运用因子分析法探索脑卒中后吞咽障碍的证候要素规律

A study on TCM syndrome elements of dysphagia after stroke based on factor analysis

目的:探讨脑卒中后吞咽功能障碍的四诊证候要素,为该病的中医病因病机的明确及其辨证临床诊治提供数据支持。方法:设计前瞻性观察方案,采用专门设计制定的脑卒中后吞咽障碍中医证候观察的量表,对224例纳入研究调查的吞咽障碍患者实施数据采集,通过频数分析及因子分析的统计方法进行证侯要素的提取,最后归纳出脑卒中后吞咽障碍疾病的中医证候要素分布规律。结果:因子分析提取6个证候要素作为公因子,综合分析观察对象的证候要素,其中包括虚证,气虚,痰浊,阴虚,血瘀,阳虚。中医认为脑卒中后吞咽障碍属"喉痹""舌喑""中风舌本病""喑痱""喉喑"等病名,病位在脑,病症在咽喉,涉及脏腑主要脾、肝、肾三脏,次为心,病机为本虚标实,本虚主要为(脾)气虚,标实主要为血瘀、痰浊,故多以补虚、化痰等立法诊治。结论:运用因子分析法对吞咽功能障碍进行中医证候要素进行数据的分析研究是可行而有价值的,可深入的剖析证候的的分布特点及规律,揭示疾病的病因病机及证候学特点,为疾病的的辨证施治提供证据支持。

Objective:To investigate the syndrome elements of dysphagia after stroke to provide objective evidence for syndrome differentiation and treatment.Methods:A prospective observation was designed and TCM syndrome scale in dysphagia after stroke.By gathering information of the standardized four methods of diagnosis,a total of 224 patients with dysphagia after stroke were included by multi-center collaboration.Characteristics of TCM syndrome factors distribution were summarized and discussed by frequency analysis and factor analysis.Results:6 common factors(syndrome factors)were acquired by the factor analysis.The distribution of syndrome factors among Qixu(气虚),Tanzhuo(痰浊),Yinxu(阴虚),Xueyu(血瘀),and Yangxu(阳虚).The location of dysphagia after stroke is brain,the disease is in the throat,and were involved in the spleen,liver,kidney,and then heart.Conclusion:It is feasible and valuable of factor analysis to analyze the TCM symptom elements of dysphagia after stroke.It can deeply analyze the distribution characteristics and laws of symptoms,reveal the etiology,pathogenesis and syndrome characteristics of the disease,to provide evidence support for the differential treatment.