功能性便秘中医证候诊断的量化研究  

Study on the Quantitative Diagnosis of Chinese Medicine Syndromes in Functional Constipation

作　　者：杨勇[1] 丁曙晴[2] 丁义江[2] YANG Yong;DING Shuqing;DING Yijiang(Xuzhou Central Hospital,Xuzhou Jiangsu China 221009;Nanjing Hospital of Chinese Medicine,Nanjing Jiangsu China 210022)

机构地区：[1]徐州市中心医院,江苏徐州221009 [2]南京市中医院,江苏南京210022

出　　处：《中医学报》2019年第11期2434-2437,共4页Acta Chinese Medicine

基　　金：江苏省南京市科技计划项目(201605038)

摘　　要：目的:研究功能性便秘中医证候量化诊断标准,提高功能性便秘证候辨证水平。方法:将南京市中医院盆底中心智慧医疗多功能一体化信息管理系统中截止2018年6月,第一诊断为功能性便秘的所有数据导出,采用判别分析,筛选对区分功能性便秘证候有显著贡献的症状变量;根据筛选的症状变量,建立功能性便秘中医证候诊断函数模型。使用回代法和刀切法,对所建立证候诊断模型进行检验。结果:筛选出12个显著贡献的症状,建立功能性便秘中医证候的函数模型:肝脾不调证=-2.634-神疲×0.464+乏力×0.154-气短×0.568+善太息×0.705+胁肋胀×0.270+腹胀×1.245+腰膝酸软×0.683+五心烦热×0.098+畏寒怕冷×0.178-四肢不温×0.070+咽部异物感×0.594+心悸×0.046;肺脾气虚证=-2.987+神疲×0.515+乏力×0.956+气短×0.281-善太息×0.296-胁肋胀×0.599+腹胀×0.279+腰膝酸软×0.089-五心烦热×0.281+畏寒怕冷×0.134-四肢不温×0.068-咽部异物感×0.269+心悸×0.302;肝肾阴虚证=-11.141-神疲×0.930+乏力×0.891-气短×0.689-善太息×0.197-胁肋胀×0.316+腹胀×0.655+腰膝酸软×1.531+五心烦热×7.545-畏寒怕冷×0.158+四肢不温×0.489+咽部异物感×0.238+心悸×0.681;脾肾阳虚证=-6.862-神疲×0.509+乏力×0.836-气短×0.809+善太息×0.448-胁肋胀×0.942+腹胀×0.677+腰膝酸软×0.241-五心烦热×0.161+畏寒怕冷×1.868+四肢不温×3.168-咽部异物感×0.811-心悸×0.273。对所建立证候诊断函数模型进行验证,逐一回代法和刀切法的总体符合率分别为88.6%、86.9%。结论:通过对功能性便秘四诊症状进行逐步判别分析,初步得到了功能性便秘证候量化诊断的数理模型,且符合中医理论。To study the quantitative diagnosis standard of TCM Syndromes of functional constipation and improve the level of syndrome differentiation of functional constipation. Methods: All data of the first diagnosis of functional constipation in the intelligent medical multi-functional integrated information management system of Nanjing traditional Chinese medicine hospital by June 2018 was export. By discriminant analysis,the symptom variables which have significant contribution to the differentiation of functional constipation syndrome were selected;according to the selected symptom variables,the TCM syndrome diagnosis function model of functional constipation was established. Using the back substitution method and knife cutting method,the established syndrome diagnosis model was tested. Results: The 12 symptoms with significant contribution were selected and the functional model of TCM syndrome of functional constipation was established: liver-spleen disharmony syndrome =-2. 634-poor spirit × 0. 464 + fatigue ×0. 154-shortness of qi × 0. 568 + sighing × 0. 705 + hypochondrium distention × 0. 270 + abdominal distention × 1. 245 + soreness of loin and knees × 0. 683 + dysphoria with feverish sensation in chest × 0. 098 + aversion to cold × 0. 178-cold limbs × 0. 070 + pharynx foreign body sensation × 0. 594 + palpitation × 0. 046;lung-spleen qi deficiency syndrome =-2. 987 + poor spirit × 0. 515 +fatigue × 0. 956 + shortness of qi × 0. 281-sighing × 0. 296-hypochondrium distention × 0. 599 + abdominal distention × 0. 279 +soreness of loin and knees × 0. 089-dysphoria with feverish sensation in chest × 0. 281 + aversion to cold × 0. 134-cold limbs × 0.068-pharynx foreign body sensation × 0. 269 + palpitation × 0. 302;liver-kidney yin deficiency syndrome =-11. 141-poor spirit ×0. 930 + fatigue × 0. 891-shortness of breath × 0. 689-sighing × 0. 197-hypochondrium distention × 0. 316 + abdominal distention ×0. 655 + soreness of loin and knees × 1. 531 + dysphoria with feverish sensation in ches

关 键 词：功能性便秘 中医证候 量化诊断 

分 类 号：R241[医药卫生—中医诊断学]