Structural Equation Modeling In Syndrome Of Deficiency Of Traditional Chinese Medicine Of AIDS

AIDS, acquired immune deficiency syndrome, is a chronic disease by the human immunodeficiency virus (HIV). In China, the AIDS epidemic is the trend of low prevalence in the overall, and is the trend of high prevalence in specific populations and in some areas. There is no cure methods for AIDS treatment currently, but the use of Chinese medicine for AIDS treatment has some advantages. It is the key to TCM treatment of disease that syndrome differentiation in the treatment of disease. They must first understand the disease syndromes of AIDS, however distribution is not clear. Because of the standards of syndromes has not been established, a clear rule of AIDS syndromes is the key to AIDS research. The syndromes of deficiency is an important part of the syndromes of Traditional Chinese Medicine, studying the syndromes of deficiency can lay the foundation for the establishment of standards of syndromes of TCM.70s in the 20th century, statisticians Joreskog, Kessling and others applied the idea of path analysis into the latent variable comblined with the factor analysis and formed structural equation modeling (SEM). Confirmatory factor analysis comblined with latent variable and observable indicators and formed the part of the measurement model of structural equation models, and the potential causal relationship between variables was researched by simultaneous equation models and path analysis, which formed the part of the structural model of the structural equation model. If the two parts were put into a whole framework, a complete structural equation model will be formed. Structural equation model can not only deal with the potentially significant variables in the variable and the potential relationship between variables, but also consider the error variables, In the past two decades, SEM have been more widely used in medicine, psychology, behavioral science and sociology and many other areas,and so on.ObjectiveThe study attempts to explore the complex relationship between the types of the syndrome of deficiency of AIDS and the information of four diagnostic information based on the early explorary research, by the method of structural equation modeling by which the types of syndrome of deficiency were considered as latent variables and the four diagnostic signs of AIDS were considered as marked variables, and to provide evidence for the establishment of standards of syndromes of TCM.Materials and methodsThe database in this study came from the database of the "ten.five" national research programs (2004BA719A13). According to a multistage cluster random sampling method,1277 HIV/AIDS patinents in which the number of HIV carries was 636, and the number of AIDS patients was 641, were selected in the countries in which AIDS happened highly in July to december 2006. All 1277 cases were the objects of study. The main methods of statistical analysis were description of central tendency and dispersion tendency, factor analysis and structural equation models. The statistical softwares EPIDATA3.02, SPSS 16.0 and AMOS7.0 were applied, and the inspection standandsαis 0.05.Results1. Descriptive Statistics In syndrome of deficiency of TCM, in HIV carries, syndrome of deficiency of lung and spleen qi was 30.5%; syndrome of deficiency of spleen qi was 18.4%; syndrome of deficiency both qi and yin was 11.3%; and syndrome of deficiency both qi and blood was 6.0%; in AIDS patients, syndrome of deficiency of lung ang spleen qi was 31.7%; syndrome of deficiency of spleen qi was 25.9%; syndrome of deficiency both qi and yin was 11.4%; and syndrome of deficiency both qi and blood was 8.1%.2. Factor analysis In HIV carries, KMO was 0.84, and Bartlett's test of sphericity was signiciant (x2=2193.87, P＜0.001). Based on extraction retains factors with eigenvalues>0.8,12 factors were extracted with cumulative loading of 68.27%; In AIDS patients, KMO was 0.86, and Bartlett's test of sphericity was signiciant (x2=2592.68, P＜0.001). Based on extraction retains factors with eigenvalues>0.8, 12 factors were extracted with cumulative loading of 69.99%.3. Structural equation model Among the syndroms of deficiency, syndrom of deficiency of spleen qi was main syndrom of HIV carries, and syndrom of deficiency of lung and spleen qi was main syndrom of AIDS patients. The following were Goodness indexs of Fit Statistics of SEM:Chi-Square=905.958 (p<0.001); approximate root mean square error (Root Mean Square Error of Approximation, RMSEA)=0.079; Normed Fit Index (NFI)=0.898; Relative Fit Index (RFI)=0.897; Incremental Fit Index (IFI)=0.853; Non-Normed Fit Index (NNFI)=0.874; Comparative Fit Index (CFI)=0.834.Conclusion1. The main symptoms and signs of AIDS in Chinese medicine has a strong correlation, and it is suitable for factor analysis.2. Structural equation model is suitable for the research of Syndrome of Traditional Chinses Medicine of AIDS.3. Confirmatory factor analysis and structural equation model can be used to validate the causal relationship between the syndromes of deficiency of AIDS and four diagnostic information, to study relation between diffierent type of syndrome of dificiency, and to provide evidence for the establishment of standards of syndromes of TCM.