原发性骨质疏松症辨证分型的聚类分析研究  

Cluster Analysis on Pattern /Syndrome Differentiation of Primary Osteoporosis

作　　者：黄宏兴[1] 邓伟民[2] 万雷[1] 谭新[2] 王海彬[3] 许少健 许学猛[5] 李顺华[6] 付丰平[7] 

机构地区：[1]广州中医药大学附属骨伤科医院,广东广州510250 [2]广州军区广州总医院,广东广州510010 [3]广州中医药大学第一附属医院,广东广州510405 [4]广州中医药大学第二附属医院,广东广州510120 [5]广东省第二中医院,广东广州510095 [6]广州市黄埔区中医院骨科,广东广州510700 [7]广州中医药大学,广东广州510405

出　　处：《世界中西医结合杂志》2014年第9期959-961,964,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：广东省自然科学基金资助项目(No.S2011010005671);广东省科学技术厅-广东省中医药科学院联合科研专项(No.2011B032200005);广东省科技厅省国际合作项目(No.2012B050600026);总后勤部卫生部保健专项课题项目(No.13BJZ13)

摘　　要：目的探讨科学、合理的原发性骨质疏松症中医临床辨证分型方法。方法采用临床流行病学调查的方法收集广东省部分地区和省内五家医院的1772例原发性骨质疏松症患者的临床症状和体征,随机分为运算组和考核组,并对其进行量化。运用统计软件对所收集的数据进行聚类分析处理,以划分原发性骨质疏松症的临床证候类型。结果运算组1480例原发性骨质疏松症证候类型经聚类分析可以被划分为三个证型,即肝肾阴虚型、脾肾阳虚型和气滞血瘀型,其中肝肾阴虚型和脾肾阳虚型居多,分别占36.6%和33.2%,这些证型与临床辨证诊断的实际一致率均达到了87%以上。结论聚类分析是对原发性骨质疏松症证候分型规范化研究的一个有益探索,有利于证型的规范化研究,也是对《中药新药临床研究指导原则》中医分型的补充和完善。由于中医证型内涵的广博与深邃,聚类分析尚不能完全解决证型规范化研究中的主客观问题,但运用临床流行病学的原理和方法进行中医"证"与"证型"的数学模型研究是合理可行的。Objective To discuss the scientific and rational method for TCM pattern/syndrome differentiation of primary osteoporosis in clinic.Methods The clinical epidemiologic investigation method was adopted to collect the clinical symptoms and physical signs of 1772 cases of primary osteoporosis in five hospitals in the regions and Guangdong province.An operation group and an assessment group were randomized for quantification.The statistical software was used to conduct cluster analysis on the collected data so that the patterns of clinical syndromes of primary osteoporosis could be divided.Results In the operation group,with cluster analysis,1480 cases of primary osteoporosis were divided into three patterns,named liver and kidney yin deficiency,spleen and kidney yang deficiency and qi and blood stagnation.Of those patterns,the percentages of liver and kidney yin deficiency,and spleen and kidney yang deficiency were higher,36.6％ and 33.2％ separately.The consistent rate of these patterns with pattern/syndrome differentiation in clinical diagnosis was up to 87％.Conclusion It is the valuable exploration for the cluster analysis on the normalization of pattern division of primary osteoporosis and benefits the study on pattern normalization.This exploration supplements and perfects the TCM pattern/syndrome division in Guiding principle for clinical research on new Chinese medicine.Because of the broad and profound connotation of pattern/syndrome division of TCM,cluster analysis has not been completely dealt with the subjective and objective questions encountered in the study on pattern/syndrome normalization yet.But,it is rational and feasible to use the principle and method of clinical epidemiology for the mathematic mode study on＂ syndrome＂ and＂ pattern＂in TCM.

关 键 词：原发性骨质疏松症 辨证分型 聚类分析 规范化 

分 类 号：R681[医药卫生—骨科学]