高龄女性不孕症患者中医证型分布聚类分析研究

A study on cluster analysis of the distribution of TCM syndromes in elderly patients with infertility

目的:探讨高龄不孕症女性临床中医证型分布规律,旨在为高龄女性临床辨证论治提供参考依据。方法:收集高龄不孕症患者432例,采用自拟《高龄不孕症女性四诊信息采集表》进行一般情况及四诊信息的调查,基于聚类分析探讨高龄不孕症女性中医证候规律。结果:对432例高龄不孕症女性患者进行四诊信息问卷调查,主要临床症状体征表现以经行腹痛、经色紫黯夹血块、腰膝酸软、脉弦最为常见,其次脉细、经量过少、脉沉、乳房胀痛、腹痛、经量时多时少、舌紫黯、神疲乏力、苔黄、月经后期、食少纳呆、眠差、五心烦热等症状体征也较为常见;聚类分析显示证型分布比例为血瘀肝郁证(27.31%)、血瘀肾阴虚证(25.93%)、血瘀肾气虚证(25.00%)、肾气虚肝郁证(21.76%)。结论:高龄女性不孕症临床症状复杂,以肾虚、血瘀为基本病机特点,兼夹肝郁、气质、阴虚;证型表现为复杂的本虚标实证,虚证以肾气虚、肾阴虚为主,实证以血瘀、肝郁为主。

Objective:To investigate the distribution pattern of clinical TCM syndromes in elderly patients with infertility,and provide reference for the clinical differentiation treatment of elderly women.Methods:432 elderly infertile patients were collected.General information and Sizhen(四诊)were detected by a questionnaire survey.Based on the cluster analysis,TCM syndromes were analyzed.Results:432 female infertile were surveyed by Sizhen questionnaires.The main clinical symptoms and signs were abdominal pain,blood clots by colorimerism and so on.The cluster analysis showed that the proportion of syndromes was the Xueyu Ganyu syndrome(血瘀肝郁证)(27.31%),the Xueyu Shenyinxu syndrome(血瘀肾阴虚证)(25.93%),the Xueyu Shenqixu syndrome(血瘀肾气虚证)(25.00%)and the Shenqixu Ganyu syndrome(肾气虚肝郁证)(21.76%).Conclusion:Clinical symptoms in infertile women are complicated.The main pathogenesis was Shenxu(肾虚),Xueyu(血瘀)and Ganyu(肝郁),Yinxu(阴虚).The syndromes are complex syndromes of Benxu Biaoshi(本虚标实证).