目的 观察新疆地区高脂血症中医证型分布规律及特点。方法 采用整群随机抽样的方法,选取新疆乌鲁木齐、吐鲁番、阿勒泰、伊犁、阿克苏、和田等地,收集年龄在18~70岁的汉、维、哈高脂血症患者1 410例,采用自拟《新疆不同民族高脂血症易感因素的流行病学调查研究调查表》进行一般情况、易感因素、血脂分类、合并症、中医证候、舌象等临床资料的调研,并因子分析及聚类分析。结果 本研究收集调查问卷的54个证候条目的克朗巴哈(Cronbach′s)系数为0.891,KMO=0.897,Bartlett的球形度检验Sig〈0.05。应用主成分分析方法得到17个公因子,筛选出54个高脂血症常见症状,每组1~6个症状不等,分为17组。可将F4(腰膝酸软,关节肌肉酸痛,肢体麻木,身体困重,畏寒肢冷)、F5(夜尿频数而清,小便不利,余溺不尽,夜尿多)、F10(口渴不欲多饮,口淡不渴)、F12(面色晄白,身热不扬,性欲减退)、F17(遗尿)合并为肾阳虚。F2(精神疲倦,嗜睡,情志抑郁,神疲懒言)、F15(食欲不振)合并为脾气虚。F3(口燥咽干,口渴喜饮,口苦,口腻,口中臭秽,心烦易怒)、F16(舌质暗红苔腻)合并为湿热困脾。聚类分析结果为新疆地区的高脂血症主要分为脾肾两虚型占46.2%(652/1 410),心脉痹阻型占31.1%(438/1 410),痰瘀内阻型占13.3%(187/1 410),脾虚湿盛型占8.3%(123/1410),肝肾阴虚型占0.7%(10/1 410),以脾肾两虚型最为常见。结论 新疆地区高脂血症以虚证为主,兼见痰浊、湿热等证,呈现涉及多脏器、气血津液聚病的复杂态势。
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 Autonomous 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 Region. 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 Ca white complexion with puffiness, hiding 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?