基于隐结构模型探析子宫内膜异位症证候分布  

Study on Symptom Distribution in Endometriosis Based on Latent Structure Models

作　　者：谢艳丽 王栩[2] 范诗宇 樊颖 李宏伟 衣佳乐 张智龙[2] XIE Yanli;WANG Xu;FAN Shiyu;FAN Ying;LI Hongwei;YI Jiale;ZHANG Zhilong(Tianjin University of Traditional Chinese Medicine,Tianjin,China,301617;Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital,Tianjin,China,300120;First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin,China,300193)

机构地区：[1]天津中医药大学,天津301617 [2]天津市中医药研究院附属医院,天津300120 [3]天津中医药大学第一附属医院,天津300193

出　　处：《河南中医》2024年第11期1718-1725,共8页Henan Traditional Chinese Medicine

基　　金：天津市中医药研究院附属医院科研课题项目(202202)。

摘　　要：目的:基于隐结构模型探究子宫内膜异位症的证候分布情况。方法:采用隐结构模型的方法,构建现代中医治疗子宫内膜异位症的病案及临证经验数据库。使用Lantern 5.0软件,运用隐类概率、条件概率、累积互信息及证候数据,辅以证候要素辨证量表分析该人群的证候分布情况。结果:共纳入441例医案,以187个显变量为基础构建隐结构模型,以累积信息覆盖率达到95%为主要证候要素的判定标准,共得到17个隐变量,34个隐类,6个综合聚类模型。子宫内膜异位症病位在肝、肾、脾;证候分为实证及虚实夹杂证,其中实证包括肝火炽盛证、寒凝血瘀证、肝郁气滞兼湿热证、痰湿困脾证;虚实夹杂证包括肝肾阴虚兼气滞证、肾虚血瘀证。结论:基于隐结构模型及证候要素辨证量表丰富了子宫内膜异位症的证候分型,为子宫内膜异位症的辨证论治提供了参考依据,同时也为其他疾病的证候研究提供思路,有利于提高临床诊治疾病的准确性及有效性。Objective:To explore the symptom distribution of endometriosis(EMS)based on latent structure models.Methods:A database of clinical cases and treatment experiences for EMS was constructed using the latent structure model.Lantern 5.0 software was utilized to analyze the symptom distribution in this population through latent class probabilities,conditional probabilities,cumulative mutual information,and symptom data,supplemented by a symptom differentiation scale.Results:A total of 441 medical cases were included,and a latent structure model was built based on 187 manifest variables,with a cumulative information coverage rate of 95%as the criterion for determining major symptomatic elements.This resulted in 17 latent variables,34 latent classes,and 6 comprehensive clustering models.The primary affected locations were the liver,kidney,and spleen.Symptoms were classified into excess and mixed deficiency-excess syndromes,where the excess syndromes included syndrome of excessive liver fire,syndrome of cold congealing blood stasis,syndrome of liver qi stagnation with dampness-heat,and syndrome of phlegm-dampness obstructing the spleen.Mixed deficiency-excess syndromes included liver-kidney yin deficiency with qi stagnation,and kidney deficiency with blood stasis.Conclusion:The use of latent structure models and symptom differentiation scales enriches the classification of symptoms in EMS,providing a reference for clinical differentiation and treatment of EMS.It also offers insights for symptom research in other diseases,enhancing the accuracy and effectiveness of clinical diagnoses and treatments.

关 键 词：子宫内膜异位症 隐结构模型 证候要素辨证量表 证候分布 肝肾阴虚兼气滞证 肾虚血瘀证 肝火炽盛证 寒凝血瘀证 肝郁气滞兼湿热证 湿困脾证 

分 类 号：R271.911.71[医药卫生—中西医结合]