基于隐结构法探讨脑出血常见中医证候及其与体质的关系  

Common Syndromes of Cerebral Hemorrhage and Correlation with Physical Fitness Based on Latent Structure Model

作　　者：周珂青 白琛 彭蒙蒙 穆昭威 冉春龙 李梦君 刘向哲[2] ZHOU Keqing;BAI Chen;PENG Mengmeng;MU Zhaowei;RAN Chunlong;LI Mengjun;LIU Xiangzhe(Henan University of Chinese Medicine,Zhengzhou 450046,Henan,China;The First Affiliated Hospital of Henan University of CM,Zhengzhou 450000,Henan,China)

机构地区：[1]河南中医药大学,郑州450046 [2]河南中医药大学第一附属医院,郑州450000

出　　处：《中西医结合心脑血管病杂志》2024年第21期3869-3873,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家重点研发计划中医药现代化研究重点专项(No.2019YFC1710001);河南省中医药传承与创新人才工程中医药学科领军人才项目,编号:豫卫中医函〔2021〕8号;河南省重点研发与推广专项(科技攻关)(No.212102310360)。

摘　　要：目的:运用隐结构法分析脑出血病人症状信息,确定中医证候类型,并探讨其与体质之间的关系。方法:收集豫东农村地区脑出血病人临床四诊信息,运用Lantern 5.0软件构建脑出血隐结构模型,确定中医证候;采用SPSS 26.0软件探讨已确定的中医证候与体质的相关性。结果:共收集豫东农村地区脑出血病例138例,运用隐结构法得到隐变量20个,综合聚类分析后得到5个相关证候,分为风痰上扰证、阴虚风动证、气虚血瘀证、痰瘀阻络证和痰热腑实证。脑出血病人体质分布:平和质>气虚质>阳虚质>气郁质>痰湿质>阴虚质>血瘀质>湿热质;证候分布:痰热腑实证>气虚血瘀证>痰瘀阻络证>风痰阻络证>阴虚风动证。气虚质、平和质在各个证候的分布中均存在明显差异(P<0.05);其中,气虚质与气虚血瘀证、阴虚质与阴虚风动证、湿热质与痰热腑实证、平和质与气虚血瘀证之间具有明显相关性(P<0.05)。结论:豫东农村社区脑出血病人的常见证候基本符合中医理论中的证候规律,为进一步完善脑出血相关证候的诊断标准提供理论基础。中医证候与体质间存在明显相关性,为临床指导脑出血病人辨证及治疗提供实践依据。Objective:Based on latent structure model to discuss the common traditional Chinese medicine(TCM)syndromes of cerebral hemorrhage and probe the relationships between the identified TCM syndromes and physical corporeity.Methods:The four clinical diagnosis information of cerebral hemorrhage patients in rural communities of eastern Henan province were collected to construct the latent structure model of cerebral hemorrhage with Lantern 5.0 software,and determine the TCM syndrome of cerebral hemorrhage.SPSS 26.0 software was used to explore the correlation between the identified TCM syndromes and constitution.Results:A total of 138 cases of cerebral hemorrhage were collected.Using the latent structure method,20 hidden variables were obtained.Five related syndromes were obtained after comprehensive cluster analysis,which were divided into Wind phlegm disturbance syndrome,Yin deficiency wind movement syndrome,Qi deficiency and blood stasis syndrome,Phlegm and blood stasis obstruction syndrome,and Phlegm heat Fu syndrome.The constitution distribution of patients with cerebral hemorrhage:Peace>Qi deficiency>Yang deficiency>Qi depression>Phlegm dampness>Yin deficiency>Blood Stasis>Damp heat.Syndrome distribution:Phlegm heat Fu syndrome>Qi deficiency and blood stasis syndrome>Phlegm stasis obstruction syndrome>Wind phlegm obstruction syndrome>Yin deficiency and wind movement syndrome.There were significant differences in the distribution of Qi deficiency and Peace in each syndrome(P<0.05).Among them,there were significant correlations between Qi deficiency and Qi deficiency and blood stasis syndrome,Yin deficiency quality and Yin deficiency wind movement syndrome,Damp heat quality and Phlegm heat Fu syndrome,and Peace quality and Qi deficiency blood stasis syndrome(P<0.05).Conclusion:The common syndromes of patients with cerebral hemorrhage in rural communities of eastern Henan province basically conform with the syndrome rules in TCM theory,which provides a theoretical basis for further improving the diagnostic criteria o

关 键 词：脑出血 隐结构法 中医证候 体质 相关性 

分 类 号：R277.7[医药卫生—中医学]