36 1 2013 1 56 Journal of Beijing University of Traditional Chinese Medicine Vol. 36 No. 1 Jan. 2013 * ( 北 京 中 医 药 大 学 东 直 门 医 院 北 京 100700) # 204 63. 73% 91. 67% 74. 51% 25 2 3 4 11 3 Z 1 Z 2 Z 3 70. 91% R271. 9 doi 10. 3969 /j. issn. 1006-2157. 2013. 01. 013 Differentiation of syndrome factors of gestational diabetes mellitus ZHANG Yu-li XIE Wei XUE Xiao-ou # Dongzhimen Hospital Beijing University of Chinese Medicine Beijing 100700 Abstract Objective To extract the syndrome factors of gestational diabetes mellitus GDM analyze the distribution and combination laws of these syndrome factors and explore the ideas of TCM syndrome differentiation for GDM. Methods A questionnaire of TCM syndromes of GDM was designed and 204 patients were selected and given syndrome differentiation for deciding disease location and disease nature. The distribution and combination laws of GDM syndrome factors were studied by using frequency analysis and factor analysis. Results The disease-location factors of GDM included kidney mind spleen and stomach and kidney had the highest occurrence frequency 63. 73%. The disease-natures factors of GDM included qi deficiency yin deficiency yang deficiency heat dampness blood deficiency and yang hyperactivity and qi deficiency had the highest occurrence frequency 91. 67% and yin deficiency had the secondary highest frequency 74. 51%. There were 25 combinations of syndrome factors and commonly were 2-factor combination 3-factor combination and 4-factor combination. There were 3 principal components selected from 11 syndrome factors after factor analysis on principal components. The first principal component Z1 was closely correlated to syndrome factors of kidney qi deficiency and yang deficiency the second principal component Z2 was closely correlated to syndrome factors of qi deficiency and yin deficiency and the third principal component Z3 was closely correlated to syndrome factors of kidney yin deficiency and heat. The total contribution degree was 70. 91%. Conclusion The major disease-location factor of GDM is kidney and disease-nature factors include # Email xxo123@ sina. com *
57 mainly qi deficiency and yin deficiency. The most common syndrome types are kidney qi deficiency dual deficiency of qi and yin and kidney yin deficiency. Qi deficiency and yin deficiency are the key pathogenesis of GDM. Key words gestational diabetes mellitus syndrome factors syndrome differentiation gestational diabetes mellitus GDM 2. 3 证 素 辨 证 1-4 GDM GDM 2 8 GDM GDM 1. 5 GDM 1 0. 7100 1 1. 1 资 料 来 源 2011 2 2012 5 SPSS ± x 珋 ± s GDM 204 1. 2 诊 断 标 准 IADPSG 2010 24 ~ 28 28 3 75 g 1 2 h 3. 1 GDM 孕 妇 的 一 般 资 料 5. 1 10. 0 8. 5 mmol /L GDM 26. 82 ± 2. 20 34 16. 7% 16 7. 8% 11. 43 ± 5. 38 kg 129 63. 2% 67 GDM 2 58 2 28 2 2 2. 1 病 例 收 集 3. 2. 1 GDM 204 GDM 5-6 7 4 130 44 15 8 2. 2 质 量 控 制 2. 4 统 计 方 法 204 GDM 30. 56 ± 2. 95 3. 2 GDM 的 证 素 分 布 情 况 63. 73% 21. 57% 7. 35% 3. 92% 3. 2. 2 GDM 204 GDM SOP 7 187 152 53 46 23 14 7 91. 67% 74. 51%
