400例更年期综合征临床证候辨证标准现场调查分析

目的 通过更年期综合征的临床流行病学调查，探讨临床证候辨证标准研究的思路和方法。方法 采用DME(design measurement evaluation)设计方法对400例更年期综合征的现场调查资料进行盲法的统计学处理和分析，采用因子分析和结构方程模型，研究本病的证候分布及各证所包含的四诊信息及实验室检测指标。结果 更年期综合征的证型可归为肝阳上亢证、肾阳亏虚证、肝肾阴虚证、肝郁伤神证。结论 病证辨证标准研究的思路是在回顾性研究的基础上确定病中证的假设辨证标准进行现场调查，采用聚类分析、因子分析、临界理论确定病中证类分布及临界证、典型证、兼夹证、鉴别诊断指标，制订新的辨证标准。

Investigation and Analysis on Diagnostic Standard for TCM Syndrome Differentiation in 400 Patients with Climacteric Syndrome

OBJECTIVE: To explore the thinking and method of studying the diagnostic standard for TCM Syndrome Differentiation by means of clinical epidemiological investigation on climacteric syndrome. METHODS: Adopting DME (design measurement evaluation), the field investigation data of 400 patients with climacteric syndrome were statistically managed and analyzed using blind method. The distribution of syndromes, including information of four-diagnosis of various syndromes as well as the laboratory findings in patients were studied using factor analysis and model of structural equation. RESULTS: The Syndrome types of climacteric syndrome were identified as the Gan-Yang exuberance type, the Shen-Yang deficiency type, the Gan-Shen Yin-deficiency type and the Gan-stagnancy injuring Spirit type. CONCLUSION: Thinking of the diagnostic standard study for TCM Syndrome Differentiation is to identify the supposed diagnostic standard of a disease based on retrospective study, to formulate a new hypothetical standard of Syndrome by way of field investigation, category analysis, factor analysis, and critical theory, followed with identification of Syndrome distribution in the disease, its critical syndrome, typical syndrome, complicated syndrome, and criteria for Syndrome Differentiation.