北京中医药大学学报2025，Vol.48Issue(3)：303-311,9.DOI:10.3969/j.issn.1006-2157.2025.03.002
基于因子分析与聚类分析的757例儿童肝豆状核变性中医证候研究
Study on the traditional Chinese medicine syndromes in 757 cases of children with hepatolenticular degeneration based on factor analysis and cluster analysis
摘要
Abstract
Objective To explore the distribution of traditional Chinese medicine(TCM)syndromes in children with hepatolenticular degeneration(Wilson disease,WD)based on factor analysis and cluster analysis.Methods From November 2018 to November 2023,general information(gender,age of admission,age of onset,course of disease,clinical staging,Western medicine clinical symptoms,and family history)and TCM four-examination informations(symptoms and signs)were retrospectively collected from 757 cases of children with WD at the First Affiliated Hospital of Anhui University of Chinese Medicine,and factor analysis and cluster analysis were used to investigate TCM syndromes in children with WD.Results A total of 757 children with WD were included,of which 483 were male and 274 were female;the median age at admission was 12.58 years,the median age at onset was 8.33 years,and the median course of disease was 24.37 months;clinical typing result indicated 506 cases of hepatic type,133 cases of brain type,99 cases of mixed-type,and 19 cases of other type;36.46%of the children had no clinical symptoms(elevated aminotransferases or abnormalities in copper biochemistry);a total of 177 cases had a definite family history,and 10 cases had a suspected family history.Forty-three TCM four-examination information were obtained,with the top 10 in descending order being feeling listless and weak,brown urine,slow action,inappetence,dim complexion,slurred speech,angular salivation,body weight loss,hand and foot tremors,and abdominal fullness.In children with WD,the syndrome element of disease location was primarily characterized by the liver,involving the spleen and kidney,and the syndrome elements of disease nature were characterized by dampness,heat,and yin deficiency.Based on factor analysis and cluster analysis,five TCM syndromes were derived,which were,in order,syndrome of dampness-heat accumulation(265 cases,35.01%),syndrome of yin deficiency of the liver and kidney(202 cases,26.68%),syndrome of liver hyperactivity with spleen deficiency(185 cases,24.44%),syndrome of qi and blood deficiency(79 cases,10.44%),and syndrome of yang deficiency of the spleen and kidney(26 cases,3.43%).Conclusion The TCM syndromes of children with WD were primarily syndromes of dampness-heat accumulation,yin deficiency of the liver and kidney,and liver hyperactivity with spleen deficiency.The liver was the main disease location,and the disease nature was characterized by deficiency in origin and excess in superficiality,excess and deficiency mixed.These findings suggest that treating children with WD should be based on the liver while also considering the spleen and kidney.关键词
肝豆状核变性/儿童/证候/因子分析/聚类分析Key words
hepatolenticular degeneration/children/syndrome/factor analysis/cluster analysis分类
医药卫生引用本文复制引用
花代平,汪瀚,宣巧玉,孙兰婷,忻凌,殷馨,杨文明..基于因子分析与聚类分析的757例儿童肝豆状核变性中医证候研究[J].北京中医药大学学报,2025,48(3):303-311,9.基金项目
国家自然科学基金区域创新发展联合基金项目(No.U22A20366) （No.U22A20366）
安徽省中医药科技攻关专项项目(No.202303a07020004) （No.202303a07020004）
2024年高水平传承人才建设项目(皖中医药发展秘[2024]1号) （皖中医药发展秘[2024]1号）
全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号) Regional Innovation and Development Joint Fund of National Natural Science Foundation of China(No.U22A20366) （国中医药人教函[2022]75号）
