老年性骨质疏松症中医证候分布规律研究

Study on the Distribution of Traditional Chinese Medicine Syndrome Types in Patients with Senile Osteoporosis

【目的】通过对179例无锡地区老年性骨质疏松症患者的中医证候进行聚类分析,找寻其中医证候分布的特点和规律。【方法】选择2014年1月~2015年1月在无锡市中医医院就诊的179例老年性骨质疏松症患者作为研究对象,首先把相关证候进行系统变量聚类分析,再进行主成分分析,最后归纳出证型。【结果】(1)纳入研究的老年性骨质疏松症的证候条目共53条,其中腰膝酸软、腰背刺痛、神疲乏力、齿摇发脱、纳呆食少等出现频率较高,分别为59.78%(107/179)、56.42%(101/179)、52.51%(94/179)、45.81%(82/179)、41.34%(74/179)。(2)聚类分析及主成分分析结果显示,聚为脾肾阳虚证、气虚血瘀证、肝肾阴虚证和肾精不足证等4型,分布较清晰,比较符合临床实际。【结论】无锡地区老年性骨质疏松症可分为脾肾阳虚证、气虚血瘀证、肝肾阴虚证和肾精不足证等4个证型,病机以虚证、瘀证为主,病位在肾、脾、肝。

Objective The traditional Chinese medicine(TCM)syndromes of 179 senile osteoporosis patients in Wuxi area were investigated by cluster analysis,so as to find out the characteristics and rules of TCM syndrome distribution in senile osteoporosis patients.Methods A total of 179 cases of senile osteoporosis patients admitted to Wuxi Traditional Chinese Medicine Hospital from January 2014 to January 2015 were enrolled into the analysis.The relevant syndromes as the variables were firstly clustered and then were analyzed by principal component analysis to obtain the classification of syndrome types.Results(1)A total of 53 syndrome elements for senile osteoporosis patients were included in the analysis.Among them,lumbar and knee aching,lumbar back pricking pain,lassitude and weakness,loosen teeth and loss of hair,and anorexia and poor appetite had the higher occurrence rate,which accounted for 59.78%(107/179),56.42%(101/179),52.51%(94/179),45.81%(82/179),and 41.34%(74/179)respectively.(2)The results of cluster analysis and principal component analysis showed that the senile osteoporosis was mainly differentiated as spleen and kidney yang deficiency syndrome,qi deficiency and blood stasis syndrome,liver and kidney yin deficiency syndrome and kidney essence deficiency syndrome,which accords with the clinical practice.Conclusion The senile osteoporosis in Wuxi area can be differentiated as 4 syndrome types of spleen and kidney yang deficiency syndrome,qi deficiency and blood stasis syndrome,liver and kidney yin deficiency syndrome and kidney essence deficiency syndrome.The pathogenesis of senile osteoporosis in Wuxi area is characterized by deficiency and blood stasis,and the disease mainly affects the kidney,spleen and liver.