基于多元回归模型探讨胃食管反流病中医证型分布的相关因素  

Relevant Factors of Traditional Chinese Medicine Syndrome Distribution in Gastroesophageal Reflux Disease Based on Multiple Regression Models

作　　者：丁媛 王少丽[1] 李萌[1] 于靖文 叶王宇 刘震[1] DING Yuan;WANG Shaoli;LI Meng;YU Jingwen;YE Wangyu;LIU Zhen(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《中国中医基础医学杂志》2024年第4期598-602,共5页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：吴阶平医学基金会临床科研专项(320.6750.2021-04-31)。

摘　　要：目的通过收集分析胃食管反流病(gastroesophageal reflux disease,GERD)患者的相关资料,探索不同证型患者的主要特点,为中医辨证提供客观依据。方法选取2021年9月至2022年9月就诊于中国中医科学院广安门医院脾胃科门诊的GERD患者,收集患者一般资料、四诊信息、胃食管反流病问卷(gastroesophageal reflux disease questionnaire,GerdQ)及反流症状指数(reflux symptom index,RSI)量表评分,基于多元Logistic回归分析各因素对中医辨证的影响。结果相对于肝胃郁热证,RSI评分越高、GerdQ评分越低,诊断胆热犯胃证的概率越大;RSI评分越高、年龄越大、GerdQ评分越低,诊断气郁痰阻证的概率越大;年龄越大、GerdQ评分越低、病程越长,诊断瘀血阻络证的概率越大;年龄越大、GerdQ评分越高、病程越长,诊断中虚气逆证的概率越大;年龄越大、RSI评分越高、GerdQ评分越低、病程越长,诊断脾虚湿热证的概率越大。结论年龄、病程、RSI评分、GerdQ评分对GERD辨证有影响,临证可借助年龄、病程、RSI评分、GerdQ评分等指标辅助辨证,提高辨证准确率。Objective To explore the main characteristics of patients with different syndrome types by collecting and analyzing the relevant data of patients with gastroesophageal reflux disease(GERD),so as to provide objective evidence for syndrome differentiation of traditional Chinese medicine(TCM).Methods Patients diagnosed with GERD at the outpatient clinic of the Department of Spleen and Stomach,Guang'anmen Hospital,China Academy of Chinese Medical Sciences from September 2021 to September 2022 were enrolled.The general data,four examination information,gastroesophageal reflux disease questionnaire(GerdQ)scores,and reflux symptom index(RSI)scores were collected.The influence of various factors on TCM syndrome differentiation was analyzed based on multinomial logistics regression.Results Compared to the stagnated heat syndrome in the liver and stomach,higher RSI scores and lower GerdQ scores increased the probability of diagnosing the syndrome of gallbladder heat invading the stomach;higher RSI scores,older age,and lower GerdQ scores increased the probability of diagnosing the syndrome of Qi stagnation with phlegm blockade;older age,lower GerdQ scores,and longer disease course increased the probability of diagnosing the syndrome of blood-stasis obstruction;older age,higher GerdQ scores,and longer disease course,increased the probability of diagnosing the syndrome of Qi deficiency and Qi counterflow;older age,higher RSI scores,lower GerdQ scores,and longer disease course increased the probability of diagnosing the syndrome of dampness-heat due to spleen deficiency.Conclusion Age,disease course,RSI scores,and GerdQ scores influence syndrome differentiation of GERD.Clinical syndrome differentiation can be assisted by indicators such as age,disease course,RSI scores,GerdQ scores to improve accuracy.

关 键 词：多元LOGISTIC回归 相关因素 证型分布 

分 类 号：R256[医药卫生—中医内科学]