基于隐结构和因子分析的原发性肝癌常见证候分类及特征研究

Classification and Characteristics of Common Syndromes of Primary Liver Cancer Based on Hidden Structure and Factor Analysis

目的探索原发性肝癌常见证候分类及特征,为临床辨治提供参考。方法采集河南省内两家三甲中医院的原发性肝癌患者四诊信息,构建数据库。运用隐结构法的Lantern 5.0软件,基于双步隐树分析,构建隐结构模型,通过综合聚类提取原发性肝癌常见证候。采用SPSS 23.0软件进行因子分析和系统聚类分析,推断潜在证候。结合不同方法结果和专业知识确定原发性肝癌证候分类。结果共纳入1353例原发性肝癌患者,105个症状。纳入分析频次≥40的59个症状构建隐结构模型,得到24个隐变量,综合聚类得到5种常见证候,分别为气虚证、肝郁气滞证、血瘀证、水湿内停证、肝胆湿热证。将频率>3%的症状进行因子分析,得到20个公因子,用公因子进行系统聚类分析,推断出8个常见证候。结合不同方法和专业知识最终确定7种常见证候及特征。结论原发性肝癌常见证候为气虚证、肝郁气滞证、血瘀证、水湿内停证、阴虚证、肝胆湿热证、脾虚湿困证。研究结果较客观的反映了原发性肝癌患者的实际情况,可为原发性肝癌的辨证治疗提供参考。

Objective To explore the classification and characteristics of common syndromes of primary liver cancer and provide reference for clinical treatment.Methods Collect the four diagnostic information of patients with primary liver cancer from two top three TCM hospitals in Henan Province,and build a database.Using Lantern 5.0 software,based on two-step hidden tree analysis,a hidden structure model was constructed,and common syndromes of primary liver cancer were extracted through comprehensive clustering.SPSS 23.0 software was used for factor analysis and systematic cluster analysis to infer the potential syndromes.Combined with the results of different methods and professional knowledge,the syndrome classification of primary liver cancer was determined.Results A total of 1353 patients with 105 symptoms of primary liver cancer were included.59 symptoms with an analysis frequency≥40 were included to construct a hidden structure model,24 hidden variables were obtained,and 5 common syndromes were obtained by comprehensive clustering,namely,qi deficiency syndrome,liver depression and qi stagnation syndrome,blood stasis syndrome,water dampness stagnation syndrome,liver and gallbladder damp heat syndrome.20 common factors were obtained by factor analysis for symptoms with frequency>3%,and 8 common syndromes were inferred by cluster analysis with common factors.7 common syndromes and characteristics were finally determined by combining different methods and expertise.Conclusion The common syndromes of primary liver cancer are qi deficiency syndrome,liver depression and qi stagnation syndrome,blood stasis syndrome,water dampness stagnation syndrome,yin deficiency syndrome,liver and gallbladder damp heat syndrome,spleen deficiency and dampness stagnation syndrome.The results objectively reflect the actual situation of patients with primary liver cancer,and can provide reference for the treatment of primary liver cancer based on syndrome differentiation.