基于聚类分析和因子分析的前列腺癌中医证候研究

Research on traditional Chinese medicine syndromes in prostate cancer based on cluster and factor analysis

目的分析前列腺癌患者的中医证候分布特点,为中医治疗前列腺癌提供参考。方法收集228例前列腺癌患者的中医四诊信息,运用主成分分析法对选取的条目进行因子分析,并结合证候要素判定标准确定前列腺癌的中医证候要素特点,再应用系统聚类分析法对条目进行聚类分析,探索前列腺癌的中医证候分布规律。结果(1)排名前10位的症状、体征为尿频、潮热盗汗、大便干结、腰膝酸软、头晕、尿急、畏寒肢冷、神疲乏力、失眠、便秘。(2)聚类分析结果显示,前列腺癌中医证候以脾肾两虚证占比最多(29.82%),其余依次为肾虚瘀阻证(21.49%)、气阴两虚证(20.61%)、气血亏虚证(20.18%)、气滞血瘀证(7.89%)。(3)因子分析结果显示,前列腺癌病性证素为气虚、阳虚、阴虚、血瘀、血虚、湿热,病位证素为肾、脾、肝、脑、心。结论前列腺癌的病位涉及肾、脾、肝、脑、心,多属虚实夹杂、本虚标实之证;临床可分为脾肾两虚证、肾虚瘀阻证、气阴两虚证、气血亏虚证、气滞血瘀证,其中脾肾两虚证占比较高。

Objective To investigate the distribution characteristics of traditional Chinese medicine(TCM)syndromes in patients with prostate cancer,providing reference for TCM treatment of prostate cancer.Methods TCM four diagnostic information of 228 prostate cancer patients was collected.Principal component analysis was used for factor analysis of selected items.The characteristics of TCM syndrome elements in prostate cancer were determined based on syndrome element determination criteria.Systematic cluster analysis was then applied to the items to explore the distribution pattern of TCM syndromes in prostate cancer.Results①The top ten symptoms and signs were frequent urination,tidal fever with night sweats,dry stools,lumbar and knee soreness,dizziness,urgent urination,aversion to cold with cold limbs,fatigue,insomnia,and constipation.②Cluster analysis showed that the most common TCM syndrome in prostate cancer was spleen-kidney deficiency syndrome(29.82%),followed by kidney deficiency with static blockage syndrome(21.49%),qi-yin deficiency syndrome(20.61%),qi-blood deficiency syndrome(20.18%),and qi stagnation and blood stasis syndrome(7.89%).③Factor analysis results showed that the pathogenic syndrome elements of prostate cancer included qi deficiency,yang deficiency,yin deficiency,blood stasis,blood deficiency,and damp-heat,while the affected organs were the kidney,spleen,liver,brain,and heart.Conclusion Prostate cancer involves the kidney,spleen,liver,brain,and heart,often presenting with mixed deficiency and excess syndromes.Clinically,it can be categorized into spleen-kidney deficiency syndrome,kidney deficiency with static blockage syndrome,qi-yin deficiency syndrome,qi-blood deficiency syndrome,and qi stagnation and blood stasis syndrome,with spleen-kidney deficiency being the most prevalent.