| Objective:To study the TCM syndrome in 179 patients with senile osteoporosis by cluster analysis.its relationship with bone fracture.Search SOP syndrome regularities of distribution and analyse the correlation of senile osteoporosis TCM Syndrome types and bone fracture.Methods:A questionnaire of TCM syndromes of SOP was designed based on the following diagnostic criteria.The criteria of osteoporosis was set by branch of osteoporosis and bone mineral salt disease, Chinese medical association in March 2011,and the criteria of TCM syndromes were referenced from China’s national standards of TCM syndrome terminology Altogether,179 SOP patients were enrolled. Results of syndrome differentiation were collected to carry out the frequency analysis. Data collected by four TCM diagnostic methods were analyzed by system variable cluster analysis and then combined with clinical practice. Four TCM syndrome types of SOP were chosen, followed by a K-Means cluster analysis and a principal component analysis,and analyse the correlation of senile osteoporosis TCM Syndrome types and bone fracture by chi-square test and one-way analysis of variance.Results:(1) Results of K-means clustering analysis and principal component analysis①spleen and kidney yang deficiency and blood stasis blocking collaterals syndrome.Main symptoms:weakness of waist and knees,cold pain of waist and back, fatigue,lack of qi and no desire to speak,stabbing pain of the waist and back,diarrhea, aversion to cold, forgetful,teeth shaking or hair loss,spontaneous perspiration,frequent night urination,and deep and thready pulseSecondary symptoms: heavy body,,loose stools,numbness of limbs, insomnia,and teeth printed tongue.② qi deficiency and blood stasis syndrome.Main symptoms:lack of qi and no desire to speak,, followed by stabbing pain of the waist and back,dizzy, weakness of waist and knees, blurred vision,teeth shaking or hair loss,poor spirit,dark complexion,and thin and small tongue.Secondary symptoms:hunchback, fatigue, insomnia,light color tongue,thin white tongue coating,and weak pulse.③liver and kidney Yin deficiency with liver yang hyperactivity and blockage of phlegm dampness and blood stasis syndrome.Main symptoms:weakness of waist and knees,dizzy,blurred vision,teeth shaking or hair loss,constipation, irritability, dazzling eyes, dark purple tongue,choppy pulse, rapid thready pulse,and wiry pulse.Secondary symptoms:red pars zygomatica,dry throat and mouth,dysacusis, depression,and night sweating.④deficient kidney essence and spleen kidney qi deficiency syndrome.Main symptoms:fatigue,lack of qi and no desire to speak,stabbing pain of the waist and back,frequent night urination,loss of appetite,dizzy,blurred vision,pale complexion, light color tongue,weak pulse,and deep and thready pulse.Secondary symptoms:abdominal distention after dating,constipation,teeth shaking or hair loss,weakness of waist and knees,dysacusis,heavy body, thin white tongue coating.58 patients,accounted for 32.40%,belong to spleen and kidney yang deficiency and blood stasis blocking collaterals syndrome type;29 patients,accounted for 16.20%,belong to qi deficiency and blood stasis syndrome type;62 patients,accounted for 34.64%,belong to liver and kidney Yin deficiency with liver yang hyperactivity and blockage of phlegm dampness and blood stasis syndrome type;and 30 patients,accounted for 16.76%,belong to deficient kidney essence and spleen kidney qi deficiency syndrome type.(2) the correlation of senile osteoporosis TCM Syndrome types and bone fracture.①the correlation of senile osteoporosis TCM Syndrome types and the incidence of bone fracture.There are 67 patients accounted for 37.43% with a history of bone fractures.30 patients,accounted for 51.72%,belong to spleen and kidney yang deficiency and blood stasis blocking collaterals syndrome type;8 patients,accounted for 27.59%,belong to qi deficiency and blood’stasis syndrome type;21 patients,accounted for 33.87%,belong to liver and kidney Yin deficiency with liver yang hyperactivity and blockage of phlegm dampness and blood stasis syndrome type;and 8 patients,accounted for 26.67%,belong to deficient kidney essence and spleen kidney qi deficiency syndrome type.The incidence of bone fracture in spleen and kidney yang deficiency and blood stasis blocking collaterals syndrome type patients are higher than other three bypes,and the difference was statistically significant(P<0.05).