采用聚类分析和对应相关方法研究1069例冠心病心绞痛证候应证组合规律

目的:研究聚类分析和对应相关方法对1 069例冠心病心绞痛的69个症状进行分类研究和证候要素组合规律。方法:在五家医院多中心、大样本收集1 069例经冠脉造影证实的冠心病心绞痛患者,记录中医四诊信息,运用聚类分析和对应相关方法进行分类研究和证候要素组合规律研究。结果:运用聚类的方法把1069例冠心病心绞痛的69个症状聚成6类,经中医专家辨证第1类心肾阴阳俱虚、第2类气虚血瘀、第3类肝气郁结、第4类脾气虚弱、第5类痰瘀互阻、第6类气虚。应用对应相关分析方法得出血瘀和痰浊之间的关系最为密切,其次依次为气虚和血瘀,气虚和痰浊,气虚和肝虚,气虚和阴虚等关系较紧密。从图表可知气虚、血瘀和痰浊位于所有症状和证候的中心,初步推断气虚、血瘀和痰浊是冠心病心绞痛的核心病机。结论:气虚、血瘀和痰浊是冠心病心绞痛的主要病机,此外再兼加阴虚、肝虚可以覆盖85%以上的病人。

Study on rule of syndrome combination of 1069 cases of angina pectoris by cluster analysis and corresponding-correlation methed

Objective: To study categorization rule of syndrome combination of 1069 cases of angina pectoris whose 69 symptoms were recorded by cluster analysis and corresponding-correlation analysis.Methods: In five hospitals,1069 cases of angina pectoris were collected,information of patients from four diagnostic methods was recorded,and then cluster analysis and corresponding-correlation analysis were applied to study rule of syndrome combination.Results:69 symptoms of 1069 cases of angina pectoris were divided into six types by cluster analysis and corresponding-correlation analysis: the first type was deficiency of both yin and yang of heart and kidney,the second type blood stasis due to deficient qi,the third type was stagnation of liver qi,the fourth type was deficiency of spleen qi,the fifth type was intermingled phlegm and blood stasis,the sixth type was qi deficiency.Blood stasis had the closest relation with phlegm,then in order qi deficiency and blood stasis,qi deficiency and phlegm,qi deficiency and hepatic asthenia,qi deficiency and yin deficiency.According to figure 1,qi deficiency,blood stasis and phlegm located in center of all symptoms and syndromes,so it can be concluded that qi deficiency,blood stasis and phlegm were key pathogenesis of angina pectoris of CAD,Conclusion: Qi deficiency,blood stasis and phlegm were key pathogenesis of angina pectoris,plus yin deficiency and hepatic asthenia,which of 85% patients can be included.