基于中医四诊和脑肠肽的腹泻型肠易激综合征中医证候判别研究  

Differentiation Study of Chinese Medical Syndrome Typing for Diarrhea-predominant Irritable Bowel Syndrome Based on Information of Four Chinese Medical Diagnostic Methods and Brain-gut Peptides

作　　者：吴皓萌[1] 徐志伟[1] 敖海清[1] 史亚飞[1] 胡海燕[1] 吉云鹏[1] 

机构地区：[1]广州中医药大学基础医学院,广州510405

出　　处：《中国中西医结合杂志》2015年第10期1200-1204,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家重点基础研究发展计划(973计划)(No.2011CB-505103);教育部2010年度新世纪优秀人才支持计划项目(No.NCET-100088);国家自然科学基金资助项目(No.81173144);国家科技支撑计划项目(No.2012BA129B00);广州中医药大学全国优秀博士学位论文培育项目(广中医研[2014]9号)

摘　　要：目的从计量诊断学的角度研究腹泻型肠易激综合征(diarrhea-predominant irritable bowel syndrome,IBS-D),构建IBS-D中医证候的判别函数,以降低IBS-D中医证候诊断和鉴别诊断中的主观因素干扰。方法采用《肠易激综合征临床信息采集表》对439例IBS-D患者进行中医临床流行病学调查,运用聚类分析获取初始证候,以四诊信息和患者血清脑肠肽为变量,运用逐步判别法进行分析。结果聚类为肝郁脾虚证、脾胃虚弱证、肝郁气滞证、脾肾阳虚证、脾胃湿热证和寒湿困脾证,其中肝郁脾虚证最多,有效百分比为34.2%,寒湿困脾证最少,有效百分比为5.5%;逐步法所得肝郁脾虚证、脾胃虚弱证、肝郁气滞证、脾肾阳虚证及脾胃湿热证5个判别函数,回顾性误判概率4.1%(16/390),交叉验证误判率为15.4%(60/390)。结论建立的判别函数,对ISB-D的中医证候的客观诊断及鉴别诊断有一定的参考价值。Objective To establish discriminant functions of diarrhea-predominant irritable bowel syndrome（IBS-D） by studying it from quantitative diagnosis angle,hoping to reduce interference of subjective factors in diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.Methods A Chinese medical clinical epidemiological survey was carried out in 439 IBS-D patients using Clinical Information Collection Table of IBS.Initial syndromes were obtained by cluster analysis.They were analyzed using step-by-step discrimination by taking information of four Chinese medical diagnostic methods and serum brain-gut peptides（BGP） as variables.Results Clustering results were Gan stagnation Pi deficiency syndrome（GSPDS）,Pi-Wei weakness syndrome（PWWS）,Gan stagnation qi stasis syndrome（GSQSS）,Pi-Shen yang deficiency syndrome（PSYDS）,Pi-Wei damp-heat syndrome（PWDHS）,colddamp disturbing Pi syndrome（CDDPS）.Of them,GSPDS was mostly often seen with effective percentage of 34.2%,while CDDPS was the least often seen with effective percentage of 5.5%.A total of 5 discriminant functions for GSPDS,PWWS,GSQSS,PSYDS,and PWDHS were obtained by step-by-step discrimination method.The retrospective misjudgment rate was 4.1%（16/390）,while the cross-validation misjudgment rate was 15.4%（60/390）.Conclusion The establishment of discriminant functions is of value in objectively diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.

关 键 词：腹泻型肠易激综合征 中医证候 判别分析 脑肠肽 

分 类 号：R259[医药卫生—中西医结合]