解放军医药杂志
解放軍醫藥雜誌
해방군의약잡지
Medical & Pharmaceutical Journal of Chinese People's Liberation Army
2015年
9期
30-33
,共4页
孟庆扬%马建伟%董静%魏汉林%马新英%支艳
孟慶颺%馬建偉%董靜%魏漢林%馬新英%支豔
맹경양%마건위%동정%위한림%마신영%지염
2型糖尿病%血脂异常%辨证分型%聚类分析
2型糖尿病%血脂異常%辨證分型%聚類分析
2형당뇨병%혈지이상%변증분형%취류분석
Diabetes mellitus%type 2%Dyslipidemias%Syndrome differ classification%Cluster analysis
目的 探讨2型糖尿病合并血脂异常中医证素特点及辨证分型情况. 方法 采集313例2型糖尿病合并血脂异常患者的四诊信息,将探索性因子分析与R型聚类分析方法相结合,对48项变量进行非线性降维研究,并运用证素辨证体系对2型糖尿病合并血脂异常中医证素特点及辨证分型规律进行研究分析. 结果 证素辨证学研究结果得出本组313例2型糖尿病合并血脂异常病位证素10项,病性证素14项,其中病位证素主要涉及肾、肝、脾,病性证素主要涉及阴虚、阳虚、气虚、痰;采用因子分析、聚类分析,共提取出18个公因子,总结出5类中医证候群,结合中医证素辨证学、临床知识及专家讨论后,将5类证候群归为5种中医证型:肾阳气虚证、肝肾阴虚夹湿热证、胃气滞证、脾肾阴阳两虚夹心气血虚证、气滞血瘀证. 结论 研究表明,2 型糖尿病合并血脂异常是本虚标实、虚实夹杂之病,且累及肾肝脾三脏,治疗时应多运用补虚、化痰、祛瘀等法;因子分析、聚类分析等多元统计方法可与证素辨证体系相结合应用于2型糖尿病合并血脂异常中医证型分析,为该病证候客观化、辨证准确化提供可行方法,但其结果仍需与临床实际相结合.
目的 探討2型糖尿病閤併血脂異常中醫證素特點及辨證分型情況. 方法 採集313例2型糖尿病閤併血脂異常患者的四診信息,將探索性因子分析與R型聚類分析方法相結閤,對48項變量進行非線性降維研究,併運用證素辨證體繫對2型糖尿病閤併血脂異常中醫證素特點及辨證分型規律進行研究分析. 結果 證素辨證學研究結果得齣本組313例2型糖尿病閤併血脂異常病位證素10項,病性證素14項,其中病位證素主要涉及腎、肝、脾,病性證素主要涉及陰虛、暘虛、氣虛、痰;採用因子分析、聚類分析,共提取齣18箇公因子,總結齣5類中醫證候群,結閤中醫證素辨證學、臨床知識及專傢討論後,將5類證候群歸為5種中醫證型:腎暘氣虛證、肝腎陰虛夾濕熱證、胃氣滯證、脾腎陰暘兩虛夾心氣血虛證、氣滯血瘀證. 結論 研究錶明,2 型糖尿病閤併血脂異常是本虛標實、虛實夾雜之病,且纍及腎肝脾三髒,治療時應多運用補虛、化痰、祛瘀等法;因子分析、聚類分析等多元統計方法可與證素辨證體繫相結閤應用于2型糖尿病閤併血脂異常中醫證型分析,為該病證候客觀化、辨證準確化提供可行方法,但其結果仍需與臨床實際相結閤.
목적 탐토2형당뇨병합병혈지이상중의증소특점급변증분형정황. 방법 채집313례2형당뇨병합병혈지이상환자적사진신식,장탐색성인자분석여R형취류분석방법상결합,대48항변량진행비선성강유연구,병운용증소변증체계대2형당뇨병합병혈지이상중의증소특점급변증분형규률진행연구분석. 결과 증소변증학연구결과득출본조313례2형당뇨병합병혈지이상병위증소10항,병성증소14항,기중병위증소주요섭급신、간、비,병성증소주요섭급음허、양허、기허、담;채용인자분석、취류분석,공제취출18개공인자,총결출5류중의증후군,결합중의증소변증학、림상지식급전가토론후,장5류증후군귀위5충중의증형:신양기허증、간신음허협습열증、위기체증、비신음양량허협심기혈허증、기체혈어증. 결론 연구표명,2 형당뇨병합병혈지이상시본허표실、허실협잡지병,차루급신간비삼장,치료시응다운용보허、화담、거어등법;인자분석、취류분석등다원통계방법가여증소변증체계상결합응용우2형당뇨병합병혈지이상중의증형분석,위해병증후객관화、변증준학화제공가행방법,단기결과잉수여림상실제상결합.
Objective To investigate the characteristics of traditional Chinese medicine ( TCM) sydrome factors and syndrome differentiation types of type 2 diabetes mellitus ( T2DM) patients with dyslipidemia. Methods Informa-tions by four diagnostic methods of 313 T2DM patients with dyslipidemia were collected. The non linear dimension reduc-tion study was performed for 48 variates using exploratory factor analysis and type R cluster analysis, and the characteris-tics of TCM syndrome factors and syndrome differentiation types of T2DM patients with dyslipidemia were analyzed using the syndrome differentiation system. Results The result of syndrome differentiation system showed that there were 10 disease factors and 14 disease resistance syndrome factors in 313 T2DM patients with dyslipidemia, in which the disease factors mainly related to kidney, liver and spleen, and disease resistance syndrome factors mainly related to Yin deficien-cy, Yang deficiency, Qi deficiency and sputum. A total of 18 common factors were gotten by factor and clustering analy-ses, and 5 types of TCM syndromes bases were summed up, and then the 5 types were classified as 5 kinds of TCM syn-dromes combined with TCM syndrome differentiation system, clinical knowledge and experts discussions, which were the deficiency of the kidney-yang Qi syndrome, deficiency of liver and kindey-yin accompanied with damp heat syndrome, Qi depression of stomach, deficiency of spleen and kidney yin and yang with Qi-blood deficiency of heart, and Qi stagnation and blood stasis. Conclusion Type 2 diabetes mellitus patients with dyslipidemia is a disease which is asthenia in origin and asthenia in superficiality and asthenia-sthenia zheng complications. This disease is related to the kidney, liver and spleen, so the treatment should be more use of therapeutic methods such as tonify,eliminating phlegm and eliminating stagnation . Multivariate statistical methods such as factor analysis and cluster analysis can be combined with the syndrome differentiation system to analyze the TCM syndrome types of T2DM patients with dyslipidemia, so it may provide a feasible method for achieving the objective and accurate syndrome differentiation, but the results still need to be combined with clinical practice.
