基于聚类分析的2型糖尿病中医证候规律研究  

A Study Based on Cluster Analysis for the Regularity of Type 2 Diabetes Mellitus Syndromes

作　　者：巩璇 马建伟[1] 董静[1] 支艳[1] 张蕾[1] 杨玉新[1] 

机构地区：[1]北京空军总医院中医科,100142

出　　处：《解放军医药杂志》2015年第9期24-29,共6页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：首都医学发展基金(SF-2009-I-13);首都临床特色应用研究课题(Z121107001012011)

摘　　要：目的应用聚类分析及主成分分析探讨2型糖尿病(type 2 diabetes mellitus,T2DM)中医临床证候的分布规律及各证候的主次症,从而为临床辨证提供客观依据。方法选取我院中医科、内分泌科T2DM患者233例,收集其四诊信息,对四诊信息频数≥10%的54个症状做变量进行聚类分析,归纳出T2DM的中医证候类型。对各证候的症状、体征、舌脉等进行主成分分析,从而得到各症状对该证候的贡献度,以此判定各证候的主症与次症。结果233例T2DM患者四诊信息通过聚类分析后最终聚为5类,分别为脾肾气虚证、肝肾阴虚证、阴虚热盛证、气阴两虚夹痰湿证、阳虚血瘀证。并在此基础上通过主成分分析初步明确了各证型的主次证。结论 T2DM可分为5个证候类型,其中以脾肾气虚证居多。采用聚类分析、主成分分析等统计学方法对T2DM进行证候学研究具有一定的临床意义。Objective To investigate the distribution regularities of type 2 diabetes mellitus （T2DM） patients in traditional Chinese medicine （ TCM） of clinical syndrome types and the main and secondary symptoms of each syndrome type using cluster analysis and principal component analysis so as to provide objective basis for clinical syndrome differen-tiation. Methods Informations by four diagnostic methods of 233 T2DM patients were collected, and 54 symptoms （fre-quency ≥10%） were used as variables for cluster analysis to generalize TCM syndromes of T2DM. Principal component analysis was performed for the symptoms, signs, tongue and pulse conditions of each syndrome type, and then the contri-bution of each symptom to its syndrome was obtained in order to find out the main and secondary symptoms of each syn-drome type. Results Informations of four diagnostic methods of the T2DM 233 patients were clustered into five types by cluster analysis, which included spleen-kidney Qi deficiency syndrome, syndrome of Yin deficiency of liver and kidney, deficiency of Yin and excessive heat syndrome, deficiency of both Qi and Yin with phlegm retention syndrome, and Yang deficiency and blood stasis syndrome, and then the primary and secondary symptoms of each syndrome type were prelimi-narily clarified by principal component analysis. Conclusion T2DM can be divided into five syndrome types, among which spleen-kidney deficiency syndrome is the most. Statistical methods such as cluster and principal component analy-ses for TCM syndrome study have some clinical significance.

关 键 词：糖尿病 2型 辨证分型 聚类分析 主成分分析 

分 类 号：R587.1[医药卫生—内分泌] R241.4[医药卫生—内科学]