58 36 25. 98% 22. 55% 11. 27% 6. 86% 3. 43% 3. 3 GDM 的 证 素 组 合 情 况 3. 3. 1 GDM 204 GDM GDM 1 2 3 4 5 6 1. 47% 27. 45% 31. 86% 23. 04% 10. 29% 5. 88% 2 3 4 3 82. 35% GDM GDM GDM 11 SPSS GDM 1 GDM 2 GDM Table 1 3. 3. 2 GDM 204 GDM 3 1 GDM Matrix of correlation coefficients of GDM syndrome factors Syndrome factor Spleen Kidney Qi Blood Yin Yang Yang Stomach Dampness Heat Mind deficiency deficiency deficiency deficiency hyperactivity Spleen 1. 000 0. 174 0. 336 0. 251 0. 692 0. 230 0. 139 0. 480 0. 108 0. 237 0. 259 Kidney 0. 174 10. 000-0. 192 0. 292 0. 540 0. 105 0. 177 0. 574 0. 166 0. 168 0. 094 Stomach 0. 336-0. 192 1. 000-0. 002 0. 280 0. 319 0. 253 0. 001 0. 119 0. 213 0. 282 Dampness 0. 251 0. 292-0. 002 1. 000 0. 316 0. 095 0. 090 0. 253 0. 006-0. 065 0. 074 Qi deficiency 0. 692 0. 540 0. 280 0. 316 1. 000 0. 449 0. 366 0. 629-0. 043 0. 252 0. 213 Blood deficiency 0. 230 0. 105 0. 319 0. 095 0. 449 1. 000 0. 435 0. 173-0. 067 0. 503 0. 163 Yin deficiency 0. 139 0. 177 0. 253 0. 090 0. 366 0. 435 1. 000-0. 001 0. 204 0. 622 0. 372 Yang deficiency 0. 480 0. 574 0. 001 0. 253 0. 629 0. 173-0. 001 1. 000-0. 179 0. 040 0. 087 Hat 0. 108 0. 166 0. 119 0. 006-0. 043-0. 067 0. 204-0. 179 1. 000 0. 113 0. 417 Mind 0. 237 0. 168 0. 213-0. 065 0. 252 0. 503 0. 622 0. 040 0. 114 1. 000 0. 587 Yang hyperactivity 0. 259 0. 094 0. 282 0. 074 0. 213 0. 163 0. 372 0. 087 0. 417 0. 587 1. 000 Table 2 2 GDM Principal component extraction and analysis by variance decomposition of GDM syndrome factors Initial characteristic root Rotation characteristic root % Principal component Contribution rate Cumulative Contribution rate Cumulative Eigenvalue Eigenvalue % Contribution rate % Contribution rate % 1 6 109. 468 37. 851 37. 851 2. 625 30. 512 30. 512 2 3 493. 785 21. 646 59. 497 2. 549 27. 332 57. 845 3 1 840. 703 11. 404 70. 901 1. 401 13. 056 70. 901 4 1 273. 541 7. 890 78. 791 5 982. 232 6. 085 84. 877 6 640. 451 3. 968 88. 845 7 548. 324 3. 397 92. 242 8 496. 755 3. 078 95. 319 9 333. 312 2. 065 97. 384 10 279. 529 1. 732 99. 116 11 142. 667 0. 884 100. 000
59 10-1 GDM 11 12 2 3 λ 1 3 3 70. 901% 3 Table 3 Syndrome factor Principal component 1 2 3 Spleen 0. 079 0. 068-0. 164 Kidney 0. 399-0. 236 0. 533 Stomach - 0. 023 0. 088-0. 087 Dampness 0. 055-0. 016 0. 015 Qi deficiency 0. 407 0. 178-0. 264 Blood deficiency 0. 000 0. 151-0. 133 Yin deficiency - 0. 124 0. 582 0. 185 Yang dificiency 0. 328-0. 096-0. 097 Heat - 0. 009-0. 075 0. 587 Mind - 0. 057 0. 260-0. 050 Yang hyperactivity - 0. 011 0. 085 0. 142 3 3 Z 1 = 0. 079 + 0. 399-0. 023 + 0. 055 + 0. 407 + 0. 000-0. 124 + 0. 328-0. 009-0. 057-0. 011 Z 2 = 0. 068-0. 236 + 0. 088-0. 016 + 0. 178 + 0. 151 + 0. 582-0. 096-0. 075 + 0. 260 + 0. 085 Z 3 = - 0. 164 + 0. 533-0. 087 + 0. 015-0. 264-0. 133 + 0. 185-0. 097 + 0. 587-0. 050 + 0. 142 3 Z 1 4 27. 33% GDM 13. 06% Z 2 GDM 10 - Z 3 12 GDM 9 1979 GDM GDM GDM GDM GDM GDM 204 GDM 3 GDM Score coefficient matrix of GDM syndrome factors GDM 11 60% GDM GDM GDM GDM 11 GDM GDM GDM 3 Z 1 Z 2 Z 3 70. 91% 3 30. 51% GDM GDM 2011 69
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