基于多元统计方法对乙肝后肝硬化辨证标准的研究

Based on multivariate statistical methods to liver cirrhosis diagnostic criteria

目的:探讨乙肝后肝硬化中医证候分类特征、证候规律,完善其常见证候的诊断标准。方法:对276例乙肝后肝硬化患者进行中医证型临床流行病学调查,并应用聚类分析、主成分分析、Logistic回归分析等多元分析方法对资料进行分析。结果:(1)应用聚类分析的方法,归纳出乙肝后肝硬化基本中医证候群;(2)运用主成分分析,综合分析乙肝后肝硬化各证的症状,寻找出乙肝后肝硬化常见证候特异性的症状指标;(3)运用多元logistic回归模型判别分析,筛选出乙肝后肝硬化证候的主次症状;(4)初步拟定出乙肝后肝硬化湿热内蕴证、肝肾阴虚证、肝郁脾虚证、脾虚湿盛证、脾肾阳虚证等5种基本证型的辨证标准。结论:采用临床流行病学的原则和方法,并运用现代数理统计分析所建立的乙肝后肝硬化基本证型的辨证标准,减少了偏倚,提高证候标准研究结果的客观性和科学性。

Objective： To investigate the hepatitis B cirrhosis TCM syndrome climate classification characteristics, syndromes, and improve the common syndrome diagnostic criteria. Methods： 276 cases of hepatitis B patients with cirrhosis of TCM clinical epidemiological investigation, and application of cluster analysis, principal component analysis, logistic regression analysis and other multivariate analysis methods for data analysis. Results：（1） application of cluster analysis, summarized the hepatitis B cirrhosis traditional Chinese medicine syndrome group;（2） the use of principal component analysis, comprehensive analysis of hepatitis B cirrhosis symptoms of each card, find out the hepatitis B cirrhosis common syndrome specific symptom indicators; （3） the use of multivariate logistic regression model of discriminant analysis, screening of the primary and secondary symptoms of the hepatitis B cirrhosis syndrome; （4） initial preparation of the hepatitis B cirrhosis the damp card, liver and kidney yin deficiency, stagnation and spleen deficiency syndrome, spleen dampness card, spleen and kidney yang permits, and other basic card diagnostic criteria. Conclusion： The clinical epidemiology principles and methods, and the use of modern mathematical statistics established by the type of syndrome of diagnostic criteria cirrhosis, reducing the bias and improve the syndromes of the standard results of objective and scientific.