基于因子分析和聚类分析的肠易激综合征证候证素分布研究  

Study on Distribution of Syndrome Elements in Irritable Bowel Syndrome Based on Factor Analysis and Clustering Analysis

作　　者：王昱茜 吕咪 张坤漓 胡佳艳 余文熙 乔希筠 王小康 王凤云[2] WANG Yuxi;LYU Mi;ZHANG Kunli;HU Jiayan;YU Wenxi;QIAO Xiyun;WANG Xiaokang;WANG Fengyun(Beijing University of Chinese Medicine,Beijing 100029,China;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]北京中医药大学,北京100029 [2]中国中医科学院西苑医院,北京100091

出　　处：《中国中医药信息杂志》2024年第12期163-168,共6页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82174363)。

摘　　要：目的探讨肠易激综合征的中医证候、证素的分布规律,为临床中医辨证治疗提供依据。方法收集2019年11月-2022年12月中国中医科学院西苑医院、广东省中医院、河南中医药大学第一附属医院等全国18家三甲中医院就诊的肠易激综合征患者,填写调查问卷,内容包括患者的一般情况、病史(起病时间、病情变化)、罗马Ⅳ症状诊断量表、躯体症状群量表、生活质量量表和医院焦虑抑郁量表、中医证候等。运用因子分析和系统聚类分析的方法,提取病证要素,归纳中医证型分类。结果共纳入157例肠易激综合征患者,其中男性87例,女性70例;年龄18~74岁;病程最长30年,最短3个月,平均(48.31±5.61)个月。焦虑评分(3.66±0.30)分,抑郁评分(3.39±0.28)分。中医症状中情绪不佳出现频率最多,约为83.4%,其次为腹泻(80.9%)、腹痛(72.6%)。因子分析结果显示,旋转最终在16次迭代后收敛,得出8个公因子、33个变量,累积贡献率60.016%。肠易激综合征的病位主要分布在肝、脾、大肠、胃,病性证素以气滞、痰、湿、热、阳虚为主。对8个公因子聚类分析结果显示,中医证型主要为肝郁气滞证、湿热内蕴证、肝郁脾虚证、肝胃不和证。腹泻型肠易激综合征患者以肝郁脾虚证为主,混合型和便秘型均以湿热内蕴证为主,不同分型患者中医证型分布差异有统计学意义(P<0.05)。结论肠易激综合征病位主要在肝、脾、大肠三脏,其中又以肝为要,中医证型多为肝郁气滞证、湿热内蕴证、肝郁脾虚证。Objective To investigate the distribution of TCM syndromes and syndrome elements of irritable bowel syndrome(IBS);To provide reference for clinical TCM syndrome differentiation and treatment.Methods The patients with IBS who filled in the questionnaire were collected from 18 tertiary Chinese medicine hospitals in China from November 2019 to December 2022,including Xiyuan Hospital,China Academy of Chinese Medical Sciences,Guangdong Provincial Hospital of Traditional Chinese Medicine,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine.The contents of questionnaire included the patients’general condition,medical history(onset time,condition changes),RomeⅣsymptom diagnostic scale,somatic symptom cluster scale,quality of life scale,hospital anxiety and depression scale,TCM syndromes,etc.The methods of factor analysis and systematic clustering analysis were used,the factors of disease and syndrome were extracted,and the classification of TCM syndrome types was summarized.Results Totally 157 patients were included,87 were male and 70 were female.The age was from 18 to 74 years old.The longest course of disease was 30 years and the shortest was 3 months,with an average of(48.31±5.61)months.Anxiety score:was 3.66±0.30,depression score was 3.39±0.28.The most common TCM symptom was emotional distress(83.4%),followed by diarrhea(80.9%)and abdominal pain(72.6%).The results of factor analysis showed that rotation finally converged after 16 iterations,and 8 common factors and 33 variables were obtained,with a cumulative contribution rate of 60.016%.The sites of IBS were mainly distributed in liver,spleen,large intestine and stomach.The main syndrome factors were qi stagnation,phlegm,dampness,heat and yang deficiency.The results of clustering analysis of 8 common factors showed that the main TCM syndrome types were liver depression and qi stagnation syndrome,damp-heat internal accumulation syndrome,liver depression and spleen deficiency syndrome,and liver-stomach digression syndrome.The main

关 键 词：肠易激综合征 证候 证素 因子-聚类分析 

分 类 号：R259.74[医药卫生—中西医结合]