基于隐结构结合因子分析探讨豫东农村地区脑梗死患者的常见证候  

Common Syndromes of Cerebral Infarction Patients in Rural Areas of Eastern Henan Based on Latent Structure Model and Factor Analysis

作　　者：白琛 冉春龙 李梦君 周珂青 彭蒙蒙 穆昭威 刘向哲[2] BAI Chen;RAN Chun-long;LI Meng-jun;ZHOU Ke-qing;PENG Meng-meng;MU Zhao-wei;LIU Xiang-zhe(Henan University of Chinese Medicine,Zhengzhou 450046,China;The First Affiliated Hospital of Henan University of Traditional Chinese Medcine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学,郑州450046 [2]河南中医药大学第一附属医院,郑州450000

出　　处：《中国实验方剂学杂志》2022年第7期190-197,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家重点研发计划中医药现代化研究重点专项(2019YFC1710001);河南省中医药传承与创新人才工程中医药学科领军人才项目(豫卫中医函[2021]8号);河南省重点研发与推广专项(科技攻关)(212102310360)。

摘　　要：目的:基于隐结构结合因子分析的方法,探讨豫东农村地区脑梗死患者的常见证候,为脑梗死的临床辨证规律提供参考。方法:对豫东农村地区脑梗死患者的数据样本进行预处理,运用隐结构法的Lantern 5.0软件,基于双步隐树分析LTM-EAST算法,构建相关症状的显变量隐结构模型,对不同隐节点诠释,通过综合聚类分析得出脑梗死的常见证型;采用SPSS 20.0软件对相关症状进行因子分析及系统聚类分析,并推断出证型分布。结果:共纳入888例脑梗死患者样本数据,涉及症状、舌、脉等共88个,将频率≥5%的65个症状构建隐结构模型,得到31个隐变量,贝叶斯信息标准(BIC)评分为-15367.17,依据专业知识进行综合聚类,得出6个常见证型,分别为风火上扰证、气虚血瘀证、痰瘀阻络证、痰热腑实证、风痰阻络证、阴虚风动证;因子分析中采用频率>10%的症状进行分析,获得13个公因子,用公因子做系统聚类分析,推断出风痰阻络证、痰热腑实证、气虚血瘀证、痰瘀互结证、阴虚内热证5个证型。根据常见中医证型的确定标准,最终得到脑梗死6个常见证型。结论:豫东农村地区脑梗死患者的常见证候,根据病情轻重分为中经络:风火上扰证、风痰阻络证、阴虚风动证;中脏腑:痰热腑实证、痰瘀阻络证;恢复期:气虚血瘀证。该研究与中医理论中的证候规律基本吻合,为进一步建立脑梗死的证候诊断标准提供思路借鉴。Objective:To explore the common syndromes of patients with cerebral infarction in rural areas of eastern Henan based on latent structure model and factor analysis,and provide reference for clinical differentiation of cerebral infarction.Method:The data samples of patients with cerebral infarction in rural areas in eastern Henan were preprocessed.With Lantern 5.0 of latent structure method and LTM-EAST algorithm of two-step latent tree analysis,the manifest variable latent structure model of related symptoms was built to interpret different latent nodes,and common syndromes of cerebral infarction were obtained via comprehensive cluster analysis.SPSS 20.0 was used for factor analysis and cluster analysis of related symptoms to infer the distribution of syndrome types.Result:The data of 888 patients with cerebral infarction were included,involving symptoms,tongue and pulse(88 in total).The 65 symptoms with a frequency of≥5%were constructed into a latent structure model,and 31 latent variables were obtained.The Bayesian information criterion(BIC)score was-15367.17.Based on professional knowledge,s6 common syndrome types were found,namely,syndrome of upward disturbance of wind-fire,Qi deficiency and blood stasis syndrome,syndrome of phlegm and blood stasis blocking collaterals,syndrome of phlegm-heat and fu-organ excess,syndrome of wind phlegm obstructing collaterals,and syndrome of stirring wind due to yin deficiency.In factor analysis,the symptoms with a frequency of>10%were selected,and 13 common factors were obtained and used for systematic cluster analysis.And 5 syndrome types were inferred:syndrome of wind phlegm obstructing collaterals,syndrome of phlegm-heat and fu-organ excess,Qi deficiency and blood stasis syndrome,syndrome of combined phlegm and blood stasis,and syndrome of yin deficiency and internal heat.According to the determination criteria of syndrome types in traditional Chinese medicine(TCM),6 common syndrome types of cerebral infarction were finally determined.Conclusion:According to the severity

关 键 词：脑梗死 隐结构模型 因子分析 证候 症状 中风 

分 类 号：R242[医药卫生—中医临床基础] R285.5[医药卫生—中医学]