基于隐结构模型探讨冠心病合并高血压糖尿病患者中医证候特征  

Exploration on the Characteristics of TCM Syndromes in Patients with Coronary Heart Disease Complicated with Hypertension and Diabetes Based on Latent Structure Model

作　　者：肖欣昂 李洁韵 夏雨墨 许朝霞[1,2] 林洁琪 王忆勤 XIAO Xin'ang;LI Jieyun;XIA Yumo;XU Zhaoxia;LIN Jieqi;WANG Yiqin(School of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Key Laboratory of Health Identification and Assessment of Shanghai,Shanghai 201203,China)

机构地区：[1]上海中医药大学中医学院,上海201203 [2]上海市健康辨识与评估重点实验室,上海201203

出　　处：《中国中医药信息杂志》2024年第7期141-147,共7页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82074333);上海市健康辨识与评估重点实验室项目(21DZ2271000)。

摘　　要：目的基于隐结构模型探讨冠心病合并高血压糖尿病患者的中医证候特征。方法采用多中心横断面研究的方法,使用本课题组研制的《冠心病中医四诊采集量表》收集患者中医四诊信息,建立临床数据库。结合频次分析和专家意见筛选四诊信息构建隐结构模型。结果共收集冠心病合并高血压糖尿病患者702例,筛选得到高频四诊症状40个,隐结构模型分析得到18个隐变量,模型贝叶斯信息准则评分为-17604.38。对模型中隐变量进行综合聚类,发现冠心病合并高血压糖尿病患者病位证素主要有心、肝、肾等,病性证素主要有气虚、阴虚、气滞、痰浊、血瘀等,归纳其证型主要有痰瘀互结证、脾肾阳虚证、肝郁气滞证、肝肾阴虚证、湿热内蕴证5类,并提示各证型与四诊信息间的互信息及信息覆盖度。结论隐结构模型分析可为冠心病合并高血压糖尿病患者的证候分类提供一定的定性定量依据。Objective To explore the characteristics of TCM syndromes in patients with coronary heart disease complicated with hypertension and diabetes based on latent structure model.Methods A multi-center cross-sectional study was used to collect the four diagnostic information of patients with coronary heart disease by using the Four Diagnostic Collection Scales of TCM developed by our research group,and a clinical database was established.Combined with frequency analysis and expert opinions,the four diagnostic information was screened to construct a latent structure model.Results Totally 702 patients with coronary heart disease complicated with hypertension and diabetes were collected.A total of 40 high-frequency four-diagnosis symptoms were screened,and 18 latent variables were obtained by latent structure model analysis.The model BIC score was-17604.38.The latent variables in the model were comprehensively clustered,and it was found that the syndrome elements of disease location in patients with coronary heart disease complicated with hypertension and diabetes were mainly heart,liver,kidney,etc.,and the syndrome elements of disease nature were mainly qi deficiency,yin deficiency,qi stagnation,phlegm turbidity,blood stasis,etc.The syndrome types were mainly phlegm and blood stasis syndrome,spleen and kidney yang deficiency syndrome,liver depression and qi stagnation syndrome,liver and kidney yin deficiency syndrome,damp-heat intrinsic syndrome,and the mutual information and information coverage between each syndrome type and the four diagnostic information were suggested.Conclusion Latent structure model analysis can provide a qualitative and quantitative basis for the syndrome classification of patients with coronary heart disease complicated with hypertension and diabetes.

关 键 词：冠心病 合并病 隐结构模型 证候特征 

分 类 号：R259.4[医药卫生—中西医结合]