193例持续性姿势-知觉性头晕患者中医证候研究

目的 通过因子分析探索持续性姿势-知觉性头晕（persistent postural-perceptual dizziness，PPPD）的中医证候特点。方法 采集193例PPPD病例症状、舌象、脉象，将每一症状、舌象、脉象作为一个统计变量，“有”则赋值为“1”、“无”则赋值为“0”，计算四诊信息的频数和频率，运用因子分析对高频症状、舌象及脉象进行非线性降维并提取公因子，得出病性、病位证素及中医证型并加以总结分析。结果 频率排名前3位症状的依次为头晕（90.67%）、心烦（54.40%）、倦怠乏力（51.30%），舌象中舌质频率最高者为舌质暗红（22.28%），舌苔频率最高者为白苔（31.09%），脉象频率最高者为滑脉（41.97%）。利用因子分析共提取13个公因子，累计贡献率为64.798%。整合相同的证素，共得到5个病性证素，依次是气滞（71.50%）、阴虚（24.35%）、血虚（22.28%）、气虚（17.10%）、痰湿（15.03%）；5个病位证素，依次是肝（93.26%）、肾（24.35%）、脾（16.58%）、心（0.52%）；6个中医证型，依次是肝郁气滞证（56.48%）、肝肾阴虚证（21.76%）、肝郁脾虚证（15.03%）、肾阴虚证（2.59%）、脾肾阴虚证（1.55%）、气血两虚证（0.52%）。结论 PPPD的病性证素以气滞为主，病位证素以肝为主，中医证型以肝郁气滞证为主。

Traditional Chinese Medicine Syndromes of Patients with Persistent Postural-Perceptual Dizziness: An Analysis of 193 Cases

Objective To investigate the traditional Chinese medicine (TCM) syndrome characteristics of persistent postural-perceptual dizziness (PPPD) by factor analysis. Methods The symptoms, tongue manifestations, and pulse manifestations were collected from 193 patients with PPPD, and each symptom, tongue manifestation, and pulse manifestation were included as a statistical variable, with a value of 1 for presence and a value of 0 for absence. The frequency of the information obtained by four diagnostic methods was calculated. Factor analysis was used to perform the non-linear dimension reduction of high-frequency symptoms, tongue manifestations, and pulse manifestations and extract the common factors, and the disease nature, syndrome elements of disease location, and TCM syndrome types were obtained, summarized, and analyzed. Results The top three symptoms in terms of frequency were dizziness (90.67%), vexation (54.40%), and fatigue/weakness (51.30%); as for the tongue nature in tongue manifestation, dark red tongue (22.28%) had the highest frequency, and as for the coating on the tongue, white tongue coating (31.09%) had the highest frequency; as for pulse manifestation, slippery pulse (41.97%) had the highest frequency. A total of 13 common factors were extracted by the factor analysis, with a cumulative contribution rate of 64.798%. Integration of the same syndrome elements obtained 5 syndrome elements reflecting the nature of disease, i.e., Qi stagnation (71.50%), Yin deficiency (24.35%), blood deficiency (22.28%), Qi deficiency (17.10%), and phlegm dampness (15.03%); 5 syndrome elements of disease location were obtained, i.e., liver (93.26%), kidney (24.35%), spleen (16.58%), and heart (0.52%); 6 TCM syndrome types were obtained, i.e., liver depression and Qi stagnation syndrome (56.48%), liver-kidney Yin deficiency syndrome (21.76%), liver depression and spleen deficiency syndrome (15.03%), kidney Yin deficiency syndrome (2.59%), spleen-kidney Yin deficiency syndrome (1.55%), and Qi-blood deficiency syndrome (0.52%). Conclusion Qi stagnation is the main syndrome element of PPPD reflecting the nature of disease, the liver is the main syndrome element of disease location, and liver depression and Qi stagnation syndrome is the main TCM syndrome type.