应用匹配矩阵、因子分析和聚类分析法研究冠心病痰瘀证候特征

Applying matching matrix, factor analysis and clustering analysis to investigation of characteristics of syndromes of phlegm and blood stasis in patients with coronary heart disease

目的研究冠心病痰瘀证候与临床四诊信息的相互关系,为其分类及规范化诊断提供参考。方法采用匹配矩阵、因子分析和聚类分析法,对200例冠心病患者痰证、瘀证、痰瘀互阻证及非痰非瘀证46项临床症状进行相关性分析。结果冠心病不同痰瘀证候舌、脉象与非痰非瘀证之间存在明显差异;中医病机脏腑定位于心和肾,以心气虚为主,兼肾气虚,痰证患者尚多伴脾气虚;在46项临床症状中,仅15项症状在痰证、瘀证和痰瘀互阻证中相伴出现频率较高。除共有的本虚证外,痰证的主要临床症状为白腻苔和滑脉,尚见胸脘痞满和腹胀等;瘀证则以紫舌、舌生瘀斑为主,尚见痛有定处;痰瘀互阻证则兼上述两种证候的主要症状。结论综合应用匹配矩阵、因子分析和聚类分析法,可以获得有关冠心病不同痰瘀证候主要临床特征及脏腑定位的信息,对冠心病不同痰瘀证候辨证及其分类研究具有一定的意义。

Objective： To investigate the characteristics of syndromes of phlegm and blood stasis in patients with coronary heart disease by multiple statistical methods of matching matrix, factor analysis and clustering analysis, and to provide some references for classification and normalization of diagnosis of syndromes of phlegm and blood stasis of coronary heart disease, Methods： The correlations among 46 kinds of symptoms in syndrome of non-phlegm and non-blood stasis, syndrome of blood stasis, syndrome of phlegm and syndrome of phlegm-blood stasis blocking in 200 patients with coronary heart disease were analyzed by matching matrix, factor analysis and clustering analysis. Results： The manifestations of tongue and pulse in syndromes of phlegm and blood stasis were significantly different from those in syndrome of non-phlegm and non-blood stasis, The pathogenesis of viscera in syndromes of phlegm and blood stasis lied in the heart and kidney, and the syndrome of deficiency of heart qi was the most common one while the syndrome of deficiency of kidney qi took the secondary place. The syndrome of phlegm was often accompanied by syndrome of deficiency of spleen qi. Only 15 ones of 46 clinical symptoms showed high frequency in concomitant appearance in syndrome of blood stasis, syndrome of phlegm and syndrome of phlegm-blood stasis blocking. Apart from having the common symptoms in syndrome of deficiency in origin, the syndrome of phlegm especially showed white and greasy fur and slippery pulse as well as distention and fullness of chest and abdominal distension; the syndrome of blood stasis showed purplish tongue and ecchymosis on tongue as well as fixed pain; and the syndrome of phlegm-blood stasis blocking showed the main symptoms of both syndrome of phlegm and syndrome of blood stasis. Conclusion. The statistical methods of matching matrix, factor analysis and clustering analysis are convenient, and can definitely indicate the clinical characteristics and syndrome differentiation of viscera of different syndromes of phlegm and blood stasis, which are beneficial to further research of diagnosis and differentiation of such syndromes of coronary heart disease.