儿童急性上呼吸道感染疗效评价量表的研究进展
收稿日期: 2025-06-03
录用日期: 2025-07-28
网络出版日期: 2026-02-02
Research progress of the symptom scale for acute upper respiratory tract infection in children
Received date: 2025-06-03
Accepted date: 2025-07-28
Online published: 2026-02-02
急性上呼吸道感染（上感）是儿童最常见的感染性疾病，但是对于症状的标准化评价方法却未得到必要的重视。标准化评价在评估疾病自然病史以及药物疗效，尤其在临床试验中具有重要作用。目前，在关于儿童上感的临床试验中多采用未经证实的主观症状评分表，或辅以中医自拟证候量表，其科学性有限，不同研究间缺乏可比性。本文系统检索并比较4种已验证的儿童上感疗效评价量表，分析其结构、信效度和适用场景，为研究者与临床医师选择评价指标提供循证依据。本文同时指出，中医药研究仍依赖缺乏统一标准的证候评分，建议未来整合中西医评价框架，开发分年龄段、多维度的儿童上感疗效评价系统，以提升研究的规范性与临床应用价值。
梁浩东 , 郭圣璇 , 胡思源 , 卢宣君 , 张云涵 , 许晨霞 . 儿童急性上呼吸道感染疗效评价量表的研究进展[J]. 临床儿科杂志, 2026 , 44(2) : 161 -166 . DOI: 10.12372/jcp.2026.25e0617
Acute upper respiratory tract infection (AURI) is the most prevalent infectious disease among children. However, standardized methods for evaluating symptoms have not garnered the necessary attention. Standardized assessment plays a pivotal role in evaluating the natural history of diseases and the efficacy of medications, particularly in clinical trials. Currently, in clinical trials focusing on pediatric AURI, unverified subjective symptom rating scales or self-developed Traditional Chinese Medicine (TCM) syndrome scales are frequently employed. These tools exhibit limited scientific validity and lack comparability across different studies. This article systematically reviews and compares four validated efficacy assessment scales for pediatric AURI, analyzing their structural frameworks, reliability, validity, and applicable scenarios, thereby providing evidence-based guidance for researchers and clinicians in selecting evaluation indicators. Additionally, this paper notes that TCM research still relies on syndrome rating scales without unified standards. It is proposed that future efforts should integrate evaluation frameworks from both TCM and Western medicine, and develop age-specific, multi-dimensional efficacy evaluation systems for pediatric AURI, with the aim of enhancing the standardization and clinical application value of related research.
| [1] | 江载芳, 申昆玲, 沈颖. 诸福棠实用儿科学[M]. 第8版. 北京: 人民卫生出版社, 2015. |
| Jiang ZF, Shen KL, Shen Y, et al. Zhu Futang practice of pediatrics[M]. 8th ed. Beijing: Renming Weisheng Chubanshe, 2015. | |
| [2] | Heikkinen T, J?rvinen A. The common cold[J]. Lancet, 2003, 361(9351): 51-59. |
| [3] | Ruohola A, Waris M, Allander T, et al. Viral etiology of common cold in children, Finland[J]. Emerg Infect Dis, 2009, 15(2): 344. |
| [4] | Zhang H, Jiang X. Importance of clinical trials and contributions to contemporary medicine: commentary[J]. Ann Med, 2025, 57(1): 2451190. |
| [5] | da Silva RM, Gebe Abreu Cabral P, de Souza SB, et al. Serial viral load analysis by DDPCR to evaluate FNC efficacy and safety in the treatment of mild cases of COVID-19[J]. Front Med, 2023, 10: 1143485. |
| [6] | Chong SL, Teoh OH, Nadkarni N, et al. The modified respiratory index score (RIS) guides resource allocation in acute bronchiolitis[J]. Pediatr Pulmonol, 2017, 52(7): 954-961. |
| [7] | Davies CJ, Waters D, Marshall A. A systematic review of the psychometric properties of bronchiolitis assessment tools[J]. J Adv Nurs, 2017, 73(2): 286-301. |
| [8] | Destino L, Weisgerber MC, Soung P, et al. Validity of respiratory scores in bronchiolitis[J]. Hosp Pediatr, 2012, 2(4): 202-209. |
| [9] | Fernandes RM, Plint AC, Terwee CB, et al. Validity of bronchiolitis outcome measures[J]. Pediatrics, 2015, 135(6): e1399-e1408. |
