基于网络分析鉴别缺血性中风急性期不同中医证候的核心症状  

Network Analysis-Based Identification of Core Symptoms in Different Chinese Medicine Syndromes During the Acute Phase of Ischemic Stroke

作　　者：古联[1] 王伟涛[2] 黎冬梅 刘声莹 宋潇宵 彩虹 苏莉[3] GU Lian;WANG Weitao;LI Dongmei;LIU Shengying;SONG Xiaoxiao;CAI Hong;SU Li(The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,China;Guangxi University of Chinese Medicine,Nanning 530001,China;School of Public Health Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西中医药大学第一附属医院,南宁530023 [2]广西中医药大学,南宁530001 [3]广西医科大学公共卫生学院,南宁530021

出　　处：《世界科学技术-中医药现代化》2024年第11期2837-2845,共9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地区科学基金项目(82160849):缺血性中风及其中医证型的血浆外泌体circRNA生物标志物鉴别及生物学功能研究,负责人:古联;国家发展和改革委员会、国家中医药管理局国家中医药传承创新中心建设项目:广西名中医学术思想挖掘及经验方中风合剂作用机制和疗效评价,负责人:古联。

摘　　要：目的旨在阐明缺血性中风急性期不同中医证候的发生率,并明确不同证候的核心症状。方法纳入1011例缺血性中风急性期患者,分别在起病72 h内、起病第7、14天,采用《中风病辨证诊断标准》对中风患者进行中医证候评分。通过R4.2.3软件进行中医证候与症状的网络分析。结果分别在起病72 h、第7、14天,痰证的发生率均为最高(54.10%、51.18%、49.39%),其后依次为风证、火热证、血瘀证、气虚证和阴虚阳亢证。风证发生率随着时间的推移而逐渐降低(χ^(2)=15.619,P<0.001)。在44条中医证候条目网络中,TZ-5(脉象)中心性指数(strength=2.4)最高,位于网络最核心。在不同中医证候的网络分析中,TZ-5(脉象)(strength=1.91)位于痰证网络的中心,FZ-1(起病)(strength=1.61)位于风证网络的中心,火热证中HRZ-2(舌苔)(strength=1.37)位于网络的中心,XYZ-1(舌质)(strength=1.18)位于血瘀证网络的中心。结论痰证是缺血性中风急性期的最主要证候,运用网络分析方法可以明确不同证候的核心症状以及症状之间的相互关联,为缺血性中风辨证提供新的思路。Objective The study aimed to investigate the prevalence of various Traditional Chinese Medicine(TCM)syndromes during the acute phase of ischemic stroke and identify the key symptoms associated with each syndrome.Methods A total of 1011 patients in the acute phase of ischemic stroke were assessed for TCM syndromes using the"Diagnostic criteria for stroke in Traditional Chinese Medicine"within 72 h of symptom onset,on the 7th day post onset,and on the 14th day.R4.2.3 software was utilized to analyze the TCM syndromes and symptoms,as well as to conduct network analysis.Results The incidence of phlegm syndrome was the highest(54.10%,51.18%,49.39%)at 72 h,7th and 14th day of disease onset,respectively,followed by wind syndrome,fire-heat syndrome,blood stasis syndrome,qi deficiency syndrome and excessive yang due to yin deficiency syndrome.The incidence of wind syndrome gradually decreased over time(χ^(2)=15.619,P<0.001).In the network of 44 TCM syndrome entries,TZ-5(pulse)had the highest centrality index(strength=2.4)and was located at the most central position of the network.In the network analysis of different TCM syndrome,TZ-5(pulse)(strength=1.91)was located in the center of the phlegm syndrome network,FZ-1(onset)(strength=1.61)was located in the center of the wind syndrome network,HRZ-2(tongue coating)(strength=1.37)was located in the center of the network in the fire-heat syndrome,XYZ-1(tongue texture)(strength=1.18)was located at the center of the network for the blood stasis syndrome.Conclusion The phlegm syndrome is the most important syndrome in the acute phase of ischemic stroke.Employing network analysis can elucidate the central symptoms of different syndromes and the interconnections between the symptoms,providing new ideas for the identification of ischemic stroke.

关 键 词：缺血性中风 中医证候 症状 网络分析 

分 类 号：R-058[医药卫生]