Sun Jing-Wen, Qu Le, Chen Miao-Miao, Wang Xiao-Teng, Hong Jun
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2016 Aug;36(8):929-932.
Objective To observe distribution laws and features of syndrome types of Chinese medicine (CM) in hyperlipidemia patients of Han, Uyghur, Kazakh nationalities in Xinjiang Uyghur Auton- omous Region. Methods Using cluster random sampling, 1 410 hyperlipidemia patients (18 -70 years old ) were recruited from Urumqi, Turpan, Altay, Ili, Aksu, Hetian in Xinjiang Uyghur Autonomous Re- gion. The general condition, susceptible factors, classification of blood lipids, complications, syndromes of CM, tongue figure, etc. clinical data were investigated using self-formulated Epidemiological Investiga- tion Questionnaire on Susceptible Factors in Different Nationalities of Hyperlipemia Patients in Xinjiang (abbreviated as Questionnaire thereafter). Factor analysis and cluster analysis were performed. Results Cronbach's coefficient for the 54 syndrome items in Questionnaire was 0.891, Kaiser-Meyer-Olkin (KMO) 0. 897, Sig <0.05 in Bartlett's sphericity test. Seventeen common factors were obtained using principal component analysis (PCA). Totally 54 common symptoms of hyperlipidemia were screened, which were then divided into 17 groups with 1 -6 symptoms in each group. F4 (soreness and weakness of waist and knees, sour pain in joints and muscles, body numbness, heavy body sensation, cold limbs), F5 (frequent and clear nocturia, dysuria,-dribble of urine, frequent urination at night), F10 (thirsty, no desire for water, tastelessness, hydroadipsia) , F12 (a white complexion with puffiness, hid- ing fever, hypoactive sexual desire) , and F17 (enuresis) were merged as Shen yang deficiency (SYD) ; F2 (fatigue, drowsiness, depression, spiritlessness, fatigue and disinclination to talk) and F15 (poor ap- petite) were merged as Pi-qi deficiency (PQD) ; F3 (dry mouth and dry pharynx, thirsty, propensity for water, bitter mouth, greasy mouth, stingy mouth, irritability and upset) and F16 (dark red tongue proper, greasy tongue fur) were merged as damp-heat trapped in Pi (DHTP). Results of cluster analysis showed that Pi-Shen deficiency (PSD) was most often seen in hyperlipidemia, and main syndrome types were sequenced from high to low as Pi-Shen deficiency type (46. 2%, 652/1 410) , blockage of cardiac vessels type ( 31. 1% , 438/1 410 ), phlegm and blood stasis internal resistance type ( 13. 3% , 187/1 410), Pi-deficiency induced damp abundance type (8. 3%, 123/1 410), Gan-Shen yin deficiency type (0. 7%, 10/1 410). Conclusions Deficiency syndrome was dominant in hyperlipidemia patients of Xinjiang Uyghur Autonomous Region. Phlegm turbidity, damp heat, and etc. were often complicated. The complex situation was manifested to be involved in multiple organs, qi-blood-fluid mixed disease.
目的 观察新疆维吾尔自治区汉族、维吾尔族、哈萨克族高脂血症患者的中医证型分布规律及特点。方法 采用整群随机抽样方法，从新疆维吾尔自治区乌鲁木齐、吐鲁番、阿勒泰、伊犁、阿克苏、和田等地选取1410例18～70岁的高脂血症患者。采用自行编制的《新疆不同民族高脂血症患者易感因素流行病学调查问卷》（以下简称《问卷》），调查其一般情况、易感因素、血脂分类、并发症、中医证候、舌象等临床资料，并进行因子分析和聚类分析。结果 《问卷》中54个证候条目的Cronbach's系数为0.891，Kaiser-Meyer-Olkin（KMO）值为0.897，Bartlett球形检验Sig<0.05。采用主成分分析法提取出17个公因子，筛选出高脂血症常见症状54个，分为17组，每组1～6个症状。将F4（腰膝酸软、关节肌肉酸痛、身体麻木、身体沉重感、四肢冰凉）、F5（夜尿频多清长、排尿困难、小便点滴不尽、夜尿频繁）、F10（口渴、不欲饮水、口淡无味、水入即吐）、F12（面色白而浮肿、身热不扬、性欲减退）、F17（遗尿）合并为肾阳虚证；将F2（神疲、嗜睡、抑郁、精神不振、神疲少言）和F15（食欲不振）合并为脾气虚证；将F3（口干咽燥、口渴、喜饮水、口苦、口腻、口涩、烦躁不安）和F16（舌质暗红、舌苔腻）合并为脾虚湿热证。聚类分析结果显示，高脂血症最常见的证型为脾肾两虚证，主要证型由高到低依次为脾肾两虚型（46.2%，652/1410）、心血瘀阻型（31.1%，438/1410）、痰瘀内阻型（13.3%，187/1410）、脾虚湿盛型（8.3%，123/1410）、肝肾阴虚型（0.7%，10/1410）。结论 新疆维吾尔自治区高脂血症患者以虚证为主，常兼夹痰浊、湿热等，病情复杂，多涉及多脏腑、气血津液同病。
