糖尿病肾病分期证候分布与聚类分析探索

目的:基于疾病分期,探索糖尿病肾病(DN)中医证候分布规律和研究方法,为进一步研究该病的病因病机及证候特点提供依据。方法:按照量表的制作方法,制定DN中医证候问卷,对180例患者进行了分层、横断面调查,对所得数据进行频数统计和聚类分析。结果:Ⅲ期以气虚、阴虚表现多见,兼有内热、血瘀、痰湿;Ⅳ期在Ⅲ期基础上出现了血虚、阳虚,还可兼有热结、湿浊表现。V期本虚更甚,还可兼有气滞、郁热等多种表现。对症状条目进行聚类分析,得到8种证候组合。结论:DN中医证候具有本虚标实的特点,血瘀证贯穿病程始终,证素组合多样,应用聚类分析方法具有可行性。

The Distribution of Stage-based TCM Syndromes of Diabetic Nephropathy and Cluster Analysis Exploration

Objective ：To explore the distribution of TCM syndromes and research methodology of diabetic nephropathy （DN） based on stage of disease, in order to further discover its etiology and pathogenesis and provide the basis for the syndrome characteristics. Methods：According to the methods of scale making, we developed DN TCM questionnaire, and performed a layered, cross-sectional survey on 180 cases of patients, dealt data with the frequency and cluster analysis. Results：The major syndromes of stage m is Qi and Yin deficiency, combined with heat, blood stasis, phlegm ; IV stage emerges Blood and Yang deficiency on top of stage m, adding the combi- nation of heat accumulating and turbid dampness. Stage V original deficiency becomes more serious, plus Qi stagnation and stagnation heat. Cluster analyses of symptoms got 8 clusters of combinations. Conclusion：DN＇ s TCM syndromes is characterized by deficiency in origin and excess in superficiality, blood stasis throughout the whole course of the disease, with multiple combinations. The application of cluster analysis method is feasible.