基于聚类分析和对应分析的稳定型心绞痛证候要素组合规律的研究

Laws of syndrome element combination in stable angina pectoris:a study based on cluster analysis and corresponding-correlation analysis

目的:运用聚类分析和对应分析法研究251例稳定型心绞痛的25个常见症状的分类和证候要素组合规律。方法:收集251例经冠状动脉造影证实的稳定型心绞痛患者,记录中医四诊信息,运用聚类分析和对应分析方法进行证候分类和证候要素组合规律研究。结果:运用聚类分析法把25个常见症状聚成4类,专家辨证第1类为心气亏虚证,第2类为脾气虚弱证,第3类为气阴两虚证,第4类为痰瘀互阻证,其中心气亏虚证和痰瘀互阻证关系最为密切。应用对应分析法发现气虚和血瘀之间的关系最为密切,其次为痰浊和热蕴以及气虚和阴虚。结论:气虚血瘀是稳定型心绞痛的核心病机,稳定型心绞痛的常见证候要素组合为气虚+血瘀、气虚+阴虚、血瘀+痰浊、心气虚+痰浊+血瘀。同时还提示聚类分析和对应分析是进行证候要素组合规律研究较适宜的方法。

Objective： To study the classification of common symptoms and the laws of syndrome element combination in 251 cases of stable angina pectoris （SAP） by using cluster analysis and corresponding-correlation analysis. Methods： A total of 251 SAP cases were selected and their information from four diagnosis in traditional Chinese medicine was recorded. The classification of common symptom and the laws of syndrome element combination were investigated by cluster analysis and corresponding-correlation analysis. Results： Twenty-five symptoms found in 251 SAP cases were divided into four types by cluster analysis： deficiency of heart qi, deficiency of spleen qi, deficiency of qi and yin, and phlegm accumulation and blood stasis. The deficiency of heart qi had the closest relation to phlegm accumulation and blood stasis. By corresponding-correlation analysis, the deficiency of qi had the closest relation to blood stasis, next was turbid phlegm and heat stagnation, and then deficiency of qi and deficiency of yin. Conclusion： Blood stasis due to deficient qi is the key factor in pathogenesis of SAP. Deficiency of qi plus blood stasis, deficiency of qi plus deficiency of yin, blood stasis plus turbid phlegm, deficiency of heart qi plus blood stasis plus turbid phlegm are common syndrome element combinations of SAP. It is proved that cluster analysis and corresponding-correlation analysis are the proper methods for studying laws of syndrome element combination.