慢性乙型肝炎常见证候特征的二元Logistic回归分析  

Binary Logistic regression analysis on common syndromes characteristics of chronic hepatitis B

作　　者：徐琳[1] 赵瑜[1] 彭景华[1] 冯琴[1] 沈晓萍[1] 海亚美 梁春耕[1] 刘林[1] 田华捷 胡义扬[1,2] 

机构地区：[1]上海中医药大学附属曙光医院上海中医药大学肝病研究所,上海201203 [2]上海市高校中医内科学E-研究院,上海201203

出　　处：《中华中医药杂志》2015年第5期1780-1783,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家科技重大专项(No.2012ZX10005001-004);国家自然科学基金(No.81373857;No.81403298);上海市科学技术委员会科研计划项目(No.14ZR1442000)~~

摘　　要：目的:运用二元Logistic回归分析探讨慢性乙型肝炎(CHB)中医临床常见证候的症状特征。方法:规范采集明确诊断的CHB患者临床四诊信息,运用频数统计CHB患者中医证型分布情况,选取证型无明显兼夹者为研究对象,经χ2检验筛选各证候差异症状,纳入二元Logistic回归分析提取特征性症状,并以刀切法验证。结果:1 474例CHB患者中,无明显兼夹证者862例。二元Logistic回归分析湿热内阻证(429例)的症状为身目发黄、口臭、大便秽臭、口干渴、苔色黄、苔质厚、腻腐;肝郁脾虚证(219例)为便溏、脘闷、倦怠乏力、舌质淡、舌体齿痕、苔色白、脉濡、缓;肝肾阴虚证(93例)为腰酸、心悸、目干、多梦、舌质红、脉细,其刀切法预测准确率达85.8%、86.1%和89.8%。结论:湿热内阻证、肝郁脾虚证和肝肾阴虚证是CHB的临床常见证型,经Logistic回归筛选出的特征性症状可为规范化的证候诊断提供参考依据。Objective： To study the clinical characteristics of common traditional Chinese medicine syndromes with chronic hepatitis B （CHB） by using binary Logistic regression analysis. Methods： The criteria was established to collect the information of CHB patients which was obtained by the four diagnostic methods. Based on frequency calculation, the distribution of CHB common syndromes in clinical practice was analyzed to get the research subjects without concurrent syndromes. After that, the information of the research subjects was screened by the chi-square test for different syndromes which were used to establish the mathematical models using binary Logistic regression analysis, and then the diagnostic accuracy was tested by Jackknife. Results： Of 1 474 CHB patients, there were 862 cases without concurrent syndromes. The symptoms selected by binary Logistic regression analysis of damp-heat resistance syndrome （429 cases） were yellow tint of sclera and skin, halitosis, fetid smelly stools, thirst, yellowish tongue fur, thick or greasy tongue fur. The symptoms of liver depression and spleen deficiency syndrome （219 cases） were sticky loose stools, epigastric distension and depression, tiredness and fatigue, light tongue color, indented tongue, whitish tongue fur, soft or moderate pulse. And the symptoms of liver-kidney yin vacuity syndrome （93 cases） were soreness of waist, palpitation, dryness of eyes, dreaminess, reddish tongue color, thready pulse. Finally, the diagnostic accuracy of jackknife was as follows： 85.8%, 86.1% and 89.8%. Conclusion： Damp-heat resistance syndrome, liver depression and spleen deficiency syndrome and liver-kidney yin vacuity syndrome are common traditional Chinese medicine syndromes of CHB in clinical practice. Thus the results can provide reference for standardizing the TCM diagnostic criteria.

关 键 词：慢性乙型肝炎 中医证候 LOGISTIC回归分析 

分 类 号：R259[医药卫生—中西医结合]