基于因子分析和隐结构探讨纤维化性间质性肺疾病的症—证规律

Study on syndrome pattern of fibrotic interstitial lung disease based on factor analysis and implicit structure

目的探讨纤维化性间质性肺疾病(fibrosing interstitial lung disease,F-ILD)症—证规律,为阐明本病病机提供参考。方法通过制定的“F-ILD患者中医四诊信息采集表”采集F-ILD患者的四诊信息,采用频数统计、关联规则筛选出F-ILD核心症状群。随后运用因子分析方法进行公因子提取、隐结构模型构建隐结构,并比较两种结构模型得到的病位证素、病性证素分布。结果F-ILD条目池中共包括124个四诊信息条目,运用频数统计及关联规则算法最终得到F-ILD的核心症状群,共包括活动后气短、咳痰、咳嗽、口燥咽干、乏力、苔白、脉细、脉滑、脉弦、胸闷、痰粘难咯、痰色白、痰少、畏寒怕冷。通过因子分析、隐结构模型两种方法构建的F-ILD证素分布基本相同,包括气虚、阴虚、阳虚等病性证素;心、肺、脾等病位证素。结论F-ILD病机复杂,非一脏一腑之因,常累及多脏,多为虚实夹杂、标实本虚,可进一步为本病的中医认知、立法用药提供参考。

Objective To explore the law of syndrome elements,the core symptom of fibrotic interstitial lung disease(F-ILD),and to provide reference for clarifying the pathogenesis of the disease.Methods The information of tongue and pulse symptoms of patients with fibrotic interstitial lung disease was collected clinically,and the four diagnostic information item pool was constructed;the“four diagnostic information collection table of traditional Chinese medicine(TCM)for patients with F-ILD”was designed,including general data,symptoms,tongue and pulse.The core symptom groups of fibrotic interstitial lung disease were selected by data mining methods such as frequency statistics and association rules.Two different statistical methods such as factor analysis and implicit structure model were used to construct and analyse the similarities and differences of the distribution of pathogenic factors of the disease location.Results There were 124 items of four diagnostic information in the item pool of fibrotic interstitial lung disease,including 60 items with a frequency of more than 10%;the basic symptoms of pulmonary fibrosis,including Qi deficiency syndrome and pharyngeal fibrosis syndrome,were analyzed by using the algorithm of the same distribution of the two core diseases,including Qi deficiency syndrome and interstitial fibrosis syndrome;syndrome elements of heart,lung and spleen.Conclusion Fibrotic interstitial lung disease belongs to“pulmonary flaccidity”,and its pathogenesis is complex.It is not the cause of one viscera.It involves multiple viscera and is mostly mixed with deficiency and excess,which can further provide references for TCM cognition,legislation and medication of this disease.