Beijing Hospital of Traditional Chinese Medicine, affiliated to Capital Medical University, Beijing 100010, China.
Institute of Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich 8001, Switzerland.
J Tradit Chin Med. 2022 Feb;42(1):132-139. doi: 10.19852/j.cnki.jtcm.20210425.003.
To treat patients with psoriasis vulgaris using Traditional Chinese Medicine (TCM), one must stratify patients into subtypes (known as TCM syndromes or Zheng) and apply appropriate TCM treatments to different subtypes. However, no unified symptom-based classification scheme of subtypes (Zheng) exists for psoriasis vulgaris. The present paper aims to classify patients with psoriasis vulgaris into different subtypes via the analysis of clinical TCM symptom and sign data.
A cross-sectional survey was carried out in Beijing from 2005-2008, collecting clinical TCM symptom and sign data from 2764 patients with psoriasis vulgaris. Roughly 108 symptoms and signs were initially analyzed using latent tree analysis, with a selection of the resulting latent variables then used as features to cluster patients into subtypes.
The initial latent tree analysis yielded a model with 43 latent variables. The second phase of the analysis divided patients into three subtype groups with clear TCM Zheng connotations: 'blood deficiency and wind dryness'; 'blood heat'; and 'blood stasis'.
Via two-phase analysis of clinic symptom and sign data, three different Zheng subtypes were identified for psoriasis vulgaris. Statistical characteristics of the three subtypes are presented. This constitutes an evidence-based solution to the syndromedifferentiation problem that exists with psoriasis vulgaris.
运用中医（TCM）治疗寻常型银屑病，必须对患者进行亚型分层（即中医证候或“证”），并针对不同亚型应用相应的中医治疗方法。然而，目前尚缺乏寻常型银屑病基于症状的统一亚型分类方案（证）。本文旨在通过分析寻常型银屑病的中医临床症状和体征数据，对患者进行不同亚型的分类。
本研究于 2005-2008 年在北京进行了一项横断面调查，共纳入 2764 例寻常型银屑病患者，采集其中医临床症状和体征数据。采用潜在树分析对近 108 个症状和体征进行初步分析，选择得到的潜在变量作为特征，对患者进行聚类以分为不同亚型。
初始潜在树分析得到了一个包含 43 个潜在变量的模型。分析的第二阶段将患者分为具有明确中医“证”内涵的三组亚型：“血虚风燥”“血热”和“血瘀”。
通过对临床症状和体征数据的两阶段分析，确定了寻常型银屑病的三种不同的“证”亚型。本文还呈现了这三种亚型的统计学特征。这为寻常型银屑病的辨证分型问题提供了一种基于证据的解决方案。
