基于因子分析与聚类分析的糖尿病周围神经病变合并血脂异常中医证候学特征研究  

Research on traditional Chinese medicine syndrome characteristics of diabetes peripheral neuropathy with dyslipidemia based on factor analysis and cluster analysis

作　　者：李家劼 申国明[1] 刘金星 郭锦晨 尤良震 奚德荣 江爱娟[1] 赵进东[3,4] 方朝晖 LI Jiajie;SHEN Guoming;LIU Jinxing;GUO Jinchen;YOU Liangzhen;XI Derong;JIANG Aijuan;ZHAO Jindong;FANG Zhaohui(Anhui University of Chinese Medicine,Hefei 230012,China;Key Laboratory of Internal Medicine of Chinese Medicine,Ministry of Education,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China;Institute of Traditional Chinese Medicine for Prevention and Treatment of Diabetes,Anhui Academy of Traditional Chinese Medicine,Hefei 230031,China)

机构地区：[1]安徽中医药大学,合肥230012 [2]北京中医药大学东直门医院中医内科学教育部重点实验室,北京100700 [3]安徽中医药大学第一附属医院,合肥230031 [4]安徽省中医药科学院中医药防治糖尿病研究所,合肥230031

出　　处：《中华中医药杂志》2024年第11期6132-6139,共8页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：安徽省重点研究与开发计划项目(No.202104j07020006);国家自然科学基金项目(No.82174153);国家重点研发计划(No.2020Y FE0201800);安徽省高校协同创新项目(No.GXXT-2020-025);安徽中医药大学省级大学生创新创业训练计划项目(No.S202310369130,No.S2022089,No.S2022092)。

摘　　要：目的:探究糖尿病周围神经病变合并血脂异常患者的中医证候特点及证型分布规律。方法:采用真实世界大样本回顾性研究,基于医院信息系统收集1150例糖尿病周围神经病变合并血脂异常患者的临床病历资料并进行统计分析,包括一般资料、中医症状体征、舌象及脉象。基于因子分析和聚类分析分别提取、归纳患者的中医证候要素(包括病位要素与病性要素)及证型分布规律。结果:筛选确定与糖尿病周围神经病变合并血脂异常密切相关的中医四诊信息87项,排名前10位的症状及体征为口干、视物模糊、肢体麻木、乏力、口渴、多饮、语声低微、头晕、面色晦暗、小便频数。舌象中频数最高的舌质、苔色、苔质分别为舌暗红、苔白、苔薄,脉象中频数最高的是脉细。纳入频率>1%的81项四诊信息进行因子分析得到病位要素包括心、肺、脾、肝、肾、胃,病性要素包括痰浊、血瘀、阳虚、阴虚、内热、精亏、气虚。聚类分析得到疾病的5种辨证分型,分别是阴虚血瘀证[34.00%(391/1150)]、痰瘀阻络证[31.30%(360/1150)]、脾肾阳虚证[15.48%(178/1150)]、肝肾亏虚证[9.74%(112/1150)]、气虚血瘀证[9.48%(109/1150)]。结论:糖尿病周围神经病变合并血脂异常属本虚标实病证,其辨证分型以阴虚血瘀证、痰瘀阻络证最为常见。Objective:To explore the traditional Chinese medicine(TCM)syndrome characteristics and distribution of syndrome types in patients with diabetes peripheral neuropathy with dyslipidemia.Methods:Using a large sample retrospective study in the real world,based on the hospital information system,the clinical medical records of 1150 patients with diabetes peripheral neuropathy and dyslipidemia were collected and statisticly analysed,including general information,TCM symptoms and signs,tongue manifestation and pulse manifestation.Based on factor analysis and cluster analysis,extract and summarize the TCM syndrome elements(including disease location elements and disease nature elements)and syndrome type distribution patterns of patients.Results:A total of 87 items of TCM four diagnostic information closely related to diabetes peripheral neuropathy complicated with dyslipidemia were screened and determined.The top 10 symptoms and signs were dry mouth,blurred vision,numbness of limbs,fatigue,thirst,excessive drinking,low voice,dizziness,dim complexion,and frequent urination.The tongue quality,fur color,and fur character with the highest frequency in tongue manifestation are dark red,white fur,and thin fur,respectively.The pulse manifestation with the highest frequency in pulse manifestation is thready pulse.Factor analysis was conducted on 81 items of four diagnostic information with a frequency greater than 1%,and the disease location elements included heart,lung,spleen,liver,kidney,and stomach.The disease location elements included turbid phlegm,blood stasis,yang deficiency,yin deficiency,endogenous heat,essence deficiency,and qi deficiency.Cluster analysis revealed five types of syndrome differentiation for diseases,namely yin deficiency and blood stasis syndrome[34.00%(391/1150)],phlegm and blood stasis obstruction syndrome[31.30%(360/1150)],yang deficiency of spleen and kidney syndrome[15.48%(178/1150)],liverkidney deficiency syndrome[9.74%(112/1150)],and qi deficiency and blood stasis syndrome[9.48%(109/1150)].Conclu

关 键 词：糖尿病周围神经病变 血脂异常 中医证候 辨证分型 因子分析 聚类分析 真实世界 

分 类 号：R259[医药卫生—中西医结合] R277.7[医药卫生—中医内科学]