900例肝炎后肝硬化中医证候判别模式的研究

目的探索肝炎后肝硬化中医证候的证候判别模式。方法运用因子分析、C均值聚类和模糊综合评价对确诊为肝炎后肝硬化900例患者临床症状、体征等基本信息进行综合分析，提取该病的中医证候因子，建立证候判别式。结果证候分类：一类是该病的共有表征信息的相关因子，反映该病基本证候病机为气虚血瘀；5个证候分类有意义的因子为肝肾阴虚、湿热内蕴、瘀热内蕴、肝郁脾虚和脾肾气虚；并构建证候判别函数式。结论肝炎后肝硬化症状和体征信息经多元统计分析可划分为两大类，即疾病的共性特征信息和证候病机分类的特征信息。前者反映疾病所具有的中医基本病机，后者反映疾病的不同综合病理状态、即证候构成的复杂性、多态性。证候判别式为肝炎后肝硬化患者的证候判识的量化标准提供依据。

Study on the Patterns of TCM Syndrome Differentiation of 900 Patients with Posthepatitic Cirrhosis

ObjectiveTo investigate the formula for TCM syndrome pattern differentiation in patients with posthepatitic cirrhosis. MethodsFactors analysis, C mean clustering and fuzzy comprehensive assessment were used for analyzing the basic information, including clinical symptoms and signs, obtained from 900 patients with posthepatitic cirrhosis to establish the formula for syndrome pattern differentiation through collecting the syndromic factors. ResultsMultivariate statistic analysis showed the syndromic factors could be classified into two categories: the common characteristics related factors, which reflected the basic pathology of cirrhosis as qi deficiency and blood stasis, and the factors for differentiating 5 syndrome patterns (Gan-Shen yin-deficiency, dampness-heat accumulation, stasis-heat accumulation, Gan-qi stagnation with Pi-deficiency, and Pi-Shen qi-deficiency), which reflected the different pathological features of different syndrome patterns, showing the complexity and polymorphism of syndrome construction. And the functional formula for differentiating syndrome pattern was established. ConclusionThe differentiating formula of TCM syndrome pattern could provide a quantified criterion for syndrome pattern differentiation in posthepatitic cirrhosis patients.