基于因子分析与聚类分析的572例乙型肝炎后肝硬化中医证候规律研究  

Study on the TCM pattern types of 572 post-hepatitis B cirrhosis patients based on factor analysis and cluster analysis

作　　者：李力 徐懂 翁奉武 赵立聪 王丽[3] 赵洁[4] 郭丽颖[5] 贾建伟[5] 徐宗佩 Li Li;Xu Dong;Weng Fengwu;Zhao Licong;Wang Li;Zhao Jie;Guo Liying;Jia Jianwei;Xu Zongpei(First Department of Gastroenterology,Affiliated Hospital of Shaanxi University of Chinese Medicine,Shaanxi 712000,China;Graduate School,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;Department of Medicinal Preparation,Tianjin Second People's Hospital,Tianjin 300192,China;Department of Special Ward,Tianjin Second People's Hospital,Tianjin 300192,China;First Department of Chinese Medicine and Integrated Chinese and Western Medicine,Tianjin Second People's Hospital,Tianjin 300192,China;Library,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]陕西中医药大学附属医院消化一科,陕西712000 [2]天津中医药大学研究生院 [3]天津市第二人民医院制剂室 [4]天津市第二人民医院特需病房 [5]天津市第二人民医院中医、中西医结合Ⅰ科 [6]天津中医药大学图书馆

出　　处：《北京中医药大学学报》2021年第12期1108-1117,共10页Journal of Beijing University of Traditional Chinese Medicine

基　　金：“十三五”国家科技重大专项(No.2018ZX10725506-002);国家中医药防治传染病重点研究室建设项目[国中医药函(2010)34号];天津市卫生健康委员会中医药重点领域科技项目(No.2019006)。

摘　　要：目的研究乙型肝炎后肝硬化(PHBC)的中医证素特点和证候分布规律。方法回顾性收集PHBC患者572例,使用自拟《PHBC中医证候临床调查表》进行中医症状、体征、舌象和脉象的四诊信息采集,基于因子分析和聚类分析探讨PHBC的中医证素特点和证候分布规律。结果收集调查表的83个症状条目因子分析,KMO统计量为0.843,Bartlett球型检验P<0.001,共提取出16个公因子,筛选出具有意义的症状66项,主要涉及病位证素为肝、脾、肾,病性证素为血瘀、气虚、气滞、阴虚、阳虚、湿热、水湿、水停。根据病性、病位证素归纳出湿热蕴结、肝肾阴虚、瘀血阻络、脾肾阳虚、脾气虚、肝气郁结、水湿内阻共7类中医证候。采用聚类分析探讨本病的证候分布,依次为瘀血阻络(26.92%)、湿热蕴结(16.96%)、水湿内阻(14.86%)、脾肾阳虚(12.41%)、肝肾阴虚(11.71%)、肝气郁结(10.66%)、脾气虚(6.47%)。结论PHBC的基本中医证候可分为湿热蕴结、肝肾阴虚、瘀血阻络、脾肾阳虚、脾气虚、肝气郁结、水湿内阻,从证候分布规律和病机特点来看,瘀血阻络证是PHBC最常见的中医证候之一。Objective To study the characteristics of traditional Chinese medicine(TCM)pattern elements and the distribution of pattern types of post-hepatitis B cirrhosis(PHBC).Methods A retrospective study of 572 PHBC patients was carried out to collect their TCM symptoms,signs,tongue manifestations and pulse conditions by using self-designed Clinical Questionnaire of TCM Patterns of PHBC.Based on factor analysis and cluster analysis,the characteristics of TCM pattern factors and the distribution of pattern types of PHBC were discussed.Results The factor analysis of the 83 symptoms in the questionnaire showed that the KMO value was 0.843 and Bartlett's ball type test result was P<0.001.A total of 16 common factors were extracted and 66 significant symptoms were identified.The pattern factors indicating disease location(positional factors)were liver,spleen and kidney and those indicating disease property(pathological factors)were blood stasis,qi deficiency,qi stagnation,yin deficiency,yang deficiency,dampness heat,dampness and water retention.From these factors,seven pattern types were identified:dampness heat accumulation(DHA)pattern,liver and kidney yin deficiency(LKYD)pattern,blood stasis blocking collaterals(BSBC)pattern,spleen and kidney yang deficiency(SKYD)pattern,spleen qi deficiency(SQD)pattern,liver qi stagnation(LQS)pattern,and dampness retention(DR)pattern.Cluster analysis was used to explore the distribution of pattern types of this disease.It was discovered that patients with BSBC pattern accounted for 26.92%of the total cases,those of DHA pattern 16.96%,DR pattern 14.86%,SKYD pattern 12.41%,LKYD pattern 11.71%,LQS pattern 10.66%,and SQD pattern 6.47%.Conclusion The basic TCM pattern types of PHBC may fall into seven categories:dampness heat accumulation pattern,liver and kidney yin deficiency pattern,blood stasis blocking collaterals pattern,spleen and kidney yang deficiency pattern,spleen qi deficiency pattern,liver qi stagnation pattern,and dampness retention pattern.In terms of distribution of pattern type

关 键 词：乙型肝炎后肝硬化 中医证素 中医证候 因子分析 聚类分析 

分 类 号：R256.42[医药卫生—中医内科学]