Liu Si-jun, Huang Zhao-sheng, Wu Qing-guang, Huang Zhang-jie, Wu Li-rong, Yan Wen-li, Wang Qi, Wang Zong-wei, Chang David Lungpao, Yang Zheng
Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
Chin J Integr Med. 2016 Apr;22(4):258-66. doi: 10.1007/s11655-014-1897-0. Epub 2014 Dec 18.
To establish the diagnostic quantitative criteria for fire-heat syndrome (FHS) of Chinese medicine (CM) based on the receiver operating characteristic (ROC) curve and principal component analysis (PCA).
The symptoms and signs of FHS cases and healthy subjects from Guangzhou, Henan and Hunan of China were collected through questionnaire, and the diagnostic quantitative score tables were established for the three regions, respectively, with the method of maximum likelihood analysis. The homogeneity test was then performed on the diagnostic score tables for the three regions with ROC curve, and the diagnostic efficiency of diagnostic score tables for the three regions was compared with the prospective test and retrospective test. The method of PCA was adopted to obtain the analysis matrix for classifying the tapes of FHS.
Twenty-seven elements of FHS were confirmed through Chi-square test, and the diagnostic score tables for the three regions were established with the method of maximum likelihood analysis on the basis of the collected case data. According to the ROC curve test, the areas under ROC curve of Guangzhou diagnostic score table assessment with candidates in Guangzhou, Henan and Hunan were 0.998, 0.961 and 0.956, respectively. It showed that the diagnostic efficiency of Guangzhou diagnostic score tables was the highest one. With the prospective test, the area under ROC of Guangzhou diagnostic score table was 0.949, and more than any other diagnostic score table. By PCA, FHS was classified into excess fire and deficiency fire, and then classified into syndrome of flaring up of Heart (Xin) fire, syndrome of Lung (Fei)-Stomach (Wei) excess fire, syndrome of deficiency of Liver (Gan)-yin and Kidney (Shen)-yin, and syndrome of deficiency of Lung-yin from the view of viscera. In the retrospective test, the consistency with clinicians' diagnosis was 69.4%, and in the prospective test, it was 70.1%.
The Guangzhou diagnostic score table could be used as the recommended criteria for the diagnosis of FHS. The classification of FHS was basically in conformity with the clinical situation.
基于受试者工作特征（ROC）曲线和主成分分析（PCA）建立中医火热证的诊断量化标准。
通过问卷调查收集中国广州、河南和湖南的火热证病例及健康受试者的症状和体征，分别采用最大似然分析方法建立三个地区的诊断量化评分表。然后用ROC曲线对三个地区的诊断评分表进行齐性检验，并通过前瞻性检验和回顾性检验比较三个地区诊断评分表的诊断效率。采用主成分分析方法获得火热证分型的分析矩阵。
通过卡方检验确定了27项火热证要素，并根据收集的病例数据采用最大似然分析方法建立了三个地区的诊断评分表。根据ROC曲线检验，广州诊断评分表对广州、河南和湖南的受试者进行评估时，ROC曲线下面积分别为0.998、0.961和0.956。结果表明广州诊断评分表的诊断效率最高。在前瞻性检验中，广州诊断评分表的ROC曲线下面积为0.949，高于其他任何诊断评分表。通过主成分分析，将火热证分为实火和虚火，再从脏腑角度分为心火上炎证、肺胃实热证、肝肾阴虚证和肺阴虚证。回顾性检验中与临床医生诊断的一致性为69.4%，前瞻性检验中为70.1%。
广州诊断评分表可作为火热证诊断的推荐标准。火热证的分类基本符合临床实际情况。
