[关键词]
[摘要]
【目的】探讨959例子宫内膜异位症 (EMs) 患者的中医体质分布特点。 【方法】选取2019年1月至2019年11月就诊于中 国中医科学院广安门医院、首都医科大学附属北京妇产医院、北京医院、北京中医药大学东方医院、首都医科大学附属友 谊医院、首都医科大学附属复兴医院的EMs患者959例,记录患者的一般情况,进行中医体质辨识,分析其中医体质分布情 况、兼夹体质的关联关系以及与年龄、合并痛经的关系。 【结果】(1) EMs患者的体质分布占比由多到少依次为阳虚质65.1% (624/959) 、气郁质58.4% (560/959) 、气虚质52.8% (506/959) 、血瘀质44.2% (424/959) 、痰湿质42.5% (408/959) 、湿热质 41.9% (402/959) 、阴虚质39.6% (380/959) 、平和质26.8% (257/959) 、特禀质16.6% (159/959) ;患者中单一体质者较少,占比 为20.2% (194/959) ,兼夹体质者居多,占比为79.8% (765/959) 。 (2) 基于Apriori算法的关联规则挖掘结果发现相关规则33条, 气虚质-阳虚质、血瘀质-阳虚质、血瘀质-气郁质是其中置信度较高的关联规则。 (3) 与35岁及以下患者相比,35岁以上患 者中血瘀质所占比例较大 (P<0.05) ;与无痛经患者相比,合并痛经患者各偏颇体质占比均增加、平和体质占比减少 (P< 0.05或P<0.01) 。 【结论】阳虚质、气郁质、气虚质、血瘀质是EMs患者的高发体质类型,EMs患者中医体质兼夹现象普遍存 在,较单一偏颇体质更为常见;从温阳、解郁、益气、活血角度管理EMs,及时纠正偏颇体质,防止疾病进展,可有效发挥 中医体质调理的“治未病”效果。
[Key word]
[Abstract]
Abstract:Objective To investigate the distribution patterns of traditional Chinese medicine (TCM) constitution in 959 patients with endometriosis (EMs) . Methods From January 2019 to November 2019,959 EMs patients were selected from Guang’ anmen Hospital of China Academy of Chinese Medical Sciences,Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University,Beijing Hospital,Dongfang Hospital of Beijing University of Chinese Medicine,Beijing Friendship Hospital Affiliated to Capital Medical University,and Fuxing Hospital Affiliated to Capital Medical University. The general clinical information of the patients was recorded and then the TCM constitution was identified. After that, the correlation of TCM constitution distribution with concurrent constitution and the relationship of TCM constitution distribution with age and the complication of dysmenorrhea were analyzed. Results (1) The constitution types of EMs patients listed in descending order of the proportion were yang deficiency constitution (65.1%,624/959) ,qi stagnation constitution (58.4%,560/959) , qi deficiency constitution(52.8%, 506/959), blood stasis constitution(44.2%, 424/959), phlegm-damp constitution (42.5%,408/959) ,damp-heat constitution (41.9%,402/959) ,yin deficiency constitution (39.6%, 380/959),balanced constitution(26.8%,257/959),and inherited special constitution (16.6%,159/959) . Among the patients,there were fewer patients with single constitution,accounting for 20.2%(194/959),and most of them had concurrent constitution types,accounting for 79.8% (765/959) . (2) The association rule mining based on Apriori algorithm obtained 33 related rules. The concurrent constitution types of qi deficiency-yang deficiency,blood stasis-yang deficiency,and blood stasis-qi stagnation were the association rules with high confidence. (3) Compared with patients aged 35 years and below,the patients over 35 years old were predominated by high proportion of blood stasis constitution (P<0.05) . Compared with patients without dysmenorrhea,the patients with dysmenorrhea had the increased proportion of biased constitutions and the decreased proportion of balanced constitution (P<0.05 or P<0.01) . Conclusion Yang deficiency constitution,qi stagnation constitution, qi deficiency constitution and blood stasis constitution are the high-risk constitution types of EMs patients. The concurrent constitution types are commonly seen in EMs patients,which are more common than single biased constitution. Management of EMs patients with the methods of warming yang,relieving stagnation,benefiting qi and activating blood will be helpful for correcting the biased constitutions in time and preventing disease progression,which will achieve the preventive treatment efficacy through TCM constitution correction.
[中图分类号]
R271.9
[基金项目]
首都卫生发展科研专项项目 (编号:首发2018-1-4151);国家中医药管理局中医药传承与创新“百千万”人才工程 (岐黄工程) 岐黄学者资助项目 (国中医药人教函[2018]284号)