目的研究颈动脉粥样硬化痰浊内阻证和血瘀证之间的内在相关性。方法用中医四诊调查表收集136例颈动脉粥样硬化痰浊内阻证和血瘀证患者的临床数据,用统计学方法提取主成分,并进行相关性分析。结果对痰浊内阻证(tz)主成分分析获得两个主成分tzl和tz2,其中tzl的贡献率为42.645%,可看作是体现痰浊内阻证痰阻四肢经络方面的指标;tz2贡献率为24.898%,可看作是体现痰浊内阻证痰湿中阻、蒙蔽清窍的指标,有可能是反映颈动脉粥样硬化痰浊内阻证的一个特异性指标。对血瘀证(xy)主成分分析获得3个主成分xyl、xy2和xy3,其中xyl贡献率为37.197%,可看作体现血瘀证血液运行不畅、瘀阻脉道、经络不通的指标;xy2的贡献率为21.627%,可看作是体现血瘀证离经之血停积体内、闭阻脉络、肌肤失养的指标;xy3贡献率为13.685%,可看作是体现血瘀证瘀阻脑窍、脑失所养的指标,有可能是反映颈动脉粥样硬化血瘀证的一个特异性指标。痰浊内阻证tzl与血瘀证xyl和血瘀证xy2呈显著正相关,痰浊内阻证tz2与血瘀证xyl和血瘀证xy3呈显著正相关(P均〈O.01)。结论在颈动脉粥样硬化发病过程中,痰瘀两者密切相关。对颈动脉粥样硬化痰浊内阻证和血瘀证的主成分进行分析研究,对于深入挖掘中医证候的内在特性具有积极的作用。
Objective To analyze the internal relationship between phlegm stasis syndrome (痰浊内阻证) and blood stasis syndrome (血瘀证) in cases with carotid atherosclerosis. Methods The clinical data of 136 patients with atherosclerosis accompanied by phlegm stasis and blood stasis syndromes were collected from the investigation table of the 4 diagnostic methods in traditional Chinese medicine (TCM); the principal components of the clinical data were statistically analyzed, and the correlative relationships of these principal components were studied. Results There were two principal components of phlegm stasis syndrome, which were tzl and tz2. And tzl cumulated 42. 645% to phlegm stasis syndrome, which could be considered as phlegm stasis in limbs and tunnel; tz2 cumulated 24.898% to phlegm stasis syndrome, which could be considered as phlegm stasis in the body that might impair the 7 orifices (such as eyes, ears, nose and mouth). And they could also be considered as special markers of phlegm stasis syndrome of carotid atherosclerosis. There were three principal components of blood stasis syndrome, which were xyl, xy2 and xy3. And xyl cumulated 37. 197% to blood stasis syndrome, which could be considered as blood stasis in the artery and tunnel; xy2 cumulated 21. 627% to blood stasis syndrome, which could be considered as the blood outside the vessels located in the body and could obstruct tunnel and could not nourish muscle and skin; then, xy3 cumulated 13. 685% to blood stasis syndrome, which could be considered as the blood stayed in the brain and could not nourish brain and might reflect as a special marker of blood stasis syndrome of carotid atherosclerosis. There was significant positive correlative relationship between phlegm stasis syndrome principal component 1 and blood stasis syndrome principal component either 1 or 2 (P〈0. 01). And there was significant positive relationship between phlegm stasis syndrome principal component 2 and blood stasis syndrome principal component either 1