摘要
目的研究非糜烂性反流病(NERD)与上腹痛综合征(EPS)胃肠症状重叠患者的中医证型分布规律。方法采用多中心、横断面研究方法,调查4家医院800例NERD与EPS胃肠症状重叠患者的一般信息,如性别、年龄、体质量指数(BMI)和中医四诊信息,对信息进行描述性频次分析、因子分析和聚类分析,归纳其中医证型及分布特征。结果800例NERD与EPS胃肠症状重叠患者平均年龄(44.50±14.43)岁,平均BMI(23.17±4.80)kg/m^(2),男女比例3∶5。95项中医症状/体征出现频率≥20%,基于因子分析得到18个公因子变量,累计贡献率为67.11%,前3位病位证素为肝、胃、脾,病性证素为气滞、气虚和阴虚。基于18个公因子变量进行聚类分析,结合专家讨论获得4个主要中医证型,分别是肝胃郁热证(213例,26.63%)、脾胃湿热证(209例,26.13%)、脾胃虚寒气滞证(190例,23.75%)和气郁痰阻证(188例,23.50%)。不同性别、年龄段、BMI值段患者中医证型分布差异无统计学意义(P>0.05),病程≥2年的患者和长期居住在秦岭-淮河以北患者以脾胃湿热证多见(P<0.05)。结论NERD与EPS胃肠症状重叠患者病位证素以肝、胃、脾为主,中医证型以肝胃郁热证、脾胃湿热证、脾胃虚寒气滞证和气郁痰阻证多见,病程、地域差异可能是证型分布的影响因素。
Objective To explore TCM syndrome distribution law in patients with overlapping non-erosive reflux disease(NERD)and epigastric pain syndrome(EPS)gastrointestinal symptoms.Methods A multi-center,cross-sectional study was conducted to investigate the general information of 800 patients with overlapping NERD and EPS gastrointestinal symptoms in four hospitals,such as gender,age,body mass index(BMI)and four diagnostic information of TCM.Descriptive frequency analysis,factor analysis and clustering analysis were used to summarize the TCM syndrome types and distribution characteristics.Results The average age of 800 patients with overlapping NERD and EPS gastrointestinal symptoms was(44.50±14.43)years old,the average BMI was(23.17±4.80)kg/m^(2),and the male to female ratio was 3:5.Frequency of 95 TCM symptoms/signs≥20%.18 common factor variables were obtained based on factor analysis,and the cumulative contribution rate was 67.11%.The first three syndrome elements of disease location were liver,stomach and spleen,and the disease nature syndrome elements were qi stagnation,qi deficiency and yin deficiency.Based on the clustering analysis of 18 common factor variables,combined with expert discussion,four main TCM syndrome types were obtained,which were liver-stomach stagnation heat syndrome(213 cases,26.63%),spleen-stomach damp heat syndrome(209 cases,26.13%),spleen stomach deficiency and cold qi stagnation syndrome(190 cases,23.75%)and qi-phlegm stagnation syndrome(188 cases,23.50%).There was no significant difference in the distribution of TCM syndrome types among patients with different genders,ages and BMI values(P>0.05).Patients with a course of disease≥2 years and those residing long term north of the Qinling-Huaihe Line showed a significantly higher prevalence of spleen-stomach dampness-heat syndrome(P<0.05).Conclusion The syndrome elements of disease location of overlapping NERD and EPS gastrointestinal symptoms are mainly liver,stomach and spleen.The TCM syndrome types are liver-stomach stagnation heat syndrome,spleen-stomach damp heat syndrome,spleen-stomach deficiency cold qi stagnation syndrome and qi-phlegm stagnation syndrome.The course of disease and the regional differences between north and south may be the influencing factors of the distribution of syndrome types.
作者
吕咪
车慧
周秉舵
刘朝霞
周晓玲
王小康
王昱茜
乔希筠
谢璟仪
王凤云
LYU Mi;CHE Hui;ZHOU Bingduo;LIU Zhaoxia;ZHOU Xiaoling;WANG Xiaokang;WANG Yuxi;QIAO Xiyun;XIE Jingyi;WANG Fengyun(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China;The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,China;Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《中国中医药信息杂志》
2025年第9期141-148,共8页
Chinese Journal of Information on Traditional Chinese Medicine
基金
国家自然科学基金(82205104、82104850)
中国中医科学院科技创新工程(CI2021A01001)。
关键词
非糜烂性反流病
上腹痛综合征
中医证型
因子分析
聚类分析
non-erosive reflux disease
epigastric pain syndrome
TCM syndromes
factor analysis
clustering analysis
