基于隐结构模型和聚类分析的2 907例支气管扩张症中医证型研究

目的 对支气管扩张症的中医证候特征进行探究。方法 基于2 907例支气管扩张症住院患者的电子病历数据，运用Lantern 5.0和SPSS 20.0软件分别进行频次描述性统计、隐结构及系统聚类分析，综合判断潜在证型，为提出支气管扩张症的临床常见中医证型提供依据。结果 纳入的2 907份病历记录中涉及43个证型，其中频率大于5%的有痰热蕴肺证（52%）、痰湿阻肺证（25.5%）、肺气阴两虚证（9.1%）、痰瘀阻肺证（7.8%）、肺脾气虚证（7.1%）、肺肾气虚证（6.6%）；共记录有219个症状，将出现频次＞30次的67个症状作为显变量，综合聚类成风热犯肺证、痰热蕴肺证、痰湿阻肺证、痰瘀阻肺证、阴虚肺热证、肺肾气虚证、肺脾气虚证、肺气阴两虚证共8个证候；对频次＞60次的52个症状进行系统聚类分析，得到风热犯肺证、痰热蕴肺证、痰湿阻肺证、肺气阴两虚证、肺脾气虚兼外感证、阴虚内热兼血瘀证、肺肾气虚证、脾气虚证、兼证络伤咳血证共10个证候。以上3种方法推断出的证型中，重复出现至少两次的证型共有8个，即可认定为支气管扩张症常见证型。结论 支气管扩张症8个常见的证型为风热犯肺证、痰热蕴肺证、痰湿阻肺证、痰瘀阻肺证、阴虚肺热证、肺肾气虚证、肺脾气虚证、肺气阴两虚证。

Traditional Chinese Medicine Syndrome Types of Bronchiectasis Based on Latent Structure Model and Cluster Analysis: A Study of 2 907 Cases

Objective To investigate the traditional Chinese medicine (TCM) syndrome features of bronchiectasis. Methods A retrospective analysis was performed for the electronic medical records of 2 907 patients with bronchiectasis. Lantern 5.0 software and SPSS 20.0 software were used to perform frequency statistics, latent structure model analysis, and hierarchical cluster analysis, and potential syndrome types were judged to provide a basis for the common clinical TCM syndrome types of bronchiectasis. Results The 2 907 medical records included involved 43 syndrome types, among which the syndrome types with a frequency of >5% were phlegm-heat accumulated in the lung (52%), phlegm-damp obstructing the lung (25.5%), deficiency of both Qi and Yin in the lung (9.1%), phlegm and blood stasis obstructing the lung (7.8%), lung-spleen Qi deficiency (7.1%), and lung-kidney Qi deficiency (6.6%). A total of 219 symptoms were recorded, among which 67 symptoms with a frequency of >30 times were used as significant variables, and the cluster analysis obtained the following 8 syndromes: wind-heat invading the lung, phlegm-heat accumulated in the lung, phlegm-damp obstructing the lung, phlegm and blood stasis obstructing the lung, Yin deficiency and lung heat, lung-kidney Qi deficiency, lung-spleen Qi deficiency, and deficiency of both Qi and Yin in the lung. A hierarchical cluster analysis was performed for 52 symptoms with a frequency of >60 times and obtained the following 10 syndromes: wind-heat invading the lung, phlegm-heat accumulated in the lung, phlegm-damp obstructing the lung, deficiency of both Qi and Yin in the lung, Qi deficiency of lung and spleen and exogenous disease, Yin deficiency with internal heat and blood stasis, lung-kidney Qi deficiency, spleen Qi deficiency, and collateral injury and hemoptysis. Among the syndrome types deduced by the above three methods, 8 syndrome types appeared at least twice and were thus identified as the common syndrome types of bronchiectasis. Conclusion The 8 common syndrome types of bronchiectasis are wind-heat invading the lung, phlegm-heat accumulated in the lung, phlegm-damp obstructing the lung, phlegm and blood stasis obstructing the lung, Yin deficiency and lung heat, lung-kidney Qi deficiency, lung-spleen Qi deficiency, and deficiency of both Qi and Yin in the lung.