公因子和聚类分析联合在肝炎后肝硬化证候分类研究中的应用

目的:探讨联合应用因子分析与系统聚类分析方法在研究中医证候分类中的实际意义,为肝炎后肝硬化证候分类提供科学依据.方法:根据肝炎后肝硬化的临床特点及中医临床四诊信息采集的基本要求,用临床流行病学调查的方法,采集310例肝炎后肝硬化患者症状、体征、舌象、脉象等中医四诊信息;应用公因子分析、方差最大化正交旋转与系统聚类相结合的方法进行统计学处理.结果:肝炎后肝硬化的中医证型分可为7个类别:湿热内蕴型55例,湿盛脾虚型74例,瘀血阻络、肝肾阴虚型73例,血瘀湿阻、气阴两虚型40例,气阴两虚型(单纯)16例,阴虚血热型6例及肝郁脾虚型23例.以上共计287例,占全部调查病例的92.58%.其余23例由于中医四诊信息量的限制(属"无症可辨")而难以进行证型分类.结论:公因子分析和聚类分析统计方法的结合应用,能对中医四诊信息较好地进行证型的客观分类,能在一定程度上揭示肝炎后肝硬化的中医证型特点,在中医证候研究中具有一定的应用价值.

Combined use of factor analysis and cluster analysis in classification of traditional Chinese medical syndromes in patients with posthepatitic cirrhosis

Objective: To explore the significance of the combination of factor analysis and systematic cluster analysis in classification of trad itional Chinese medical syndromes in patients with posthepatitic cirrhosis, and to provide a scientific basis for the criterion of the classification. Methods: We designed a clinical questionnaire according to the clinic al characteristics and the demands of traditional Chinese medical information collection for patients with posthepatitic cirrhosis. By means of clinical ep idemiological research, with the four diagnosis methods for clinical information collection of traditional Chinese medicine, symptoms, physical signs, tongue co nditions and pulse conditions in 310 patients with posthepatitic cirrhosis were collected, and the characteristics of traditional Chinese medical syndromes in these patients were explored with statistical methods, such as factor analysi s, varimax and systematic cluster analysis. Results: Analyzed by fac tor analysis and systematic cluster analysis with SPSS 11.0, the traditional Chi nese medical syndromes in 287 of the 310 cases (92.58%) of posthepatitic cirrhos is could be classified. The syndromes could be divided into 7 categories, wh ich were internal accumulation of damp-heat (55 cases), insufficiency of the sp leen with overabundance of dampness (74 cases), accumulation of blood stasis plu s deficiency of liver-yin and kidney-yin (73 cases), accumulation of blood sta sis plus deficiency of both blood and qi (40 cases), deficiency of both bloo d and qi (16 cases), deficiency of yin and blood heat (6 cases) and stagnation o f the liver-qi and deficiency of the spleen (23 cases). The traditional Chi nese medical syndromes in the other 23 cases could not be classified. Conclusions: The clinical information collected with the four diagnostic methods of traditional Chinese medicine can be classified into different cat egories with the factor analysis and systematic cluster analysis. The factor analysis and systematic cluster analysis can reveal the characteristics and r egularity of traditional Chinese medical syndromes in patients with posthepati tic cirrhosis in a way, and have value in researching the syndromes of t raditional Chinese medicine.