慢性乙型肝炎中医证型分类的研究

Study on TCM Syndrome Typing of Chronic Hepatitis B

目的探索慢性乙型肝炎的中医证型分类方法。方法制定临床流行病学调查表格,现场采集871例慢性乙型肝炎患者的相关信息,进行因子分析、聚类分析、对应分析等多元统计。通过因子分析与变量聚类这一新的组合方式,得出患者群体的基础证型分类及患者个体的证型判定,并分析证型与舌脉象的对应关系。结果证型分布:无证型190例(21.8%);单纯证型380例(43.6%),其中肝肾阴虚型126例(14.5%),肝胆湿热型126例(14.5%),肝郁脾虚型128例(14.7%);复合证型301例(34.6%)。多重对应分析显示肝肾阴虚型与舌红、苔薄黄、脉弦有关;肝胆湿热型与苔黄腻、脉滑有关;肝郁脾虚型与苔薄白、脉弦细有关。结论利用上述方法进行证型分类与临床诊疗实际比较符合;单纯证型与舌脉象的对应关系较好。

Objective To explore the method for TCM syndrome typing of chronic hepatitis B （CHB）. Methods Clinical questionnaire of epidemiological investigation was established, by which the relative information from 871 patients with CHB was collected on the spot to conduct multi-analysis, including factor analysis, cluster analysis, correspondence analysis, etc. Then the population basic TCM syndrome types and the individual TCM syndrome type of patients were obtained adopting the new combination of factor analysis and variable cluster, and the corresponding relation between TCM syndrome type and the figures of tongue and pulse was analyzed as well. Resuits Analysis on distribution of TCM syndrome type in patients showed that single syndrome type presented in 380 cases （43.6%）, including Gan-Shen yin deficiency type in 126 （ 14.5% ）, Gan-Dan dampness-heat type in 126 （ 14. 5% ）, Gan-depression and Pi-deficiency type in 128 （ 14. 7% ） ; compound syndrome type presented in 301 （ 34. 6% ） ; the other 190 patients （ 14. 5% ） without any symptom was regarded as no syndrome type. Multiple correspondence analysis showed that Gan-Shen yin deficiency type is related to red tongue, thin yellowish fur, and taut pulse; Gan-Dan dampness-heat type is related to yellowish greasy fur and slippery pulse; Gan-depression with Pideficiency type is related to thin whitish fur and taut thready pulse. Conclusion The above-mentioned typing of TCM syndrome well coincided with the clinical practice, and the correspondence between single syndrome type and the manifestation of tongue and pulse is obvious.