原发性骨质疏松症患者维吾尔医异常体液病证诊断标准

 为建立原发性骨质疏松症维吾尔医异常体液病证量化诊断标准,以非疾病诊断临床相关信息为依据,对诊断明确的248例原发性骨质疏松症患者进行量化诊断入选项专家咨询研究。入选的证候要素进行多分类Logistic 回归分析、共线性诊断及主成分分析,使用主成分改进的多分类Logistic 回归分析方法确立各证候要素对证候的贡献度,根据优势比(OR 值)的大小分为原发性骨质疏松症各异常体液主症、次症;最后结合原发性骨质疏松“病”的自身特点,建立原发性骨质疏松症维医异常体液病证诊断标准。结果显示,原发性骨质疏松症临床上表现为腰背疼痛或周身骨骼疼痛,负荷增加时疼痛加重或活动受限,严重时翻身、起坐及行走有困难;可有身高缩短和驼背,脊柱畸形和伸展受限,低能量或非暴力骨折。其中,异常黑胆质型--主症:周身关节隐痛,面色晦暗,皮肤粗糙起鳞屑,多梦、噩梦,抑郁心态;次证:口味苦涩,舌质暗红,舌苔灰或黑色,大便干结,脉细、沉。异常血液质型--主症:腰背肢体胀痛,面色发红,皮肤较热,小便色橙黄,肢体沉重,脉象粗、有力;次症:睡眠尚少,口干,舌质暗红,舌苔少。异常黏液质型--主症:腰背肢体冷痛,肢体畏寒喜暖,面色暗淡,口黏,少气懒言;次证:面色晄白,舌体胖大边缘齿痕,睡眠较多,肢体麻木,脉象粗、沉、弱。异常胆液质型--主症:骨有灼痛、刺痛、疼有定处,皮肤较热,口干咽燥,口味甘苦,失眠,小便次数偏多,脉细、紧。次症:面色微黄,舌苔黄,盗汗。由此得出结论:通过量化诊断入选项专家咨询研究建立了原发性骨质疏松症的异常体液病证量化诊断标准。

Screening of quantitative diagnosis indices of typing abnormal Hilit syndrome in Uyghur medicine of 248 cases

Based on non-disease clinical diagnostic information, 248 patients with primary osteoporosis were selected in diagnosis specialist counseling to establish quantitative diagnostic criteria for abnormal Hilit typing in Uyghur medicine for primary osteoporosis patients. The selected factors were analyzed using multi-class logistic regression analysis, colinearity diagnostics, and principal component analysis. The contribution of various factors to the symptom was determined using modified multi-class logistic regression analysis. The chief and secondary symptoms of abnormal Hilit of primary osteoporosis were discerned by OR values. As a result, the meaningful symptoms were found in all the abnormal Hilit syndromes. The results show that the chief symptoms of the abnormal Savda type primary osteoporosis include obtuse pains in all arthroses, dark and gloomy complexion, dry and coarse skin with scales, dreaminess with nightmares, and depression. The secondary symptoms include bitter taste, dark red tongue, dark or gray tongue coating, dry and hardened feces, and thready and deep pulse. For abnormal Kan type primary osteoporosis, the chief symptoms include back and low-back aches, swelling pain in the limbs, flushed complexion, orange urine, dry and hot skin, heavy limbs, and thick and strong pulse. The secondary symptoms include sleepless, dry mouth, dark red tongue, and little tongue coating. For abnormal Balgham type primary osteoporosis, the chief symptoms include sore pains in the back, waist and limbs, seeking-warm, intolerance of cold, dark complexion, sticky mouth, low spirit and laziness to speak. The secondary symptoms include pallid complexion, indentation boundary of the tongue, sleepiness, numbness of limbs, and thick, deep, weak pulse. For abnormal Sapra type primary osteoporosis, the chief symptoms include burning or pricking pain in the bone, dry and hot skin, dry mouth, bittersweet taste, insomnia, frequent urine, and thready and tightened pulse. The secondary symptoms include slightly yellowish complexion, yellowish tongue coating, and night sweat. The establishment of the standards may provide references for clinical practice of traditional Uyghur medicine.