②the correlation of senile osteoporosis TCM Syndrome types and the number of bone fractures.23 patients with multiple bone fractures(the number of bone fractures≥ 2) accounted for 34.33% of the total patients with bone fractures.16 patients,accounted for 53.33%,belong to spleen and kidney yang deficiency and blood stasis blocking collaterals syndrome type; 1 patients,accounted for 12.50%,belong to qi deficiency and blood stasis syndrome type;5 patients,accounted for 23.81%,belong to liver and kidney Yin deficiency with liver yang hyperactivity and blockage of phlegm dampness and blood stasis syndrome type;and 1 patients,accounted for 12.50%,belong to deficient kidney essence and spleen kidney qi deficiency syndrome type.The incidence of multiple bone fracture in spleen and kidney yang deficiency and blood stasis blocking collaterals syndrome type patients are higher than other three bypes,and the difference was statistically significant(P<0.05).There are 9 patients with three bone fractures.8 patients of them belong to spleen and kidney yang deficiency and blood stasis blocking collaterals syndrome type; 1 patient of them belonged to liver and kidney Yin deficiency with liver yang hyperactivity and blockage of phlegm dampness and blood stasis syndrome type.There are 2 patients with four bone fractures,and both of them belong to spleen and kidney yang deficiency and blood stasis blocking collaterals syndrome type. ③the correlation of senile osteoporosis TCM Syndrome types and bone fractures sites.32 patients with hip fracture accounted for 47.76% of the total patients with bone fractures.20 patients,accounted for 66.67%,belong to spleen and kidney yang deficiency and blood stasis blocking collaterals syndrome type;2 patients,accounted for 25.00%,belong to qi deficiency and blood stasis syndrome type;8 patients,accounted for 38.10%,belong to liver and kidney Yin deficiency with liver yang hyperactivity and blockage of phlegm dampness and blood stasis syndrome type;and 2 patients,accounted for 25.00%,belong to deficient kidney essence and spleen kidney qi deficiency syndrome type.The incidence of hip fracture in spleen and kidney yang deficiency and blood stasis blocking collaterals syndrome type patients are higher than other three bypes,and the difference was statistically significant(P<0.05).27 patients with waist fracture accounted for 40.30% of the total patients with bone fractures.13 patients,accounted for 43.33%,belong to spleen and kidney yang deficiency and blood stasis blocking collaterals syndrome type;3 patients,accounted for 37.50%,belong to qi deficiency and blood stasis syndrome type;8 patients,accounted for 38.10%,belong to liver and kidney Yin deficiency with liver yang hyperactivity and blockage of phlegm dampness and blood stasis syndrome type;and 3 patients,accounted for 37.50%,belong to deficient kidney essence and spleen kidney qi deficiency syndrome type.The incidence of waist fracture has no significant difference in these four types(P>0.05).19 patients with wrist fracture accounted for 28.36% of the total patients with bone fractures.8 patients,accounted for 26.67%,belong to spleen and kidney yang deficiency and blood stasis blocking collaterals syndrome type;2 patients,accounted for 25.00%,belong to qi deficiency and blood stasis syndrome type;5 patients,accounted for 16.13%,belong to liver and kidney Yin deficiency with liver yang hyperactivity and blockage of phlegm dampness and blood stasis syndrome type;and 4 patients,accounted for 50.00%,belong to deficient kidney essence and spleen kidney qi deficiency syndrome type.The incidence of wrist fracture has no significant difference in these four types(P>0.05).④the correlation of senile osteoporosis TCM Syndrome types and bone mineral density(BMD).Compared with qi deficiency and blood stasis syndrome type and liver and kidney Yin deficiency with liver yang hyperactivity and blockage of phlegm dampness and blood stasis syndrome type,BMD of the patients belong to spleen and kidney yang deficiency and blood stasis blocking collaterals syndrome type are decreased significantly(P<0.05);there has no significant difference compared between the rest of the types.Conclusion(1)The SOP syndromes were divided into 4 types:spleen and kidney yang deficiency and blood stasis blocking collaterals syndrome,qi deficiency and blood stasis syndrome,liver and kidney Yin deficiency with liver yang hyperactivity and blockage of phlegm dampness and blood stasis syndrome,and deficient kidney essence and spleen kidney qi deficiency syndrome by cluster analysis,which showed substantial consistency with clinical practice.(2)Kidney deficiency may be the basic pathogenesis of this disease.Blood stasis may be the aggravating factors throughout the disease and always cooccur with every SOP syndromes type.Spleen and kidney yang deficiency and blood stasis blocking collaterals syndrome is a important pathogenesis of this disease.(3)The patients with kidney yang deficiency and blood stasis blocking collaterals syndrome have the lowest bone mineral density,the highest total incidenci of bone fracture,the highest incidenci of multiple and the highest incidenci of hip bone fracture. |
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