DHLGS are reliable, valid , sensitive, and acceptable and can be used to differentiate and evaluate the two syndromes, but the scales need further research.