| [10] | Golan-Tripto I, Goldbart A, Akel K, et al. Modified Tal Score: Validated score for prediction of bronchiolitis severity[J]. Pediatr Pulmonol, 2018, 53(6): 796-801. |
| [11] | Justicia-Grande A J, Martinón-Torres F. The ReSVinet score for bronchiolitis: a scale for all seasons[J]. Am J Perinatol, 2019, 36(S2): S48-S53. |
| [12] | Justicia-Grande AJ, Pardo-Seco J, Cebey-López M, et al. Development and validation of a new clinical scale for infants with acute respiratory infection: the ReSVinet scale[J]. PLoS One, 2016, 11(6): e0157665. |
| [13] | Mussman GM, Sahay RD, Destino L, et al. Respiratory scores as a tool to reduce bronchodilator use in children hospitalized with acute viral bronchiolitis[J]. Hosp Pediatr, 2017, 7(5): 279-286. |
| [14] | R?dl S, Resch B, Hofer N, et al. Prospective evaluation of clinical scoring systems in infants with bronchiolitis admitted to the intensive care unit[J]. Eur J Clin Microbiol Infect Dis, 2012, 31: 2667-2672. |
| [15] | Santanello NC, Norquist JM, Nelsen LM, et al. Validation of a pediatric caregiver diary to measure symptoms of postacute respiratory syncytial virus bronchiolitis[J]. Pediatr Pulmonol, 2005, 40(1): 31-38. |
| [16] | van Miert C, Abbott J, Verheoff F, et al. Development and validation of the Liverpool infant bronchiolitis severity score: a research protocol[J]. J Adv Nurs, 2014, 70(10): 2353-2362. |
| [17] | G?k?e ?, D?rtkarde?ler BE, Yurtseven A, et al. Effectiveness of pelargonium sidoides in pediatric patients diagnosed with uncomplicated upper respiratory tract infection: a single-blind, randomized, placebo-controlled study[J]. Eur J Pediatr, 2021, 180: 3019-3028. |
| [18] | Anheyer D, Cramer H, Lauche R, et al. Herbal medicine in children with respiratory tract infection: systematic review and meta-analysis[J]. Acad Pediatr, 2018, 18(1): 8-19. |
| [19] | Jacobs B, Young N L, Dick PT, et al. CARIFS: The Canadian acute respiratory illness and flu scale[J]. Pediatric Research, 1999, 45(7): 103-103. |
| [20] | Jacobs B, Young NL, Dick PT, et al. Canadian Acute Respiratory Illness and Flu Scale (CARIFS): development of a valid measure for childhood respiratory infections[J]. J Clin Epidemiol, 2000, 53(8): 793-799. |
| [21] | Fischer JB, Prasad PA, Coffin SE, et al. Canadian Acute Respiratory Illness and Flu Scale (CARIFS) for clinical detection of influenza in children[J]. Clin Pediatr (Phila), 2014, 53(12): 1174-1180. |
| [22] | Gerasimov SV, Belova HA, Pavuk HL, et al. The Ukrainian version of the pediatric Canadian acute respiratory illness and flu scale: a linguistic validation study[J]. Patient Relat Outcome Meas, 2014: 111-117. |
| [23] | Nathan A M, Zaki R, Rozario R, et al. Cross cultural translation, adaptation and reliability of the Malay version of the Canadian Acute Respiratory Illness and Flu Scale (CARIFS)[J]. Health Qual Life Outcomes, 2015, 13: 1-5. |
| [24] | 徐田华, 胡思源, 晋黎, 等. 《加拿大急性呼吸道疾病和流感量表》中文版本的修订与信度效度检验[J]. 中国循证儿科杂志, 2014, 9(1): 1-5. |
| Xu TH, Hu SY, Jin L, et al. Revision and evaluation of the reliability and validity of the Chinese version of Canadian Acute Respiratory Illness and Flu Scale[J]. Zhongguo Xunzheng Erke Zazhi, 2015, 9(1): 1-5. | |
| [25] | 郭圣璇, 胡思源, 光军秀, 等. 加拿大急性呼吸道疾病和流感量表中文版在儿童普通感冒中的最小临床重要差异值研究[J]. 药物评价研究, 2021, 44(5): 1010-1015. |
| Guo SX, Hu SY, Guang JX, et al. Minimal clinically important difference of Canadian Acute Respiratory Illness and Flu Scale Chinese version in children with common cold[J]. Yaowu Pingjia Yanjiu, 2021, 44(5): 1010-1015. | |
