应用集对分析法构建寻常型银屑病血热证辨证模型  

To Establish the Syndrome-typing Model of Psoriasis Vulgaris Blood-heat Syndrome Based on the Set Pair Analysis Method

作　　者：李峰[1] 迮侃[1] 曹筱筱[1] 李欣[1] 李斌[1] 陈洁[1] 徐蓉[1] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院皮肤科,上海200437

出　　处：《中国中西医结合杂志》2012年第10期1308-1312,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金青年基金资助项目(No.30801460);上海市科学技术委员会项目(09dZ1972300);上海市高校创新团队(第2期)资助项目;上海市自然基金资助项目(No.11ZR1438000)

摘　　要：目的通过对寻常型银屑病血热证临床症状进行同、异、反的定量刻画,建立相应的集对分析数学模型,从而指导临床,提高临床辨证的准确性。方法选择采用凉血潜阳法治疗后具有完整资料的202例寻常型银屑病血热证患者,系统收集其临床症状、体征等。通过集对分析的方法 ,将治疗结局为痊愈及显效的归为同部,有效归为异部,无效归为反部,根据公式计算各项辨证因子的U值,筛选寻常型银屑病血热证中医辨证相关的联系因子,根据各辨证因子联系数的大小,构建寻常型银屑病血热证辨证模型。结果鳞屑积分>2.04,红斑积分>2.34,年龄>50岁,面积积分>2.07,口干,脉滑,苔黄,脉濡,大便干结为银屑病血热证的主要辨证因子;汗出减少,失眠,脉数,任何程度的病变浸润,皮损发于任何部位,舌红,精神抑郁,病程1～360个月,年龄16～50岁,脉弦,苔薄,面积积分0+～2.07,苔白,舌紫,鳞屑积分0+～2.04,脉细弱为次要辨证因子;红斑积分0+～2.34,舌淡为再次辨证因子。寻常型银屑病血热证集对分析模型建立为:U血热证=∑An/N+∑Bmi/M+∑Cpj/P。结论 U血热证≥0.75可判定为血热证,采用中医凉血治疗即可取得不错的疗效;U血热证<0.75,则患者在血热证基础上伴有其他证型,单纯凉血治疗效果不好。Objective To establish corresponding set pair analysis mathematic model using the clinical symptoms of blood-heat type psoriasis vulgaris （ BHTPV）, thus guiding the clinical accuracy of clinical syndrome typing. Methods Recruited were 202 BHTPV with complete data after they were treated by yang subduing blood cooling method. Their clinical symptoms and signs were systematically collected. Using set pair analysis method, the therapeutic results of cured and markedly effective were recruited as the same portion, of effective as the dif- ferent portion, and of ineffective as the contrary portion. The U value of each syndrome factor was calculated ac- cording to the formula. The correlation factor of syndrome typing of BHTPV was screened. The syndrome typing model of BHTPV was established according to the correlation factor. Results The main factors of BHTPV includ- ed the scale integral 〉 2.04, the erythema integral 〉 2. 34, age 〉 50 years old, the area integral 〉 2.07, dry mouth, slippery pulse, yellowish fur, soggy pulse, dry and hard stool. The secondary factors included less sweat, insomnia, frequent pulse, any infiltration, erythra of any area, red tongue, depression, the disease course ranging 1 -360 months, age ranging 16 -50 years old, string-tight pulse, thin fur, the area integral ran- ging 0 ~ -2.07, white fur, purplish tongue, the scale integral ranging 0 ~ -2.04, and feeble pulse. The third fac- tors included the erythema integral ranging 0 ~ -2.34 and pale red tongue. The set pair analytical model of BHT- PV was as follows. Conclusions U blood-heat syndrome ≥ 0.75 could be judged as blood-heat syndrome. Satisfactory efficacy could be achieved by blood cooling method. For patients with U blood-heat syndrome 〈 0.75, no satisfactory efficacy could be achieved by blood cooling method alone since they were accompanied with other syndrome types.

关 键 词：寻常型银屑病 血热证 集对分析 

分 类 号：R-332[医药卫生] R275