基于因子分析与聚类分析对溃疡性结肠炎中医证候规律的研究

发布时间：2018-11-26 10:22

【摘要】：目的观察溃疡性结肠炎中医证型分类及分布规律。方法收集溃疡性结肠炎患者441例,采用自拟《溃疡性结肠炎的中医证候流行病学调查表》进行一般情况、中医证候、舌象等临床资料的调研,基于因子分析及聚类分析探讨溃疡性结肠炎中医证候规律。结果本研究收集调查问卷的58个症状条目因子分析,KMO统计量为0.916,Bartlett球型检验P0.0001,适于因子分析。应用最大似然估计法共提取出13个公因子,筛选出具有意义的症状46项,根据病性、病位证素归纳出基本中医证型分为6类。聚类分析显示证型分布比例为:脾胃气虚证占27.66%(122/441),大肠湿热证占26.30%(116/441),脾肾阳虚证占17.69%(78/441),肝郁脾虚证占15.65%(69/441),阴虚肠燥证占8.39%(37/441),血瘀肠络证占4.31%(19/441)。不同病情分期和临床类型的证型分布比例为:大肠湿热证在活动期占48.00%(108/225),脾胃气虚证在缓解期占41.20%(89/216),大肠湿热证在初发型占53.55%(83/155),脾胃气虚证在慢性复发型占45.11%(60/133),脾肾阳虚证在慢性持续型占40.52%(47/116),其他证型分布相当。结论溃疡性结肠炎基本中医证型为6类,活动期以大肠湿热证为主,缓解期以脾胃气虚证为主,初发型以大肠湿热证为主,慢性复发型以脾胃气虚证为主,慢性持续型以脾肾阳虚证为主。
[Abstract]:Objective to observe the classification and distribution of TCM syndromes of ulcerative colitis. Methods A total of 441 patients with ulcerative colitis were collected and investigated with the questionnaire of TCM syndrome epidemiology of ulcerative colitis. Based on factor analysis and cluster analysis, the TCM syndromes of ulcerative colitis were discussed. Results in this study, 58 symptom items were analyzed by factor analysis. The KMO statistic was 0.916% Bartlett sphere test (P0.0001), which was suitable for factor analysis. A total of 13 common factors were extracted by maximum likelihood estimation (MLE) and 46 significant symptoms were screened. The basic TCM syndromes were classified into 6 categories according to the pathogenicity and the syndromes of the diseased position. Cluster analysis showed that the distribution of syndrome types was 27.66% (122 / 441) of spleen and stomach qi deficiency, 26.30% (116 / 441) of large intestine dampness and heat, 17.69% (78 / 441) of spleen and kidney yang deficiency. Liver stagnation and spleen deficiency accounted for 15.65% (69 / 441), Yin deficiency and intestinal dryness 8.39% (37 / 441), blood stasis and collaterals 4.31% (19 / 441). The distribution ratio of different stages and clinical types of syndromes was 48.00% (108 / 225) in active stage of large intestine damp-heat syndrome, 41.20% (89 / 216) in remission stage of spleen and stomach qi deficiency syndrome. The incidence of dampness and heat in large intestine was 53.55% (83 / 155), that of spleen and stomach qi deficiency was 45.11% (60 / 133), that of spleen and kidney yang deficiency was 40.52% (47 / 116), and that of other syndromes was similar. Conclusion there are 6 types of basic TCM syndromes of ulcerative colitis, including large intestine damp-heat syndrome in active stage, spleen and stomach qi deficiency syndrome in remission period, large intestine dampness and heat syndrome in initial onset, and spleen and stomach qi deficiency syndrome in chronic recurrent type. Chronic persistent type is mainly spleen and kidney yang deficiency syndrome.
【作者单位】：陕西中医药大学内科学教研室;陕西中医药大学附属医院消化内科;中国中医科学院党委办公室;
【基金】：国家自然科学基金资助项目(No.81173156) 陕西省科技厅研究资助项目(No.2013JQ4009) 陕西省教育厅研究资助项目(No.2014JK1200)
【分类号】：R259

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