| [26] | Schmit KM, Brown R, Hayer S, et al. Wisconsin upper respiratory symptom survey for kids: validation of an illness-specific quality of life instrument[J]. Pediatr Res, 2021, 90(6): 1207-1214. |
| [27] | Ostrzy?ek-Prze?dziecka K, Panczyk M, Ratajczak A, et al. Validation and clinical evaluation of a Polish translation of the Wisconsin Upper Respiratory Symptom Survey for Kids (WURSS-K)[J]. Health Qual Life Outcomes, 2021, 19(1): 153. |
| [28] | Alexandrino AMFS, Santos RIGV, Melo MCDA, et al. Subjective and objective parameters in paediatric respiratory conditions: cultural adaptation to Portuguese population[J]. Fisioterapia Em Movimento, 2017, 30(1): 49-58. |
| [29] | Halstead P, Arbuckle R, Marshall C, et al. Development and content validity testing of patient-reported outcome items for children to self-assess symptoms of the common cold[J]. Patient, 2020, 13: 235-250. |
| [30] | Arbuckle R, Halstead P, Marshall C, et al. Testing and psychometric validation of a pediatric instrument to self-assess symptoms of the common cold[J]. Patient, 2021, 14: 101-117. |
| [31] | Shaikh N, Martin JM, Casey JR, et al. Development of a patient-reported outcome measure for children with streptococcal pharyngitis[J]. Pediatrics, 2009, 124(4): e557-e563. |
| [32] | Shaikh N, Wald ER, Jeong JH, et al. Development and modification of an outcome measure to follow symptoms of children with sinusitis[J]. J Pediatr, 2019, 207: 103-108. |
| [33] | Caserta MT, Qiu X, Tesini B, et al. Development of a global respiratory severity score for respiratory syncytial virus infection in infants[J]. J Infect Dis, 2017, 215(5): 750-756. |
| [34] | de la Loge C, Fofana F, Williams P, et al. Monitoring severity of respiratory syncytial virus (RSV) in infants and young children using the Pediatric RSV Electronic Severity and Outcome Rating System (PRESORS): results of initial quantitative validation[J]. Patient Relat Outcome Meas, 2021: 247-265. |
| [35] | 张永玲, 王保和. 中医证候临床疗效评价方法研究进展[J]. 山东中医药大学学报, 2010, 34(5): 463-465. |
| Zhang YL, Wang BH. Research progress on clinical efficacy evaluation methods of TCM syndromes[J]. Shandong Zhongyiyao Daxue Xuebao, 2010, 34(5): 463-465. | |
| [36] | 王龙龙, 吕霞. 小儿热速清颗粒治疗儿童急性上呼吸道感染风热夹滞证临床观察[J]. 实用中医药杂志, 2025, 41(2): 259-261. |
| Wang LL, Lyu X. Clinical observation on the treatment of wind-heat obstruction syndrome in children with acute upper respiratory tract infection using pediatric resuqing granules[J]. Shiyong Zhongyiyao Zazhi, 2025, 41(2): 259-261. | |
| [37] | 陈文琦, 欧阳丽萍. 小儿柴桂退热颗粒联合头孢呋辛治疗小儿急性上呼吸道感染的效果观察[J]. 黑龙江医药, 2025, 38(1): 106-108. |
| Chen WQ, Ouyang LP. Observation on the effect of xiao 'er chai gui tui re granules combined with cefuroxime in the treatment of acute upper respiratory tract infection in children[J]. Heilongjiang Yiyao, 2025, 38(1): 106-108. | |
| [38] | 胡思源, 李新民, 魏小维, 等. 馥感啉口服液治疗小儿急性上呼吸道感染上市后再评价[J]. 中草药, 2017, 48(9): 1829-1833. |
| Hu SY, Li XM, Wei XW, et al. Post-marketing evaluation of fuganlin oral liquid in treatment of acute upper respiratory infection[J]. Zhongcaoyao, 2017, 48(9): 1829-2833. | |
| [39] | 孙瑞华, 李欢, 徐凯, 等. 中医证候临床评价的探讨[J]. 世界中医药, 2017, 12(6): 1470-1474. |
| Sun RH, Li H, Xu K, et al. Clinical evaluation in Traditional Chinese Medicine (TCM)[J]. Shijie Zhongyiyao, 2017, 12(6): 1470-1474. |
/
| 〈 |
|
〉 |
沪公网安备 31011002000392号
