Kappa 分析在中医五行音乐辩证选乐质量控制中的应用

目的：用Kappa 分析来检验和控制中医五行音乐辩证选乐的质量。方法：在中医五行音乐选乐的标准上，通过临床主管医师客观性中医辩证选乐对比患者的主观喜好选乐之间的Kappa 值，评价中医五行音乐选乐一致性，检验和控制中医五行音乐辩证选乐的质量。结果：共选取接受中医五行音乐治疗的住院肿瘤患者73 例，通过对中医五行音乐一致性程度分析，单一调式选乐显示，除微调Kappa 值无法分析，无一致性测量；其余4 种调式Kappa 值>0.4，一致性程度适中，且统计学上有相互一致性。多调式选乐显示，心肾不足，心脾两虚，肝肾不足，肺肾不足，肺脾两虚所选择的调式中，Kappa值>0.4，一致性程度适中，且统计学上有相互一致性。结论：通过Kappa 对中医五行音乐辩证选乐一致性程度分析，临床主管医师客观性中医辩证选乐同患者的主观喜好选乐之间存相关一致性，为肿瘤患者进行中医五行音乐治疗奠定了良好的基础。

Kappa Analysis on the Application of Selecting Traditional Chinese Medicine Five Elements Music under Syndrome Differentiation

The quality of traditional Chinese medicine (TCM) five elements music was evaluated and selected under syndrome differentiation using Kappa test. Two different Kappa values were compared between the physician and cancer patient in order to analyze the inter consistency of TCM five elements music selection. A total of 73 hospitalized cancer patients were allocated to receive TCM five elements music. The result of a single tune selection showed that the Kappa value of more than 0.4 for four modal, moderate degree of consistency with statistical consistent for each other. However, no consistent measurement and no statistical consistency for Zhi tune. Multi-modal music selection showed that the Kappa value of more than 0.4 regarding to heart-kidney deficiency, heart-spleen deficiency,liver-kidney deficiency, lung-kidney deficiency, and lung-spleen deficiency in modal choice. There was moderate degree of consistency with statistical consistent for each other. It is concluded that there was consistency of TCM five elements music selection between physician and patient by Kappa analysis. The study set a good foundation for TCM five elements music for cancer patients.