基于因子分析和聚类分析的279例中老年干眼症患者中医证候研究OA

Objective To explore the distribution of traditional Chinese medicine(TCM)syndrome elements and syndrome types in middle-aged and elderly patients with dry eye disease,thereby providing a syndrome-based medical foundation for its clinical treatment.Methods A retrospective analysis was conducted on the clinical data of 279 middle-aged and elderly patients with dry eye disease enrolled in the Ophthalmology Department of Lu'an Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Chinese Medicine between March 2024 and October 2024.Patient general information and TCM four-examination information were recorded to establish a database.Based on clinical experience,39 four-examination signs with a frequency of occurrence≥20%were selected as variables for factor analysis.Eleven common factors with eigenvalues＞1 were extracted and subsequently subjected to cluster analysis.Results(1)General patient information:Regarding gender distribution,among the 279 dry eye patients,82 were male(29.39%)and 197 were female(70.61%).Regarding age distribution,116 patients(41.58%)were aged 45-59 years,89 patients(31.90%)were aged 60-74 years,and 74 patients(26.52%)were aged 75-89 years,the prevalence showing a decreasing trend with the increase of age.(2)Factor analysis:Eleven common factors were extracted,with a cumulative contribution rate of 73.676%.The disease location syndrome elements included liver,kidney,spleen,exterior,large intestine,and heart spirit,with the primary locations being the liver and kidney.The disease nature syndrome elements included yin deficiency,heat,qi deficiency,yang hyperactivity,dampness,blood stasis,and external wind,with the primary nature being yin deficiency.(3)Cluster analysis:The distribution of syndrome types was most reasonable when clustered into 4 categories.Category 1,comprising common factors F4,F5,and F6,corresponded to qi and yin deficiency syndrome(52 cases,18.64%).Category 2,comprising common factors F2,F7,F8,and F9,corresponded to liver-kidney yin deficiency with yang hyperactivity syndrome(96 cases,34.41%).Category 3,comprising common factor F1,corresponded to damp-heat and blood stasis obstruction syndrome(85 cases,30.47%).Category 4,comprising common factors F3 and F10,corresponded to lingering pathogenic heat syndrome(46 cases,16.49%).Conclusion Middle-aged and elderly patients with dry eye disease present with complex disease locations and diverse disease natures.The specific syndrome types include liver-kidney yin deficiency with yang hyperactivity,obstruction of damp-heat and blood stasis,deficiency of both qi and yin,and lingering pathogenic heat.