糖尿病合并脑梗死急性期证候演变的聚类分析

Cluster Analysis of Syndrome Evolution in Diabetes Complicated by Acute Cerebral Infarction

目的探究糖尿病合并脑梗死急性期患者证候的演变规律。方法共纳入102例糖尿病合并脑梗死急性期患者,分别在发病第3天(72h内)、第7天、第15天采集患者的四诊信息,对四诊变量进行层次聚类分析,对不同时点的证候要素进行动态分析。结果层次聚类分析结果提示,发病第3天证候可聚为阴虚、内风、气虚血瘀、痰热四类,发病第7天的证候可聚为气阴两虚、痰热、血瘀、痰湿、内风五类,发病第15天的证候可聚为血瘀、气阴两虚、痰热、痰湿四类。结论糖尿病合并脑梗死急性期不同时点的证候要素与文献报道相似,发病72h内以内风较为突出,而后则以痰热、痰湿、血瘀证候为主,气阴两虚贯穿于糖尿病合并脑梗死的急性期。

Objective To investigate the syndrome evolution in patients with diabetes complicated by acute cerebral infarction.Methods A total of 102 patients with diabetes complicated by acute cerebral infarction were included in the study.The information obtained by four diagnostic methods was collected on days 3（within 72 h）,7,and 15 of onset.Hierarchical cluster analysis was performed on relevant variables,and dynamic analysis was conducted on the syndrome factors at different time points.Results Hierarchical cluster analysis showed that syndromes consisted of yin deficiency,endogenous wind,qi deficiency and blood stasis,and phlegm heat on day 3 of onset,deficiency of both qi and yin,phlegm-heat,blood stasis,phlegm dampness,and endogenous wind on day 7 of onset,and blood stasis,deficiency of both qi and yin,phlegm-heat,and phlegm-dampness on day 15 of onset.Conclusion For patients with diabetes complicated by acute cerebral infarction,the syndrome factors at different time points are similar to those reported in the literature.Within 72 h of onset,endogenous wind is the common syndrome,then phlegm-heat,phlegm dampness,and blood stasis became the main ones,and deficiency of both qi and yin exists throughout the acute phase of cerebral infarction in diabetes.