摘要
【目的】研究功能性便秘中医证候分布,探讨其不同证候的计量诊断规律。【方法】根据相关诊断标准,制定中医四诊调查问卷(包括功能性便秘常见的39个症状),对297例功能性便秘患者进行问卷调查。将中医证型分为肝脾不调型(y1)、肺脾气虚型(y2)、肝肾阴虚型(y3)、脾肾阳虚型(y4)4个证型。根据患者中医证候对四诊变量进行逐步判别分析,将有显著贡献的四诊变量建立判别函数式,并使用逐一回代法和刀切法对函数式的一致率进行检验。【结果】筛选出对区分4类中医证候有显著贡献的15个变量,包括:临厕努挣无力(x1)、便出艰难(x2)、神疲(x3)、乏力(x4)、气短(x5)、善太息(x6)、胁肋胀(x7)、腹胀(x8)、胃脘痞闷(x9)、腰膝酸软(x10)、五心烦热(x11)、畏寒怕冷(x12)、四肢不温(x13)、咽部异物感(x14)、心悸(x15)。通过这些变量所建立的功能性便秘中医证候判别函数为:肝脾不调y1=-9.068+0.262x1+1.307x2-0.458x3-0.208x4-0.716x5+2.975x6+3.101x7+3.020x8+2.818x9-1.698x10+0.221x11+1.339x12+0.393x13+4.902x14+0.228x15;肺脾气虚y2=-9.355+1.575x1+0.725x2+1.915x3+3.002x4+2.747x5-1.205x6-2.361x7+0.760x8+0.601x9-2.802x10-0.008x11+1.220x12+1.496x13+0.072x14+1.163x15;肝肾阴虚y3=-43.246-1.154x1-0.886x2-1.129x3+0.153x4-0.125x5-1.711x6+1.299x7+1.275x8-1.950x9+10.253x10+33.841x11-0.839x12+0.517x13+0.009x14+6.640x15;脾肾阳虚y4=-20.280+2.006x1+1.549x2-0.595x3+2.742x4-1.154x5+0.757x6-2.434x7+1.641x8+1.458x9-2.857x10+1.317x11+7.846x12+7.045x13+0.581x14-0.630x15。逐一回代法判别总误判率为3.4%;刀切法计算误判率为4.7%。【结论】功能性便秘中医证候判别函数模型与临床诊断吻合良好,可提高功能性便秘中医证候诊断的客观性和准确性。
Objective To investigate the traditional Chinese medicine（TCM） syndrome distribution regularity of functional constipation（ FC）, and to establish the quantitative diagnosis of its syndrome patterns. Methods The data of 297 FC patients were collected. TCM syndrome questionnaire for FC was worked out, which included 39 frequent symptoms of FC patients. The patients were differentiated into four syndromes, liver-spleen disharmony（y1）, lung-spleen qi deficiency（ y2）, liver-kidney yin deficiency（ y3） and spleen-kidney yang deficiency（ y4）. The clinical symptoms were divided into 4 grades including none, mild, moderate, severe, which were recorded as 0, 1, 2, 3 score（ s）. And then the variables were analyzed with a stepwise discriminant analysis according to the syndrome patterns, those significant contributors were attributed into the discriminate function formulas, and the uniformity of function formulas was tested with step-by-step backward substitution method and Jackknife method. Results The 15 variables with significant contribution for the four syndromes were screened out as following： inability of defecation（ x1）, difficult in defecation（ x2）, poor spirit（ x3）, fatigue（ x4）,shortness of breath（ x5）, sighing（ x6）, hypochondrium distention（ x7）, abdominal distention（ x8）, fullness or distension of stomach（x9）, soreness of loin and knees（x10）, burning sensation in chest and palms-soles（x11）,aversion to cold（ x12）, cold limbs（ x13）, pharyngeal foreign body sensation（ x14）, palpitation（ x15）. The discriminant function formulas were established as： y1=-9.068＋0.262x1＋ 1.307x2-0.458x3-0.208x4-0.716x5＋ 2.975x6＋3.101x7＋ 3.020x8＋ 2.818x9-1.698x10＋ 0.221x11＋ 1.339x12＋ 0.393x13＋4.902x14＋ 0.228x15 for liver-spleen disharmony, y2=-9.355＋1.575x1＋ 0.725x2＋ 1.915x3＋ 3.002x4＋ 2.747x5-1.205x6-2.361x7＋ 0.760x8＋ 0.601x9-2.802x10-0.008x11＋ 1.220x12＋ 1.496x13＋ 0.072x14＋1.163x15 for lung-spleen qi defi
出处
《广州中医药大学学报》
CAS
2015年第2期189-193,共5页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
"十二.五"国家重大科技专项(编号:2012ZX10005001)
关键词
功能性便秘
中医证候
判别分析
Functional constipation
Traditional Chinese medicine syndromes
Discriminant analysis
