200例慢性肾小球肾炎中医证候因子分析研究

Factor analysis of TCM patterns in 200 patients with chronic glomerulonephritis

目的依据临床流行病学方法和原则,通过回顾性临床调研,对200例慢性肾小球肾炎患者中医证候进行研究,探求慢性肾小球肾炎正虚与邪实的证候分布特点。通过采用因子分析法对中医证候的分布规律进行分析和归纳,客观再现慢性肾小球肾炎中医证候的本质。方法采用问卷调查的形式对患者临床症状进行记录。运用因子分析统计学方法提取支配慢性肾小球肾炎四诊变量的公因子,根据专业知识对其进行分析和解释。结果 1因子分析结果得出13个公因子,其中因子10的出现率最高,其包括的中医证候为湿热证和瘀血证;单纯本虚证的因子中以气虚为主的因子8的出现率最高。2传统人为证候分析与因子分析结果之间存在显著差异(P<0.01)。结论慢性肾小球肾炎本虚证以气虚发生率最高,而标实证以湿热和瘀血最为多见,提示湿热和瘀血是慢性肾小球肾炎的重要病机。因子分析虽不能代替传统中医辨证,但能对中医证候进行较理想的分离,顺利得到独立的证候分组,特别是发生率在前3位的证候中两者都包括了瘀血证和气虚证,这也验证了临床证候研究部分的主要研究结论。

Objective In accordance with the method and principle of clinical epidemiology,a retrospec-tive survey of 200 patients with chronic glomerulonephritis was carried out to study the rules of TCM pat-terns,ao as to discover the distribution features of asthenia of healthy qi and sthenia of pathogenic fac-tors.By using the factor analysis to analyze and summarize the distribution rules of TCM patterns,the na-ture of TCM pattern of chronic glomerulonephritis was explored.Methods The clinical symptoms of the 200 patients were recorded by using questionnaire responses.By the method of factor analysis,the com-mon factors which dominated the variables of four diagnosis for chronic glomerulonephrits were extracted, analyzed and interpreted.Results Total 13 common factors were included,with the highest occurrence rate of Factor 10.Factor 10 represented the pattern of damp heat and pattern of blood stasis.Of the defi-ciency patterns,the incidence rate of pattern of qi deficiency represented by Factor 8 was the highest. Furthermore,the results from the traditional pattern analysis by TCM physicians and the factor analysis by software showed significant difference（P 〈0.01）.Conclusion Of the deficiency syndromes,the inci-dence rate of qi deficiency was the highest.The damp heat pattern and the blood stasis pattern were the most common of the excessive syndromes,which suggested that damp heat and blood stasis be the key pathogenesis.The method of factor analysis,not be equal to traditional pattern differentiation,would sep-arate the TCM patterns well to obtain the independent groups of patterns.The main study results were ap-proved,because the leading three incidence rates of patterns including blood stasis pattern and damp heat pattern.