基于聚类分析和因子分析的肺小结节患者中医证候特点研究

目的分析肺小结节患者中医证候分布特点,为中医治疗肺小结节提供参考依据。方法收集385例肺小结节患者中医四诊信息,运用聚类分析、因子分析方法对肺小结节患者的中医证候特点和分布规律进行分析。结果肺小结节患者中医症状以虚为主,神疲乏力、夜寐不安、舌红、咳嗽、口渴、口干咽燥、面萎黄、气短、脉细弱、食少纳呆等居多。中医证候以肺脾气虚证最多,占52.2%,其余依次为肺阴亏虚证、气虚血瘀证、肝肾不足证。肺脾气虚证主症为喘息、大便稀溏、腹胀、食少纳呆、神疲乏力、自汗、舌淡红、齿痕舌、苔薄白、脉细弱,次症为夜寐不安、面萎黄;肺阴亏虚证主症为口干咽燥、口渴、咳嗽、痰少难咳、盗汗、痰中血丝、裂纹舌、苔少、脉细,次症为烦躁易怒、面红润、舌红;气虚血瘀证主症为头晕、胸痛、气短、面晦黯、舌黯红,次症为心悸;肝肾不足证主症为胸胁隐痛、喜太息、脉细弦、苔白、腰膝酸软、胸闷、耳鸣、便秘,次症为浮肿。结论肺小结节中医证候以肺脾气虚证、肺阴亏虚证、气虚血瘀证、肝肾不足证为主,正气亏虚是肺小结节变化发展的主要病机。

Study on Characteristics of TCM Syndromes of Small Pulmonary Nodules Based on Cluster Analysis and Factor Analysis

Objective To analyze the distribution characteristics of TCM syndromes in patients with small pulmonary nodule(SPN);To provide references for TCM treatment of SPN.Methods The clinical symptoms and tongue and pulse information of 385 patients with SPN were collected.The characteristics and distribution of TCM syndromes were analyzed through cluster analysis and factor analysis.Results The main symptoms of TCM were deficiency syndromes.Fatigue,restlessness,red tongue,cough,thirst,oropharynx drying,yellow face,shortness of breath,weak pulse,and eating less were the main symptoms.TCM syndromes were mainly lung-spleen qi deficiency syndrome,accounting for 52.2%,followed by lung-yin deficiency syndrome,qi deficiency and blood stasis syndrome,and liver-kidney deficiency syndrome.The primary symptoms of lung-spleen qi deficiency syndrome were wheezing,loose stool,abdominal distention,eating less,fatigue,sweating,pale red tongue,toothed tongue,thin white tongue fur and weak pulse,and secondary symptoms were restlessness,yellow face.The primary symptoms of lung-yin deficiency syndrome were oropharynx drying,thirst,cough,phlegm less difficult to cough,sweating,phlegm with blood,cracked tongue,thin white tongue fur,and weak pulse,and secondary symptoms were irritability,red face and red tongue.The primary symptoms of qi deficiency and blood stasis syndrome were dizziness,chest pain,shortness of breath,dull face,dark tongue,and secondary symptoms was palpitation.The primary symptoms of liver-kidney deficiency syndrome were chest pain,sighing,weak pulse,white tongue fur,soreness and weakness of waist and knees,chest tightness,tinnitus,constipation,and secondary symptom was edema.Conclusion TCM syndromes of SPN are mainly lung-spleen qi deficiency syndrome,lung-yin deficiency syndrome,qi deficiency and blood stasis syndrome,and liver-kidney deficiency syndrome.Deficiency of vital qi is the main pathogenesis of the development of SPN.