基于因子与聚类分析的2型糖尿病合并血脂异常中医证素特点及辨证分型研究  

A Study on Characteristics of TCM Syndrome Factors and Syndrome Differentiation Types of Type 2 Diabetes Mellitus Patients with Dyslipidemia by Factor Analysis and Cluster Analysis

作　　者：孟庆扬[1] 马建伟[1] 董静[1] 魏汉林[1] 马新英[1] 支艳[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30-33,共4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：目的探讨2型糖尿病合并血脂异常中医证素特点及辨证分型情况。方法采集313例2型糖尿病合并血脂异常患者的四诊信息,将探索性因子分析与R型聚类分析方法相结合,对48项变量进行非线性降维研究,并运用证素辨证体系对2型糖尿病合并血脂异常中医证素特点及辨证分型规律进行研究分析。结果证素辨证学研究结果得出本组313例2型糖尿病合并血脂异常病位证素10项,病性证素14项,其中病位证素主要涉及肾、肝、脾,病性证素主要涉及阴虚、阳虚、气虚、痰;采用因子分析、聚类分析,共提取出18个公因子,总结出5类中医证候群,结合中医证素辨证学、临床知识及专家讨论后,将5类证候群归为5种中医证型:肾阳气虚证、肝肾阴虚夹湿热证、胃气滞证、脾肾阴阳两虚夹心气血虚证、气滞血瘀证。结论研究表明,2型糖尿病合并血脂异常是本虚标实、虚实夹杂之病,且累及肾肝脾三脏,治疗时应多运用补虚、化痰、祛瘀等法;因子分析、聚类分析等多元统计方法可与证素辨证体系相结合应用于2型糖尿病合并血脂异常中医证型分析,为该病证候客观化、辨证准确化提供可行方法,但其结果仍需与临床实际相结合。Objective To investigate the characteristics of traditional Chinese medicine （ TCM） sydrome factors and syndrome differentiation types of type 2 diabetes mellitus （ T2DM） patients with dyslipidemia. Methods Informa-tions by four diagnostic methods of 313 T2DM patients with dyslipidemia were collected. The non linear dimension reduc-tion study was performed for 48 variates using exploratory factor analysis and type R cluster analysis, and the characteris-tics of TCM syndrome factors and syndrome differentiation types of T2DM patients with dyslipidemia were analyzed using the syndrome differentiation system. Results The result of syndrome differentiation system showed that there were 10 disease factors and 14 disease resistance syndrome factors in 313 T2DM patients with dyslipidemia, in which the disease factors mainly related to kidney, liver and spleen, and disease resistance syndrome factors mainly related to Yin deficien-cy, Yang deficiency, Qi deficiency and sputum. A total of 18 common factors were gotten by factor and clustering analy-ses, and 5 types of TCM syndromes bases were summed up, and then the 5 types were classified as 5 kinds of TCM syn-dromes combined with TCM syndrome differentiation system, clinical knowledge and experts discussions, which were the deficiency of the kidney-yang Qi syndrome, deficiency of liver and kindey-yin accompanied with damp heat syndrome, Qi depression of stomach, deficiency of spleen and kidney yin and yang with Qi-blood deficiency of heart, and Qi stagnation and blood stasis. Conclusion Type 2 diabetes mellitus patients with dyslipidemia is a disease which is asthenia in origin and asthenia in superficiality and asthenia-sthenia zheng complications. This disease is related to the kidney, liver and spleen, so the treatment should be more use of therapeutic methods such as tonify,eliminating phlegm and eliminating stagnation . Multivariate statistical methods such as factor analysis and cluster analysis can be combined with the syndrome differentiation system to a

关 键 词：2型糖尿病 血脂异常 辨证分型 聚类分析 

分 类 号：R587.1[医药卫生—内分泌] R589.2[医药卫生—内科学]