膝骨关节炎证型分布:二步聚类分析与对应分析法调查的比较

Two-step cluster analysis and corresponding analysis in the syndrome type of knee osteoarthritis

背景:对应分析和二步聚类分析属于高级统计分析,将其引入膝骨关节炎中医证型标准化研究,通过数学统计原理和中医证型结合,可为中医证型向标准化、规范化提供客观依据。目的:运用对应分析及二步聚类分析法探索膝骨关节炎中医证型分布特点。方法:运用膝骨关节炎症候调查表对200例膝骨关节炎患者的临床症候进行调查,结合《中医病证诊断疗效标准》所制定的3种证候类型为标准,分别采用二步聚类分析法及对应分析法确定各证型的辨证要点;确立膝骨关节炎的中医证型特点。结果与结论:对于找出《中医病证诊断疗效标准》症候群之外的证型,聚类分析无法完成。对应分析结果显示膝骨关节炎除了《中医病症临床诊断标准》规定的症候肾虚髓亏型(50.5%)、阳虚寒凝型(3.5%)、瘀血阻滞型(23%)之外,还存在兼夹证型,包括肾虚髓亏合并阳虚寒凝型(6.5%)、阳虚寒凝合并瘀血阻滞型(3%)、肾虚髓亏合并瘀血阻滞型(3.5%),因此课题尝试采用对应分析方法。综合粗分半径在0.5,1.0,1.1,1.2,1.3,1.4,1.5症候群分析后,认为对应分析取值半径为1.1时个体值归属的症候群证型最合理,说明对应分析法用于膝骨关节炎证型的分类研究具有一定科学性。

BACKGROUND：Both correspondence analysis and two-step cluster analysis are high-grade statistical analysis, the introduction of these analyses into the research on traditional Chinese medicine （TCM） syndrome type of knee osteoarthritis wil provide objective evidence for the standardization and normalization of TCM syndrome type, through the combination of mathematical statistical principle and TCM syndrome type.OBJECTIVE：To explore distribution characteristics of knee osteoarthritis TCM syndrome type using correspondence analysis and two-step cluster analysis.METHODS：The clinical symptoms of 200 patients with knees osteoarthritis were investigated through a knee osteoarthritis symptoms questionnaire. According to the criteria for three kinds of syndrome type issued in Diagnostic Criteria for TCM Syndrome, the characteristics of each syndrome were analyzed using two-step＆amp;nbsp;cluster analysis and corresponding analysis. Then knee osteoarthritis TCM syndrome type characteristics were defined.RESULTS AND CONCLUSION：Cluster analysis is ineffective for the syndrome type, which is not present in the Diagnostic Criteria for TCM Syndrome. Corresponding analysis showed that, in addition to kidney marrow deficiency syndrome （50.5%）, yang deficiency and congealing syndrome （13.5%）, and blood stasis syndrome （23%）, concurrent syndromes were also found, including kidney marrow deficiency combined yang deficiency and congealing syndrome （6.5%）, yang deficiency and congealing combined blood stasis syndrome （3%）, kidney marrow deficiency combined blood stasis syndrome （3.5%）. Therefore we performed corresponding analysis. After analyzing the syndromes at 0.5, 1.0, 1.1, 1.2, 1.3, 1.4, 1.5 radius, the most reasonable syndrome was those at 1.1 radius by corresponding analysis. Corresponding analysis is a scientific method for the classification of knee osteoarthritis syndrome.