公因子和聚类分析联合在肝炎后肝硬化证候分类研究中的应用  

Combined use of factor analysis and cluster analysis in classification of traditional Chinese medical syndromes in patients with posthepatitic cirrhosis

作　　者：张琴[1] 张文彤[2] 魏建军[1] 王宪波[1] 刘平[1] 

机构地区：[1]上海中医药大学肝病研究所,上海201203 [2]复旦大学公共卫生学院社会医学与统计学教研室,上海200032

出　　处：《中西医结合学报》2005年第1期14-18,共5页Journal of Chinese Integrative Medicine

基　　金：上海市教委重点学科建设基金资助项目;国家杰出青年科学基金资助项目 (No .3982 5 12 8)

摘　　要：目的 :探讨联合应用因子分析与系统聚类分析方法在研究中医证候分类中的实际意义 ,为肝炎后肝硬化证候分类提供科学依据。方法 :根据肝炎后肝硬化的临床特点及中医临床四诊信息采集的基本要求 ,用临床流行病学调查的方法 ,采集 310例肝炎后肝硬化患者症状、体征、舌象、脉象等中医四诊信息 ;应用公因子分析、方差最大化正交旋转与系统聚类相结合的方法进行统计学处理。结果 :肝炎后肝硬化的中医证型分可为 7个类别 :湿热内蕴型 5 5例 ,湿盛脾虚型 74例 ,瘀血阻络、肝肾阴虚型 73例 ,血瘀湿阻、气阴两虚型4 0例 ,气阴两虚型 (单纯 ) 16例 ,阴虚血热型 6例及肝郁脾虚型 2 3例。以上共计 2 87例 ,占全部调查病例的92 .5 8%。其余 2 3例由于中医四诊信息量的限制 (属“无症可辨”)而难以进行证型分类。结论 :公因子分析和聚类分析统计方法的结合应用 ,能对中医四诊信息较好地进行证型的客观分类 ,能在一定程度上揭示肝炎后肝硬化的中医证型特点 ,在中医证候研究中具有一定的应用价值。Objective： To explore the significance of the combination of factor analysis and systematic cluster analysis in classification of traditional Chinese medical syndromes in patients with posthepatitic cirrhosis, and to provide a scientific basis for the criterion of the classification. Methods： We designed a clinical questionnaire according to the clinical characteristics and the demands of traditional Chinese medical information collection for patients with posthepatitic cirrhosis. By means of clinical epidemiological research,with the four diagnosis methods for clinical information collection of traditional Chinese medicine, symptoms,physical signs, tongue conditions and pulse conditions in 310 patients with posthepatitic cirrhosis were collected, and the characteristics of traditional Chinese medical syndromes in these patients were explored with statistical methods, such as factor analysis, varimax and systematic cluster analysis. Results： Analyzed by factor analysis and systematic cluster analysis with SPSS 11.0, the traditional Chinese medical syndromes in 287 of the 310 cases （92.58%） of posthepatitic cirrhosis could be classified. The syndromes could be divided into 7 categories, which were internal accumulation of damp-heat （55 cases）, insufficiency of the spleen with overabundance of dampness （74 cases）, accumulation of blood stasis plus deficiency of liver-yin and kidney-yin （73 cases）, accumulation of blood stasis plus deficiency of both blood and qi （40 cases）,deficiency of both blood and qi （16 cases）, deficiency of yin and blood heat （6 cases） and stagnation of the liver-qi and deficiency of the spleen （23 cases）. The traditional Chinese medical syndromes in the other 23 cases could not be classified. Conclusions： The clinical information collected with the four diagnostic methods of traditional Chinese medicine can be classified into different categories with the factor analysis and systematic cluster analysis. The factor analysis and systematic cluster analys

关 键 词：肝炎后肝硬化 中医证型 公因子分析 聚类分析 方差最大化正交旋转 

分 类 号：R259[医药卫生—中西医结合]