慢性肝炎肝纤维化的中医症状聚类及分期  

Cluster analysis of traditional Chinese medicine symptoms and pathological staging of liver fibrosis in chronic hepatitis

作　　者：王中甫 宋素华[2] 王玉中[3] 宋彬彬[2] 门楠楠[2] 孟德阳 

机构地区：[1]舞阳县疾病预防控制中心,河南省漯河市462400 [2]漯河市第三人民医院,河南省漯河市462000 [3]漯河医学高等专科学校,河南省漯河市462002 [4]漯河市中医院,河南省漯河市462000

出　　处：《世界华人消化杂志》2010年第11期1157-1162,共6页World Chinese Journal of Digestology

摘　　要：目的:总结慢性肝炎肝纤维化的中医证型,探讨中医证型与肝纤维化病理分期的关联性.方法:纳入4个中心285例慢性肝炎肝纤维化患者,病理组织学检查肝纤维化分期,观察中医症状表现,采用指标聚类法对中医症状聚类降维,在适当位置截取,析出中医证型,采用简单对应分析中医证候分布与肝纤维化分级的关系.结果:44个中医症状聚为肝郁脾虚证、湿热内蕴证、气滞血瘀证、气阴两虚证和肝肾两亏证5大证型;中医证型与肝纤维化分期密切相关(χ2=33.998,P=0.005);维度1、维度2和维度3的惯量值分别是0.084、0.022和0.011,贡献率分别是70.6%、18.7%和9.2%(累计98.5%);肝郁脾虚证偏重于肝纤维化S0,湿热内蕴证偏重于S1,气滞血瘀证偏重于S2,气阴两虚证偏重于S3,肝肾两亏证偏重于S4.结论:中医证型与肝纤维化程度有一定关联性,随肝纤维化分期由S0→S4的增加,中医证型也由肝郁脾虚证→湿热内蕴证→气滞血瘀证→气阴两虚证→肝肾两亏证逐渐加重.AIM：To perform a cluster analysis of traditional Chinese medicine（TCM）symptoms of liver fibrosis in chronic hepatitis and to explore the relevance between TCM syndromes and pathological stages of liver fibrosis. METHODS：A total of 285 patients with chronic hepatitis and liver fibrosis in three centers were included in the study.Liver fibrosis was graded by histopathological examination.TCM symptoms were observed.Dimensionality reduction and clustering of TCM symptoms were performed using a clustering method.By selecting appropriate locations as interception points, TCM syndromes were precipitated.A simple correspondence analysis was then performed to evaluate the relevance between TCM syndromes and pathological stages of liver fibrosis. RESULTS：Forty-four TCM symptoms were clustered into five syndromes：liver Qi stagnation and spleen deficiency,internal accumulation of damp-heat,Qi stagnation and blood stasis,Qi-Yin deficiency,and liver and kidney Yin deficiency.TCM syndromes are closely related with the pathological stages of liver fibrosis（χ^2 =33.998,P=0.005）.The inertia values of dimensions 1,2 and 3 were 0.084,0.022 and 0.011, respectively,while the contribution rates were 70.6%,18.7%and 9.2%,respectively.Liver Qi stagnation and spleen deficiency,internal accumulation of damp-heat,Qi stagnation and blood stasis,Qi-Yin deficiency,and liver and kidney Yin deficiency were frequently seen in stage S0, S1,S2,S3,and S4 liver fibrosis,respectively. CONCLUSION：TCM syndrome is closely correlated with the degree of liver fibrosis.TCM syndrome is aggravated with the progression of liver fibrosis.

关 键 词：慢性肝炎 肝纤维化 组织学检查 中医证型 聚类分析 对应分析 

分 类 号：R259[医药卫生—中西医结合]