The Application Of Second-order Confirmatory Factor Analysis On TCM Syndrome Factor In Hypertension

Background:Syndrome differentiation treatment, the essence of clinical medicine, is the core of TCM, but it is also the obstacle to the develepment of the clinical medicine and research due to the lack of the objective and uniform standards of the traditional dialectic. Since the standardization of syndrome was made in the 80s, some progresses has been taken place, a number of syndrome standards were established. But making just a few standard syndrome names is not enough because of the complexity and dynamic of diseases, and the complexity and multi-dimension of the TCM system. In the recent years, Academician Wang Yongyan from Chinese Academy of Chinese Medical Sciences has proposed the concept of "syndrome factor", which improves the awareness of TCM dialectic, and deepens the research of clinical differentiation therapy in order to improve clinical effect. Cluster analysis, Exproratory factor analysis and correspondence analysis are common data analysis for researches of syndrome factors, but they can not accurately determine the syndrome factors, nor can they definite the relationship of four diagnostic indicators and syndrome factors, so the accuracy of their connclusions are uncertain. This research provides data support for the next phase of the establishment of syndrome factors and diagnostic criterion for hypertension, with the utilization of clinical epidemiological surveys, modern statistical methods, theoretical study, literature research, clinical investigation and data analysis, extracts the main TCM syndrome factors and analyzes the corresponding relationships between the symptoms factors and four diagnostic indicators, then try to explore the second-order confirmatory factor analysis and its application in TCM syndrome factors, which provides new ideas and methods for the establishment of the dialectical system.Objective:to explore the second-order confirmatory factor analysis and its application in TCM syndrome factors, at the same time, explore the distributing rules of TCM Syndrome factors in Hypertension Grate-â…¢for the improvement of clinical diagnosis and treatment.Methods:Based on hypertension, the research is carried out by clinical practice, with the utilization of clinical epidemiology and modern statistical analysis methods, we collect the diagnostic information including symptoms, tongue and pulse of 634 patients with grade-â…¢hypertension, establish the relevant databases by EpiData software systems, then we use SAS9.1 and AMOS 17.0 statistical software to process and analyze the data. The applied Analysis methods include cluster analysis, second-order confirmatory factor analysis. On the basic of the analysis we extract The TCM syndrome factors of grade-â…¢hypertension, and define the corresponding relationships between the symptoms factors and symptoms.Results:The TCM syndrome factors for nature of disease of grade-â…¢hypertension are mainly Yin Xu, Yang Kang, inner fire, heat, phlegm, damp, Yang Xu, liver stagnation and vitality disability, inner wind, and the TCM syndrome factors for location of disease of grade-â…¢hypertension are mainly liver, kidney, heart, spleen(stomach).Conclusion:Second-order confirmatory factor analysis is an effective data analysis methods for extracting Syndrome factor.The syndrome factors of Yin Xu, Yang Kang, inner fire, heat, phlegm, damp, Yang Xu, liver stagnation and vitality disability, inner wind, liver, kidney, Heart, spleen(stomach) are helpful for clinicians to simplify the complicated clinical materials, they also cater for the needs and improve the flexibility of syndrome differentiation.