目的 探讨结构方程模型在西医病名HIV/AIDS中医证候分布规律以及艾滋病中医证候与四诊信息关系方面的应用.方法 采用多阶段分层随机抽样技术,在河南省艾滋病高发区随机抽取1 277例HIV/AIDS进行调查,收集研究对象的中医四诊信息和中医证候指标,采用无序多分类logistic回归分析、多重对应分析和探索性因子分析建立初始理论模型,并应用结构方程模型进行验证.结果 湿热内蕴、湿热蕴毒、邪结皮肤、肝郁气滞是HIV/AIDS的主要实证:结构方程模型拟合指数x2 =985.26,P＜0.01,近似误差均方根RMSEA=0.070,非范拟合指数NNFI=0.84:肝郁气滞是HIV携带者的主要实证,邪结皮肤是AIDS患者的主要实证.结论 结构方程模型可以用来验证艾滋病中医证候与四诊信息的内在结构关系,研究不同证型(即隐变量)间的联系和演变规律.%Objective To explore the distribution regularity of syndrome of traditional Chinese medicine and the relationship between syndromes of traditional Chinese medicine and four diagnostic information among HIV/AIDS by structural equation model. Methods 1277 HTV7 AIDS patients were chosen using multistage stratified random sampling technique. Their four diagnostic information and syndrome of Chinese medicine was collected. Multinomial logistic regression,correspondence analysis and exploratory factor analysis were used to set up the original theoretical model,confirmed by structural equation model(SEM) further. Results Syndrome of dampness-heat accumulated interior, syndrome of dampnessheat and accumulated toxin,syndrome of pathogens accumulation involving skin and syndrome of liver and qi stagnation were main excess syndromes of HTV/AIDS. The goodness indexes of SEM, minimum fit function was x2 =985.26,P<0.01. Root mean square error of approximation( RMSEA) =0.070,Non-normed fit index( NNFI) =0.84. Syndrome of deficiency of spleen qi was main syndrome of HIV carriers,and syndrome of deficiency of lung and spleen qi was main syndrome of AIDS patients. Conclusion SEM can be used to validate the structure and causal relationship between syndromes of AIDS and four diagnostic information,to study the relationship between different syndromes(latent variable).
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