围绝经期综合征常见证型证候特征的二元Logistic回归分析  

Analysis on characteristics of common syndromes of perimenopausal syndrome by binary Logistic regression method

作　　者：崔淑兰[1] 李萍 樊一波 郭晓黎[1] 谷文芳 吴晨燕[3] 张平[3] CUI Shu-lan;LI Ping;FAN Yi-bo;GUO Xiao-li;GU Wen-fang;WU Chen-yan;ZHANG Ping(Baoji Vocational&Technical College,Baoji 721013,China;Affiliated Hospital of Baoji Vocational&Technical College,Baoji 721001,China;Baoji Traditional Chinese Medicine Hospital,Baoji 721001,China)

机构地区：[1]宝鸡职业技术学院,宝鸡721013 [2]宝鸡职业技术学院附属医院,宝鸡721001 [3]宝鸡市中医医院,宝鸡721001

出　　处：《中华中医药杂志》2022年第7期4121-4124,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：陕西省教育厅专项科研计划(No.17JK0910)。

摘　　要：目的:应用二元Logistic回归法分析围绝经期综合征(PPS)临床常见证候与证素之间的相关性,以期为规范、完善现有中医PPS临床病症体系提供数据支撑。方法:收集2017年7月至2019年3月临床诊断为PPS的365例患者的临床四诊信息,证型结果,统计PPS患者中医证型分布情况,经χ^(2)检验筛选各证候差异证素,并纳入二元Logistic回归分析提取特征性证素,并以刀切法验证。结果:出现频率>10%的证型为肝郁肾虚、阴虚火旺、心肾不交,分别为31.8%、17.8%、13.7%。其中肝郁肾虚证涉及的19项证素中,脉沉迟弱、皮肤干燥、腰膝酸软等8项证素B>0,OR>1;阴虚火旺证涉及的24项证素中,烘热汗出、五心烦热、大便干结等6项证素B>0,OR>1;心肾不交证涉及的19项证素中,盗汗、脉细数、潮热面红等5项证素B>0,OR>1。结论:PPS临床常见证型为肝郁肾虚、阴虚火旺、心肾不交,分别以脉沉迟弱、脉细数、盗汗为最重要的特征性证素,为临床PPS中医证型判定提供客观依据。Objective: To apply binary Logistic regression method to analyze the correlation between common clinical syndromes and symptoms of perimenopausal syndrome(PPS), in order to provide data support for standardizing and perfecting the existing TCM perimenopausal syndrome clinical symptoms system. Methods: Collected the clinical four-diagnosis information and syndrome type results of 356 patients with perimenopausal syndrome clinically diagnosed from July 2017 to March 2019,used frequency to count the distribution of TCM syndrome types of PPS patients, and screened different symptoms of different syndromes by χ^(2) test, and include binary Logistic regression analysis to extract characteristic symptoms, and verify with knifecutting method. Results: The syndrome types with a frequency of more than 10% were liver depression and kidney deficiency,yin deficiency and fire prosperity, and heart-kidney incompatibility. The frequency of occurrence was 31.8%, 17.8%, and 13.7%,respectively. Among the 19 symptoms related to liver depression and kidney deficiency, 8 symptoms such as delayed pulse, dry skin, and sore waist and knees, B>0, OR>1;Among the 24 symptoms related to yin deficiency and fire prosperity, 6 symptoms of hot sweating, dysphoria in chestpalms-soles, dry stool, B>0, OR>1;Among the 19 symptoms involved in heart-kidney incompatibility, 5 symptoms including night sweats, thready and fast pulse, hot flash and flushing, B>0, OR>1. Conclusion: The common clinical syndromes of PPS are liver depression and kidney deficiency, yin deficiency and fire prosperity, and heartkidney incompatibility. The three syndromes are characterized by deep and slow pulse, thready and fast pulse, and night sweats as the most important characteristic elements, which provide an objective basis for the determination of TCM syndrome types in clinical PPS.

关 键 词：围绝经期综合征 证型 中医证候 肝郁肾虚 阴虚火旺 心肾不交 Logistic回归分析 

分 类 号：R271.1[医药卫生—中医妇科学]