基于聚类分析的PCI术后患者中医证候分布规律研究  

Study on The Distribution of TCM Syndromes of Patients after PCI Based on cluster Analysis

作　　者：谢婷婷 张楠 魏岩[2] 姜丽红[3] XIE Ting-ting;ZHANG Nan;WEI Yan;JIANG Li-hong(College of Traditional Chinese Medicine,Changchun University of Traditional Chinese Medicine,Changchun 130117,China;Changchun University of Traditional Chinese Medicine,Changchun 130117,China;Affiliated Hospital of Changchun University of Traditional Chinese Medicine,Changchun 130021,China)

机构地区：[1]长春中医药大学中医学院,长春130117 [2]长春中医药大学,长春130117 [3]长春中医药大学附属医院,长春130021

出　　处：《中国中医基础医学杂志》2021年第6期973-977,共5页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：国家自然科学基金面上项目(81673846)-冠心病伏寒证的遗传特征及生物学机制研究;全国名老中医药专家传承工作室建设项目(国中医药人教发201059号)-黄永生名老中医药传承工作室。

摘　　要：目的:应用聚类分析法探讨经皮冠状动脉介入治疗(percutaneous coronary Intervention,PCI)术后患者中医证候分布规律及不同时间节点的证候分布特点。方法:设计冠心病临床流行病学调查表,采集1037例PCI术后患者中医症状、体征、舌苔、脉象四诊信息,采用excel建立病例数据库,将数据导入SPSS22.0进行聚类分析,并结合专家意见及相关诊断标准,归类总结PCI术后的中医证候,对术后不同时间节点证候分布进行分析。结果:对符合条件的1006例问卷分析后发现,PCI术后中医证候主要有气虚血瘀证、气阴两虚夹瘀证、气虚气滞夹痰证、痰瘀互结证、伏寒证、心肾阴虚证、心肾阳虚证,术后时间越长实证占比越少,虚证占比越多。结论:PCI术后病人的证候呈动态时空变化随着PCI术后时间的延长,证候由实向虚转化,虚证及虚实夹杂证候增多,为PCI术后患者不同时间节点的中医药干预提供依据;先天伏寒证为冠心病特有证候表现,在PCI术后各时间段证候比例基本相同,说明先天伏寒是一种特殊体质,需要长期干预。Objective:Cluster analysis was used to explore the distribution of TCM syndromes and the distribution characteristics of syndromes at different time points after percutaneous coronary intervention.Methods:Design a clinical epidemiological questionnaire for coronary heart disease,and collect information on the four symptoms of TCM symptoms,signs,tongue coating,and pulse signs in 1037 patients after PCI.Then use excel to establish a case database and import the data into SPSS22.0 for cluster analysis,and combine expert opinions and related diagnostic criteria,classify and summarize TCM syndromes after PCI,and analyze the distribution of node syndromes at different time points after surgery.Results:An analysis of 1006 eligible questionnaires revealed that the main symptoms of TCM after PCI include Qi deficiency and blood stasis syndrome,Qi and Yin deficiency clip stasis syndrome,of Qi deficiency and stagnation,phlegm and blood stasis syndrome,Fuhan syndrome,heart and kidney yin deficiency syndrome,heart and kidney Yang deficiency syndrome.The longer the postoperative time,the less the proportion of empirical syndromes and the greater the proportion of false syndromes.Conclusion:The symptoms of patients after PCI show a dynamic spatiotemporal change.With the extension of the time after PCI,the syndromes are transformed from real to virtual,and the number of false and mixed syndromes increases,which provide evidence for TCM intervention at different time points for patients after PCI.Congenital Fuhan syndrome is the unique syndrome performance of coronary heart disease,of which the proportion of syndromes is basically the same in each time period after PCI.This shows that congenital Fuhan is a special constitution and requires long-term intervention.

关 键 词：PCI术后 不同时间节点 证候分布 

分 类 号：R541.4[医药卫生—心血管疾病]