360例腹泻型肠易激综合征的聚类分析及证候特征研究  

Cluster analysis and characteristics of syndrome on IBS-D:A study of 360 cases

作　　者：张声生[1] 汪红兵[1] 李振华[2] 唐旭东[2] 王新月[3] 张福文[4] 吴兵[1] 陈明[1] 陶琳[1] 唐博祥[1] 朱培一[1] 李保双[2] 宋秀江[2] 刘敏[3] 查波[3] 

机构地区：[1]首都医科大学附属北京中医医院消化中心,北京100010 [2]中国中医科学院西苑医院,北京100091 [3]北京中医药大学东直门医院,北京100700 [4]北京通州区中医医院,北京101100

出　　处：《中华中医药杂志》2010年第8期1183-1187,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京市科委课题(No.Z0005190043711);首都医学科技发展基金重点支持课题(No.SF-2005-9)~~

摘　　要：目的:以证候要素为目,分别从聚类分析和传统辨证的角度,探讨腹泻型肠易激综合征(IBS-D)主要证候特点。方法:采取临床流行病学调查方法采集360病例资料,采用"腹泻型肠易激综合征中医证候要素提取表"进行数据挖掘,以传统辨证的证候为纲,以证候要素提取表中的中医症状为目,分别进行各证候中医症状频率、频数分析及聚类分析,探讨IBS-D的主要证候特征。结果:中医症状分析发现IBS-D主要以肠内症状为主,其次表现为精神心理症状,其病机与中医肝、脾关系密切;聚类分析发现肝郁脾虚证、脾虚湿阻证、脾胃湿热证、脾肾阳虚证4个证候涵盖了IBS-D的大部分证候。结论:肝郁脾虚证、脾虚湿阻证、脾胃湿热证、脾肾阳虚证是IBS-D的主流证候。Objective： To discuss the characteristics of IBS-D major syndromes, cluster analysis and patterns-identification were used based on the essential elements of syndromes. Method： 360 cases were collected by the epidemiological methods, and the data was obtained from the IBS-D extracting table of essential elements of TCM syndromes. Based on the classification of patterns-identification and orders of essential elements of TCM syndromes, the symptom frequency and cluster analysis of different syndromes were studied. Results： Symptom analysis showed that intestine enteral symptoms were the major symptoms in IBS-D and psychological ones ran second. The pathogenesis is closely related to the liver and the spleen. Cluster analysis showed that the 4 syndromes, which included stagnation of liver qi with spleen deficiency , spleen deficiency with dampness, spleen and stomach damp-heat, and deficiency of Yang of both spleen and kidney, cover most of the IBS-D syndromes. Conclusion： The syndromes of stagnation of liver qi with spleen deficiency, spleen deficiency with dampness, spleen and stomach damp-heat, and the deficiency of Yang of both spleen and kidney meight be the mainstream syndromes of IBS-D.

关 键 词：中医药 腹泻型 肠易激综合征 证候 聚类分析 

分 类 号：R259[医药卫生—中西医结合]