基于复杂系统熵聚堆方法的680例冠心病合并血脂异常的中医证候研究  

Study of TCM Syndromes of 680 Patients with Coronary Heart Disease and Dyslipidemia Based on Complex System Entropy Clustering Method

作　　者：于珊珊 何庆勇[2] 覃堃 张辉[1] 吴海芳[2] 钟小雪 刘旭东[2] Yu Shanshan;He Qingyong;Qin Kun;Zhang Hui;Wu Haifang;Zhong Xiaoxue;Liu Xudong(Henan University of Chinese Medicine,Zhengzhou 450046,China;Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]河南中医药大学,郑州450046 [2]中国中医科学院广安门医院,北京100053

出　　处：《世界科学技术-中医药现代化》2021年第11期3948-3955,共8页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家自然科学基金委员会青年科学基金项目(81202803):运脾化浊法干预血脂异常大鼠microRNA-33调控脂肪细胞因子信号通路的研究,负责人:何庆勇;中国中医科学院科技创新工程重大攻关项目(CI2021A0O1O1):《伤寒论》辨证论治体系传承创新研究,负责人:苏庆民。

摘　　要：目的 探讨冠心病合并血脂异常患者的中医证候要素规律,以期为临床辨证施治提供一定的依据。方法 采集680例冠心病合并血脂异常患者的四诊信息,建立数据库,采用复杂系统熵聚堆、复杂网络展示方法对数据库进行数据挖掘分析。结果 研究发现680例冠心病合并血脂异常患者中核心症状为:胸闷、舌质紫暗、脉细、咳痰、咳嗽、喘憋、胸前区胀痛、气短、心悸、苔黄、脉滑、苔腻、脉弦、眩晕、苔白、失眠、倦怠乏力、舌质红、口干、脉沉。此症状主要分为血瘀、气虚、痰浊3类;基于复杂系统熵聚类方法的研究发现冠心病合并血脂异常常见证候(> 6.6%)为:痰瘀互阻171例(25.1%),气虚血瘀62例(9.1%),阴血津虚51例(7.5%),脾虚气滞49例(7.2%),痰浊阻滞46例(6.7%);证候要素靶位居前3位的是:脾465频次(68.4%),心463频次(68.1%),肺298频次(43.8%)。结论 血瘀、气虚、痰浊为冠心病合并血脂异常的核心证候要素。中医临床治疗冠心病合并血脂异常可以抓住痰、瘀、虚3个主要证候,治法以化浊(化痰、活血)、益气(行气、理气)为主,主张从脾论治,兼顾心、肺。Objective To explore the syndrome and syndrome elements of patients with coronary heart disease and dyslipidemia, in order to provide a certain basis for clinical syndrome differentiation and treatment.Methods The four diagnostic information of 680 patients with coronary heart disease and dyslipidemia were collected and database was established. The data mining analysis of the database was performed by means of complex system entropy aggregation and complex network display.Results The results showed that the core symptoms of 680 patients with coronary heart disease and dyslipidemia were chest tightness, purple tongue, fine pulse, expectoration, cough, asthma, chest area swelling, pain, shortness of breath, palpitation, yellow fur, sliding pulse, greasy fur, string pulse, vertigo, white fur,insomnia, fatigue, red tongue, dry mouth and sinking pulse. The symptoms were divided into three categories: blood stasis, Qi deficiency and phlegm turbidity. Based on the entropy clustering method of complex system, it was found that the common syndromes of coronary heart disease and dyslipidemia(> 6.6%) were: phlegm-blood stasis blocking in 171 cases(25.1%), blood stasis in 62 cases(9.1%), Yin blood deficiency in 51 cases(7.5%), spleen deficiency and Qi stagnation in 49 cases(7.2%), phlegm turbid block in 46 cases(6.7%);the top 3 frequency of target position of syndrome elements was spleen 465(68.4%), heart 463(68.1%), and lung 298(43.8%).Conclusion Blood stasis, Qi deficiency and phlegm turbid are the core syndrome factors of coronary heart disease and dyslipidemia. The clinical treatment of coronary heart disease and dyslipidemia can grasp the syndromes of phlegm, blood stasis and deficiency. The treatment method is mainly to remove turbidity(phlegm and activate blood), and invigorate Qi(exercise Qi and regulate qi). It is suggested to treat from spleen theory and take care of heart and lung.

关 键 词：冠心病合并血脂异常 证候 复杂熵聚堆方法 复杂网络展示 核心病机 

分 类 号：R241[医药卫生—中医诊断学]