132例缺血性糖尿病足溃疡患者局部病变的中医证候特征

Characteristics of Traditional Chinese Medicine Syndromes of Local Lesions in 132 Patients with Ischemic Diabetic Foot Ulcer

目的 探讨缺血性糖尿病足溃疡患者局部病变中医证候特征。方法 回顾性收集132例患者缺血性糖尿病足溃疡的32项症状体征指标数据,统计其出现的频数及百分比。采用因子分析法进行分析降维、归类处理。结果 32项指标中趺阳脉消失的出现频率最高(100%),出现频率≥50%的症状体征依次为足部麻木(69.7%)、皮肤温度低(56.8%)、皮肤少华干燥脱屑(53.8%)。因子分析按照公共因子特征值大于1、且旋转后累计方差贡献率在80%以上的标准,确定为公共因子的个数是前6个,旋转后因子载荷平方和累积为93.466%。提炼出6个公共因子,第一公共因子主要反映湿热变量的信息,解释了原变量27.908%的信息;第二公共因子主要反映热毒变量的信息,解释了原变量27.333%的信息;第三公共因子主要反映湿邪困阻变量的信息,解释了原变量17.523%的信息;第四公共因子主要反映气血两亏变量的信息,解释了原变量10.856%的信息;第五公共因子主要反映寒邪凝滞变量的信息,解释了原变量5.656%的信息;第六公共因子主要反映血瘀变量的信息,解释了原变量4.191%的信息。结论 缺血性糖尿病足溃疡的局部证候可以归结为湿热证、热毒证、湿阻证、气血两亏证、寒凝证、血瘀证6类基本证型。

Objective To explore the characteristics of traditional Chinese medicine(TCM) syndrome of local lesions in patients with ischemic diabetic foot ulcer.Methods The data of 32 symptoms and signs specific to ischemic diabetic foot ulcers in 132 patients were retrospectively collected,and the frequency and percentage were counted.Factor analysis was performed for dimensionality reduction and classification.Results Among the 32 symptoms and signs,disappearance of instep yang pulse was most frequent(100%),and numbness of feet(69.7%),low skin temperature(56.8%),and withering dry skin with desquamation(53.8%) were those having a frequency no less than 50%.With the rule of eigenvalue of the common factor greater than one and the cumulative variance contribution rate after rotation more than 80% in the factor analysis,the prime factors of 6 was determined to be the common factors,and the cumulative sum of squared factor loadings after rotation was 93.466%.Six common factors were obtained,of which the first one mostly reflected the information of damp-heat variables,accounting for27.908% of the original variables.The second common factor mainly described the information of heat toxin variables,while the third factor reflected the pathogenic damp obstruction variables,accounting for 27.333% and17.523% of the original variables,respectively.The fourth to sixth common factor separately reflected the information of qi-blood depletion,pathogenic cold coagulation,and blood stasis,explaining 10.856%,5.656% and4.191% of the original variables,respectively.Conclusion The local syndromes of ischemic diabetic foot ulcer can be classified into six types,including damp-heat syndrome,heat toxin syndrome,damp obstruction syndrome,qi-blood depletion syndrome,cold coagulation syndrome and blood stasis syndrome.