690例慢性乙型肝炎病毒感染伴脂肪肝患者证候要素特征的隐结构分析  

Latent Structure Analysis of Syndrome Elements in 690 Patients with Chronic Hepatitis B Virus Infection Complicated with Fatty Liver

作　　者：余钦 余宋 洪靖 鲁健 梁淑芳 刘群 程彬彬 陈建国[3,5] 郭晓冬[1] 翟笑枫 YU Qin;YU Song;HONG Jing;LU Jian;LIANG Shu-fang;LIU Qun;CHENG Bin-bin;CHEN Jian-guo;GUO Xiao-dong;ZHAI Xiao-feng(Shanghai University of Traditional Chinese Medicine,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 200081,China;Department of Traditional Chinese Medicine,Naval Medical University,Shanghai 200433,China;Qidong Liver Cancer Institute,Jiangsu Qidong 226200,China;Changhai Hospital,Naval Medical University,Shanghai 200433,China;Nantong University Tumor Hospital,Jiangsu Nantong 226231,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]中国人民解放军海军军医大学中医系,上海200433 [3]江苏省启东肝癌防治研究所,江苏启东226200 [4]中国人民解放军海军军医大学第一附属医院,上海200433 [5]南通大学附属肿瘤医院,江苏南通226231

出　　处：《中国中医基础医学杂志》2022年第5期762-767,共6页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：长海医院青年启动基金项目(2019QNA06)-基于AGE-RAGE信号通路探讨甘枣宁治疗非酒精性脂肪性肝病的作用及机制;国家自然科学基金面上项目(81774077)-从HIF1-α/IL-8/VEGF信号通路探讨熊胆粉抑制原发性肝癌TACE术后血管新生的作用及机制;上海市科学技术委员会医学引导类科技支撑项目(18401901400)-解毒颗粒对中晚期原发性肝癌患者TACE术后炎症反应及生存期影响的随机对照研究;上海市卫健委中医药重大临床研究[ZY(2018-2020)-CCCX-4003]-原发性肝癌病证结合诊疗模式研究。

摘　　要：目的:探讨慢性乙型肝炎病毒(hepatitis B virus,HBV)感染伴脂肪肝患者的中医证候要素特征。方法:采用隐结构模型方法,构建690例HBV慢性感染伴脂肪肝患者的隐结构模型,采用隐类概率、条件概率、互信息及累积信息覆盖率量化症状及证候数据,同时辅以人工判读的方式诠释该人群的主要证候要素特征。结果:以累积信息覆盖率达到95%为主要证候要素的判定标准,HBV慢性感染伴脂肪肝患者中医证候要素常见的有气滞、脾虚、湿热、寒湿、瘀血、阴虚、阳虚,证候要素涉及脏腑为肝、脾、肾。对同类别相关证素进行综合聚类分析得到6种常见中医证型,即肝郁气滞证、湿热蕴结证、脾虚证、瘀血阻络证、气阴两虚证、脾肾阳虚证,各证候出现概率分别为30%、25%、23%、22%、16%、9%。结论:基于隐结构模型的证候要素评价方法可量化各变量的关联程度及发生概率,HBV慢性感染伴脂肪肝患者以肝郁气滞、湿热蕴结、脾虚证更为多见。Objective:The distribution characteristics of TCM syndromes in patients with chronic HBV infection complicated with fatty liver disease(FLD)were analyzed using the latent structure model.Methods:An latent structure model was constructed for 690 patients with chronic HBV infection complicated with FLD.The implicit probability,conditional probability,mutual information and cumulative information coverage were used to quantify the symptoms and syndrome data.The method of manual interpretation was supplemented to analyze the characteristics of the main syndrome elements.Results:With cumulative information coverage up to 95%as the main criteria to determine the major syndromes,the TCM syndromes of patients with chronic HBV infection complicated with FLD were Qi stagnation,spleen deficiency,dampness and heat,cold and humidity,blood stasis,Yin deficiency and Yang deficiency.The syndromes involve liver,spleen and kidney.A comprehensive cluster analysis was conducted to obtain six common TCM syndromes,namely,liver stagnation syndrome,spleen deficiency syndrome,blood stasis syndrome,Yin deficiency syndrome,dampness-heat accumulation syndrome,spleen-kidney-Yang deficiency syndrome and the occurrence probability of which in the total population were 30%,25%,23%,22%,16%and 9%,respectively.Conclusion:The evaluation method of syndrome elements based on latent structure model can quantify the correlation degree and occurrence probability of syndrome elements and TCM symptoms.The most common syndromes of patients with chronic HBV infection complicated with FLD were liver qi stagnation and spleen deficiency.

关 键 词：隐结构模型 证候要素 慢性乙型肝炎病毒 脂肪肝 

分 类 号：R259[医药卫生—中西医结合] R575.5[医药卫生—中医内科学]