基于聚类分析对高血压病中医证型演变规律的研究  

Study on the evolution of TCM syndrome types of hypertension based on cluster analysis

作　　者：尹胡海 张爱珍[2] 马晓聪[1] 李建橡 钟路 蔡涛[1] 岳桂华[2,3] YIN Hu-hai;ZHANG Ai-zheng;MA Xiao-cong;LI Jian-xiang;ZHONG Lu;CAI Tao;YUE Gui-hua(Guangxi University of Traditional Chinese Medicine,Nanning Guangxi 530001,China;Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine,Nanning Guangxi 530011,China;Guangxi Medical College,Nanning Guangxi,530023,China)

机构地区：[1]广西中医药大学,广西南宁530001 [2]广西中医药大学附属瑞康医院,广西南宁530011 [3]广西卫生职业技术学院,广西南宁530023

出　　处：《时珍国医国药》2020年第2期472-474,共3页Lishizhen Medicine and Materia Medica Research

基　　金：国家自然科学基金(81560757);广西壮族自治区卫生和计划生育委员会中医药民族医药传承创新专项课题(GZLC16-28)。

摘　　要：目的探讨高血压病中医证型随时间变化的演变规律。方法设计《高血压症候要素调查表》采集450例高血压病患者5年前、后的中医四诊信息,采用k-means聚类分析法将其症状进行聚类,根据聚类结果结合临床判定为相应证型。结果 2012年450例高血压病患者中医证型分为3类:肝阳上亢证306例(68.0%)、痰湿中阻证117例(26.0%)、肾精不足证27例(6.0%);2017年高血压病患者中医证型分为3类:肾精不足证186例(41.3%)、瘀血阻窍证150例(33.3%)、气血两虚证114例(25.3%)。结论随着时间的进展,高血压病患者出现证候由实到虚、病位由肝到肾、病理因素由痰湿向瘀血的转化,且演变规律符合"久病及肾、久病入络"的中医病机理论。Objective To explore the evolution of TCM syndromes of hypertension with time.Methods 450 cases of hyperten-sion patients were collected by the questionnaire of essential factors of hypertension symptoms before and after 5 years.The symp-toms were clustered by K-means cluster analysis,and the corresponding syndromes were determined according to the clustering results combined with clinical data.Results In 2012,450 patients with hypertension were divided into three types:306 cases of hyperactivity of liver Yang(68.0%),117 cases of obstruction of phlegm and dampness(26.0%)and 27 cases of insufficiency of kidney essence(6.0%).In 2017,there were 186 cases of insufficiency of kidney essence(41.3%),150 cases of obstruction of blood stasis(33.3%)and 114 cases of deficiency of Qi and blood(25.3%).Conclusion With the development of time,the symptoms of hypertension patients change from solid to deficiency,the location of disease from liver to kidney,and the pathologi-cal factors change from phlegm-dampness to blood stasis,and the evolution law conforms to the TCM pathogenesis theory of"chronic disease and kidney,chronic disease into collaterals".

关 键 词：高血压 聚类分析 中医证型 演变规律 

分 类 号：R2-03[医药卫生—中医学]