154例血栓前状态病例临床特征及中医证候分布规律的聚类分析

Cluster Analysis of Clinical Features and Distribution of Traditional Chinese Medicine Syndrome Patterns in 154 Cases of Pre-thrombosis State

目的:探讨血栓前状态患者的中医证候分布特征,为临床辨证论治提供依据。方法:采用K类中心聚类法对154例血栓前状态病例的临床资料和证候信息进行聚类分析。结果:传统临床辨证分为12种证型,分别为血瘀证、气虚证、湿浊证、阴虚证、阳虚证、痰浊证、湿热(毒)证、气滞证、血虚证、痰热证、寒凝证;其中,血瘀证、气虚证明显多于其他证候,占49.1%,寒凝证最为少见。证候聚类分析结果得出4型,其中阳虚血瘀证占60.4%,痰湿蕴热兼气滞证占20.1%,气阴两虚证占13.0%,寒凝证占6.5%,阳虚血瘀证是血栓前状态的最常见的中医证型。结论:聚类分析对于中医证候研究有一定的积极意义,可以为证候的归纳提供相对可靠的辨证依据,为辨证治疗用药及科学地评估中医疗效打下基础。

Objective： To investigate the distribution of traditional Chinese medicine （TCM） syndrome patterns of patients with pre-thrombosis state, and to provide clinical evidence for the syndrome differentiation and treatment. Methods. The K-center clustering method was adopted for the analysis of clinical data and syndrome information of 154 cases of pre-thrombosis state. Results, Traditional clinical syndrome differentiation presented 12 syndrome patterns, and they were blood stasis syndrome, qi deficiency syndrome, damp turbidity syndrome, yin deficiency syndrome, yang deficiency syndrome, phlegm turbidity syndrome, damp- heat （toxicity） syndrome, qi stagnation syndrome, blood deficiency syndrome, phlegm heat syndrome, and cold accumulation syndrome. Among the 12 patterns, the blood stasis syndrome and qi deficiency syndrome were more commonly seen than other syndromes, accounting for 49.1%, and cold accumulation syndrome was most rarely seen. Syndrome clustering analysis results presented 4 syndrome patterns, yang deficiency and blood stasis accounted for 60.4% , syndrome of phlegm damp aggregated with heat and qi stagnation accounted for 20.1%, qi and yin deficiency syndrome accounted for 13.0%, and cold accumulation syndrome accounted for 6.5%. Yang deficiency and blood stasis syndrome was the most common type. Conclusion. Cluster analysis is helpful for the research of TCM syndrome, and can provide reliable basis for syndrome differentiation, which will lay the foundation for TCM treatment and efficacy evaluation.