基于聚类分析的病毒性心肌炎证候分类及证候特征研究

目的明确病毒性心肌炎的证候分类及证候特征。方法通过对201例病毒性心肌炎病例进行动态观察,建立病毒性心肌炎病例数据库。采用频数统计及聚类分析、交叉列联分析等数据挖掘方法,对病毒性心肌炎的证候进行归纳分析。结果病毒性心肌炎主要有8个证型。邪毒侵心证多见于急性期,辨证要点是发热,咳嗽,咽痛,或腹泻,心悸,苔黄,脉数;大气下陷证多见于迁延期和慢性期,辨证要点是气短,咽中拘急,胸中坠胀,神疲乏力,苔白,脉结代;痰阻心络证常见于迁延期和慢性期,辨证要点为胸闷,恶心呕吐,舌暗红,苔厚或腻,脉滑;心脾两虚证多见于迁延期和慢性期,辨证要点是心悸,气短,失眠多梦,纳少,神疲乏力,腹泻,舌淡苔白;气阴两虚证多出现在急性期和迁延期,也可见于慢性期,辨证要点为气短,神疲乏力,失眠多梦,盗汗,苔少或剥,脉细数;心血瘀阻证主要见于慢性期,辨证要点为心前痛,舌紫或暗红,脉弦;阴虚火旺证多见于迁延期,辨证要点为心悸,心烦,少寐多梦,手足心热,盗汗,苔少或剥,脉细数;阴阳两虚证主要见于慢性期,辨证要点为心动悸,气短甚,浮肿,舌紫或紫暗,脉沉迟或结代。结论运用聚类分析方法研究证候分类及证候特征有一定的科学性、实用性和可信性。

Study on Chinese Medical Pattern Classification and Characteristic of Viral Myocarditis by Cluster Analysis

Objective To study Chinese medical pattern classification and characteristic of viral myocarditis (VM).Methods Database was established by dynamic observation on 201 cases of VM. Chinese medical pattern of VM was analyzed by data-mining methods such as frequency statistics, cluster analysis and crosstabs analysis.Results VM had 8 kinds of Chinese medical pattern. Evil toxin invading the heart pattern occurred most frequently at acute stage and its cardinal symptoms were febris, cough, pharyngalgia, diarrhea, cardiopalmus, yellow tongue fur and rapid pulse. Great qi fall pattern occurred most frequently at lag or chronic stage and its cardinal symptoms were short breath, tension in the throat, sagging distention in the chest, lassitude, white tongue fur and bound and intermittent pulse. Phlegm obstructing heart network vessels pattern occurred most frequently at lag or chronic stage and its cardinal symptoms were chest distress, nausea and vomitting, dark red tongue, thick slimy tongue fur and slippery pulse. Heart and spleen deficiency pattern occurred most frequently at lag or chronic stage and its cardinal symptoms were cardiopalmus, short breath, insomnia, dreaminess, anorexia, lassitude, diarrhea, pale tongue and white tongue fur. Qi and yin deficiency pattern occurred most frequently at acute, lag or chronic stage and its cardinal symptoms were short breath, lassitude, insomnia, dreaminess, night sweat, peeling tongue fur and fine rapid pulse. Heart blood stasis obstruction pattern occurred most frequently at chronic stage and its cardinal symptoms were precordialgia, purple or dark red tongue and stringlike pulse. Effulgent yin deficiency fire pattern occurred most frequently at lag stage and its cardinal symptoms were cardiopalmus, upset, insomnia, dreaminess, feverish palms and soles, night sweat, peeling tongue fur and fine rapid pulse. Yin and yang deficiency pattern occurred most frequently at chronic stage and its cardinal symptoms were cardiopalmus, serious short breath, bloat, purple or dark purple tongue and deep slow or bound and intermittent pulse.Conclusion Cluster analysis is scientific, pragmatic and credible for study on Chinese medical pattern classification and characteristic.