慢性乙型肝炎中医证候聚类分析研究

目的探讨四川地区慢性乙型肝炎中医证候规律，为该病的中医客观化研究提供参考依据。方法采用横断面研究方法，根据课题组前期制定的慢性乙型肝炎中医证候规律研究病例报告表，记录四川地区8家子课题临床单位收集的1064例慢性乙型肝炎患者的四诊信息，运用K—means聚类分析的方法，探索慢性乙型肝炎证候特征规律。结果利用K-means聚类分析对1064例慢性乙型肝炎患者中医证候进行研究，结合专业知识，经专家讨论后，最终确定8类切合临床的证型，由多到少依次为脾胃湿热（326例，30．6％）、肝胆湿热（193例，18．1％）、肝脾湿热（158例，14．8％）、肝郁脾虚（92例，8．6％）、肝郁化热（89例，8．4％）、脾虚湿困（74例，7．0％）、湿热夹肝肾阴虚（73例，6．9％）及阳虚夹血瘀证（59例，5．5％）。结论四川地区慢性乙型肝炎的主要证型为脾胃湿热、肝胆湿热、肝脾湿热、肝郁脾虚、肝郁化热、脾虚湿困、湿热夹肝肾阴虚及阳虚夹血瘀证。

Cluster Analysis on TCM Syndrome Characteristics of Chronic Hepatitis B

Objective To explore the characteristics of Chinese medicine （CM） syndromes of chronic hepatitis B （CHB） in Sichuan area, thus providing referential evidence for objective research of CHB. Methods According to the CRF chart, 1 064 CHB patients＇ four diagnostic information from 8 clinical units were recorded in Sichuan region using cross-sectional method. The laws of CHB syndrome character- istics were explored using the K-means clustering analysis method. Results Based on the K-means clus- ter analysis, we found 8 categories that fulfill the clinical practice combined professional knowledge with experts＇ opinions. They were Pi-Wei dampness heat （326 cases,30.6%）, Gan and gallbladder dampness heat （193 cases, 18.1%）, Gan and Pi dampness heat （158 cases, 14.8%）, Gan depression and Pi defi- ciency （92 cases,8.6%）, Gan depression transforming into heat （89 cases, 8.4%）, Pi deficiency with dampness encumbrance （74 cases ,7.0% ）, dampness-heat combined with yin deficiency of Gan and Shen （73 cases,6.9%）, yang deficiency mingled with blood stasis （59 cases,5.5%）. Conclusion The results of cluster analysis showed Pi-Wei dampness heat, Gan and gallbladder dampness heat, Gan and Pi damp- ness heat, Gan depression and Pi deficiency, Gan depression transforming into heat, Pi deficiency with dampness encumbrance, dampness-heat combined with yin deficiency of Gan and Shen, yang deficiency mingled with blood stasis were mainly syndromes of CHB patients in Sichuan area.