基于因子分析的771例慢性咳嗽患者中医证候分布特点研究  

Factor analysis-based TCM pattern distribution characteristics of chronic cough in 771 patients

作　　者：季坤[1] 史利卿[1] 宋欢 王颖 马建岭[1] 李扭扭[1] 董尚娟 王丽云[1] 温绍惠[1] JI Kun;SHI Liqing;SONG Huan;WANG Ying;MA Jianling;LI Niuniu;DONG Shangjuan;WANG Liyun;WEN Shaohui(Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078;Qingdao Hospital of Traditional Chinese Medicine;Zhejiang Provincial Hospital of Traditional Chinese Medicine)

机构地区：[1]北京中医药大学东方医院,北京100078 [2]青岛市中医医院 [3]浙江省中医院

出　　处：《现代中医临床》2023年第2期30-36,共7页Modern Chinese Clinical Medicine

基　　金：国家自然科学基金资助项目(No.81373588);北京市自然科学基金面上项目(No.7192115);北京市自然科学基金青年项目(No.7184224);中国民族医药学会科研项目(No.2021Z1215-510201)。

摘　　要：目的探讨慢性咳嗽患者中医证候分布特点。方法收集慢性咳嗽患者771例,使用自行设计的慢性咳嗽中医证候临床调查表,采集中医症状、体征、舌象和脉象等中医四诊信息,运用SPSS 22.0软件进行频数统计分析,通过探索性因子分析总结慢性咳嗽患者病性证素、病位证素分布及中医证候分布特点。结果从76个四诊信息变量中筛选出出现频率>8%的变量36个作为中医四诊的观察指标进行因子分析。KMO取样适切性量数为0.620(>0.5),Bartlett球形检验,F=630,P<0.001,适合进行因子分析。提取初始特征值>1的公因子共12个,累计贡献率为59.368%。通过回归法计算得出771例慢性咳嗽患者病性证素按频次从高到低依次为风(77.43%)、湿热(62.13%)、痰湿(35.15%)、阳虚(29.31%)、寒饮(26.98%)、阴虚(11.41%),病位证素按频次从高到低依次为肺(88.98%)、脾(79.77%)、胃(39.43%)、肾(30.35%)。根据患者的病性病位证素情况获得各病例的证候,慢性咳嗽中医证候主要涉及风邪伏肺证(71.85%)、湿热郁肺证(47.86%)、痰湿阻肺证(25.42%)、寒饮伏肺证(21.14%)、肺脾阳虚证(10.89%)、肺阴亏虚证(0.91%)。结论慢性咳嗽中医证候以风邪伏肺证最为常见,湿热郁肺证、痰湿阻肺证、寒饮伏肺证、肺脾阳虚证、肺阴亏虚证也较为多见,各证可单独存在,亦常相兼互见。该证候特点反映出慢性咳嗽病因病机复杂,以风邪伏肺为共同病机,具有内外合邪、脏腑相关、虚实夹杂的病机特点,亦反映出慢性咳嗽病程长、反复发作、迁延难愈的疾病特征。Objective To explore pattern distribution characteristics of chronic cough.Methods A total of 771 chronic cough patients were included.A clinical questionnaire for TCM syndromes of chronic cough designed by us was used to collect four TCM diagnostic information,including TCM symptoms,signs,tongue and pulse.SPSS 22.0 was used for frequency statistical analysis.Pathological factors,positional factors and syndrome distribution characteristics of chronic cough patients were discussed based on the exploratory factor analysis.Results Thirty six variables with frequency>8%were selected from 76 information variables of four diagnostic information,then factor analysis was conducted as observation indexes of four diagnostic information.The KMO value was 0.620(>0.5)and Bartlett ball type test result was F=630,P<0.001,indicating it was suitable for factor analysis.A total of 12 common factors with initial eigenvalue>1 were extracted.The cumulative contribution rate was 59.368%.The common factor scores of 771 cases were calculated by the regression method.Pathological factors of 771 chronic cough patients were wind(77.43%),dampness-heat(62.13%),phlegm dampness(35.15%),Yang deficiency(29.31%),cold rheum(26.98%)and Yin deficiency(11.41%).Positional factors were the lung(88.98%),spleen(79.77%),stomach(39.43%)and kidney(30.35%).Syndrome distribution characteristics of 771 chronic cough patients were wind hidden in the lung pattern(71.85%),dampness heat retained in the lung pattern(47.86%),phlegm dampness blocking the lung pattern(25.42%),cold fluid hidden in the lung pattern(21.14%),the lung and spleen Yang deficiency pattern(10.89%)and lung Yin deficiency pattern(0.91%).Conclusion The most common traditional Chinese medicine pattern type of chronic cough is wind hidden in the lung pattern,followed by dampness heat blocking the lung pattern,phlegm dampness blocking the lung pattern,cold rheum hidden in the lung pattern,the lung and spleen Yang deficiency pattern and the lung Yin deficiency pattern.Each pattern can exist alone,but

关 键 词：慢性咳嗽 病性证素 病位证素 中医证候 因子分析 

分 类 号：R256.11[医药卫生—中医内科学]