摘要
目的探究血脂异常患者的证候要素及靶标的分布规律,以期对其中医临床诊疗提供理论依据。方法采集1 019例血脂异常患者的临床资料(包括89个症状、体征、舌象和脉象等),建立数据库矩阵,根据初始模型分析提取因子,得到特征根大于1.0的公因子,通过方差最大旋转后得到各指标在公因子上的新的因子载荷,得到若干公因子,归纳出一定数量的证候要素,并得到其靶标情况,按患者在各证候要素及靶标的得分,将其分组,计算各组得分,统计出各证候要素和靶标的分布情况。结果共提取得到38个公因子,归纳出14个证候要素,最主要的证候要素有6个,包括3个实性证候要素:痰浊284例(25.07%)、血瘀130例(11.48%)、内热109例(9.62%);3个虚性证候要素:气虚170例(15.00%)、阳虚164例(14.47%)、阴虚108例(9.53%)。得出8个证候要素靶标,最主要的有4个,分别为脾508例(40.38%)、肺269例(21.38%)、心218例(17.33%)、肝190例(15.10%)。结论血脂异常的基本病性为本虚标实,实者为痰浊、血瘀、内热,虚者为气虚、阳虚、阴虚,主要的证候靶标(病位)为脾,涉及肺、心、肝。提示其治疗宜化痰、活血、清热与益气、温阳、滋阴为主,主张从脾论治,兼顾肺、心、肝等脏腑。
Objective To explore the distribution of pattern elements and target organs in dyslipidemia aiming at providing theoretical basis for dyslipidemia diagnosis and treatment in clinical practice. Methods A database matrix including clinical manifestations（ containing 89 symptoms,physical signs,tongue and pulse） of 1019 patients with dyslipidemia. Factors were extracted according to initial models and rotated with Varimax,then the factor loading and the score of common factors was calculated. Pattern elements were concluded by the common factors,and the patients were grouped by the score of each pattern element. Thus the distribution of pattern elements and target organs were assigned according to its score of each group. Results 38 common factors and 14 pattern elements were extracted,from which 6 primary pattern elements were selected,including 3 excessive elements,phlegm（ 284 cases,25. 08%）,blood stasis（ 130 cases,11. 48%）,and heat（ 109 cases,9. 62%） and 3 deficient elements,qi deficiency（ 170 cases,15. 00%）,yang deficiency（ 164 cases,14. 47%）,and yin deficiency（ 108 cases,9.53%）. 8 target organs were extracted in which the main target included the spleen（ 508 cases,40.38%）,lung（ 269 cases 21. 38%）,heart（ 218 cases,17. 33%） and liver（ 190 cases,5. 25%）.Conclusions Dyslipidemia in traditional Chinese medicine belongs to deficiency in its root（ nature） and excess in branch（ manifestation）. Excessive manifestations include phlegm,blood stasis and heat,and deficient nature includes qi deficiency,yang deficiency and yin deficiency. The main symptom target（ location） was the spleen,the lung,the heart and the liver. Therefore,the findings suggest that treatment of dyslipidemia in traditional Chinese medicine could rely on resolving phlegm,activating blood,removing heat,tonifying qi,warming yang,and reinforcing yin. Spleen should be considered as the first and foremost organ in the treatment,while the lung,heart,and liver should also be taken into consideration.
作者
杨韬
何庆勇
钟小雪
刘旭东
王辉
郭建波
丁宇坤
Yang Tao1,2, He Qingyong1, Zhong Xiaoxue1,2, Liu Xudong1,2, Wang Hui1,2, Guo Jianbo1,2, Ding Yukun1,2(1 Department of Cardiology, Guang＇ anmen hospital of China Academy of Chinese Medical Sciences, Beijing 100053, China; 2 Beijing University of Chinese Medicine, Beijing 100029, Chin)
出处
《北京中医药大学学报》
CAS
CSCD
北大核心
2018年第2期165-170,共6页
Journal of Beijing University of Traditional Chinese Medicine
基金
国家自然科学基金青年科学基金资助项目(No.81202803)
中央公益性科研院所基本科研业务费专项资金资助项目(No.ZZ0908023)~~
关键词
血脂异常
因子分析
证候要素
临床调查
dyslipidemia
factor analysis
syndrome elements
clinical investigation
