基于聚类与因子分析探讨女性乳腺良性结节中医证候规律

Discussion on Medication Law of TCM Syndrome of Female Benign Breast Nodules Based on Clustering Analysis and Factor Analysis

目的 研究女性乳腺良性结节中医证候要素和证候类型分布规律。方法 采用多中心横断面研究方法,前瞻性收集女性乳腺良性结节患者乳腺症状、月经情况、中医症状、体征及舌脉等四诊信息,基于聚类分析和因子分析探讨女性乳腺良性结节中医证素特点和证候分布规律。结果 共收集419例女性乳腺良性结节相关资料,筛选得到27个核心条目。系统聚类结果涉及证候要素9项,包括病性证素气滞、阳虚、痰、气虚、血瘀,病位证素肝、肾、脾、胞宫。K-means聚类得到3类证候,第一类为冲任失调证,第二类为痰瘀互结证,第三类为肝郁气滞证,其中肝郁气滞证占比最高(51.1%),其次为冲任失调证(33.2%)、痰瘀互结证(15.7%)。因子分析证候要素结果根据病性证素和病位证素划分为气滞、阳虚、痰、气虚、血瘀,以及肝、肾、脾、胞宫。结论 女性乳腺良性结节的基本证候分布规律主要是:证候要素中病位证素为肝、肾、脾、胞宫,病性证素为气滞、痰、血瘀、气虚、阳虚;主要的证候类型为肝郁气滞证、冲任失调证和痰瘀互结证,肝郁气滞证是最常见的证候类型。

Objective To study the TCM syndrome elements and syndrome types of female benign breast nodules.Methods This study was a multi-center cross-sectional study.The information of breast symptoms,menstruation,TCM symptoms and signs and tongue and pulse were retrospectively collected from female patients with benign breast nodules.Based on clustering analysis and factor analysis,the characteristics of TCM syndrome elements and syndrome distribution of benign breast nodules were discussed.Results Totally 419 female patients with benign breast nodules were selected and 27 core items were obtained.The systematic clustering results involved 9 syndrome elements,including disease syndrome elements:qi stagnation,yang deficiency,phlegm,qi deficiency,blood stasis,and disease location syndrome elements:liver,kidney,spleen,and uterus.There were three types of syndromes in K-means clustering.The first type was the syndrome of chong-ren disorder,the second type was the syndrome of mutual accumulation of phlegm and blood stasis,and the third type was the syndrome of liver depression and qi stagnation.Among them,the syndrome of liver depression and qi stagnation accounted for the largest proportion(51.1%),followed by the syndrome of chong-ren disorder(33.2%),and the syndrome of mutual accumulation of phlegm and blood stasis(15.7%).According to the result of factor analysis,the syndrome elements were divided into qi stagnation,yang deficiency,phlegm,qi deficiency,blood stasis,liver,kidney,spleen and uterus.Conclusion The distribution of basic syndromes of female benign breast nodules is mainly as follows:the syndrome elements of disease location are liver,kidney,spleen and uterus,and the syndrome elements of disease are qi stagnation,phlegm,blood stasis,qi deficiency and yang deficiency.The main syndrome types are liver depressions and qi stagnation syndrome,chong-ren disorder syndrome and mutual accumulation of phlegm and blood stasis syndrome,and the syndrome of liver depression and qi stagnation is the most common type.