气血亏虚型便秘模型化评价及补中益气汤加减临床疗效分析OACSTPCD
Model-Based Evaluation of Constipation of Qi and Blood Deficiency Type and Efficacy Analysis of Modified Buzhong Yiqi Decoction(补中益气汤)in Its Treatment
目的:基于统计学模型分析影响气血亏虚型便秘发生的因素,评价补中益气汤加减治疗气血亏虚型便秘的临床疗效.方法:选取气血亏虚型便秘患者194例,其中,103例用补中益气汤加减治疗,91例用乳果糖口服液治疗.通过软件Matlab 2018B对气血亏虚型便秘进行主成分因子和聚类分析.通过单因素和多因素Logistic回归分析气血亏虚型便秘临床疗效的独立影响因素.结果:本研究患者经过主成分因子分析和聚类分析后,被聚为3类,轮廓系数(SIL)=0.723,聚类质量较好.第1类患者痊愈比例最高(P＜0.05),总有效率最高(P＜0.05);第3类患者痊愈比例最低(P＜0.05),总有效率最低(P＜0.05).第1类患者白细胞介素-6(IL-6)、C反应蛋白(CRP)水平显著低于第2类、第3类,接受补中益气汤加减治疗患者比例显著高于第2类、第3类(P＜0.05);第2类患者CRP水平显著低于第3类患者,接受补中益气汤加减治疗患者比例显著高于第3类(P＜0.05).第1类、第2类患者生活质量量表(PAC-QOL)评分明显低于第3类患者(P＜0.05).第1类患者中医证候积分明显低于第2类、第3类患者(P＜0.05).高水平IL-6、高水平CRP、PAC-QOL高评分、中医证候高积分为预后无效的独立危险因素.结论:基于多因素回归模型,发现高水平IL-6、高水平CRP、PAC-QOL高评分、中医证候高积分为预后无效的独立危险因素,补中益气汤加减治疗方案为保护因素.
Objective:To analyze the influencing factors for constipation of qi and blood deficiency type,and to evaluate the efficacy of modified Buzhong Yiqi Decoction(补中益气汤)in its treatment.Methods:A total of 194 patients with constipation of blood and qi deficiency type were included in this study.Among them,103 patients were treated with modified Buzhong Yiqi Decoction,and 91 patients were treated with lactulose oral solution.Principal component factor analysis and cluster analysis were performed using Matlab 2018B software to analyze the constipation of qi and blood deficiency type.The independent factors affecting the clinical efficacy of constipation were analyzed using univariate and multivariate Logistic regression analysis.Results:After principal component factor analysis and cluster analysis,patients in this study were clustered into three categories in which SIL=0.723 indicating a good clustering quality.The first category was of the highest recovery rate(P＜0.05)and of the highest total effective rate(P＜0.05),while the third category was of the lowest recovery rate(P＜0.05)and of the lowest total effective rate(P＜0.05).The first category was of significantly lower levels of interleukin-6(IL-6)and C-reactive protein(CRP)compared to the second and the third categories,and of a significantly higher proportion of patients treated with modified Buzhong Yiqi Decoction compared to the second and the third categories(P＜0.05).The second category was of significantly lower level of CRP compared to the third category,and of a significantly higher proportion of patients treated with modified Buzhong Yiqi Decoction compared to the third category(P＜0.05).The first and second categories was of significantly lower Patient Assessment of Constipation Quality of Life(PAC-QOL)scores compared to the third category(P＜0.05).The first category was of significantly lower traditional Chinese medicine(TCM)syndrome scores compared to the second and third categories(P＜0.05).High levels of IL-6 and CRP,and high PAC-QOL and TCM syndrome scores were identified as independent risk factors for.prognosing no effect.Conclusions:Based on the multi-factor regression model,high levels of IL-6 and CRP,and high PAC-QOL and TCM syndrome scores were found to be independent risk factors for prognosing no effect,while the modified Buzhong Yiqi Decoction treatment was a protective factor.
何明礼;马嘉忆;李莎
绵阳市人民医院,四川 绵阳 621000
中医学
补中益气汤加减便秘气血亏虚证临床疗效主成分因子分析聚类分析
modified Buzhong Yiqi Decoctionconstipationqi and blood deficiency syndromeclinical efficacyprincipal component factor analysiscluster analysis
《山东中医杂志》 2024 (007)
715-722 / 8
四川省科技计划项目(编号:3v43RL)
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