高血压病人中医证型的聚类分析

The Traditional Chinese Medicine Syndromes in Hypertension Patients Based on Cluster Analysis

目的探讨高血压病中医证型分类,为中医临床辨证论治提供理论依据。方法在944例高血压病病人与中医证候相关变量原始数据基础上,检查录入结果一致性后,导入SPSS 20.0统计软件并运用聚类分析进行数据统计分析。结果通过对收集的944例高血压病病人症状进行频率描述,剔除频率百分比≤2.0%症状后,将剩余58个临床症状作为变量进行K-means聚类分析,得出聚类为7类时症状分布最明显,原始证型分类为痰湿壅盛、脾运失健、心肾失养,占21.2%;阴阳两虚、气血不足,占17.5%;气虚血瘀,占15.6%;肝火亢盛、心肾不足,占14.5%;中气不足、生化失源、水湿不化,占13.8%;肾阴不足、肝阳上亢、心肾不交,占8.9%;肾阳不足、心脾两虚,占8.6%。经过聚类分析总结后,按其所占比例排序,最终分类为7类:痰湿壅盛型、阴阳两虚型、气虚血瘀型、肝火亢盛型、中气不足型、阴虚阳亢型、肾阳不足型。结论痰湿壅盛型在调查病人中所占比例最高,肾阳不足型所占比例最少,与病例收集所在区域地域气候可能相关。

Objective To explore the classification of traditional Chinese medicine syndromes of hypertension and provide the objective and scientific theories for clinical treatment based on syndrome differentiation of Traditional Chinese Medicine.Methods Based on the original data of 944 patients with hypertension and variables related to Traditional Chinese Medicine syndromes,the data were managed by SPSS 20.0 statistical software after checking the consistency of input results,and cluster analysis to do statistical analysis of data were used.Results The frequency of symptoms was collected from 944 patients with hypertension,and the 58 remaining clinical symptoms were used as the variables for K-means cluster analysis after eliminating the frequency percentage of the symptoms which is less than or equal to 2.0%.The symptom distribution was most obvious when the cluster was seven.The primitive syndrome type is classified as:excessive accumulation of the phlegm-dampness,dysfunction of the spleen in transport,malnutrition of heart and kidney,totally accounting for 21.2%;deficiency of Yin and yang,deficiency of blood and Qi,17.5%;blood stasis due to Qi deficiency,15.6%;hyperactivity of liver fire,deficiency of heart and kidney,14.5%;insufficiency of splenogastric Qi,loss of generation and transform source,water-damp failing to transform,13.8%;Yin deficiency of kidney,hyperactivity of liver Yang,imbalance between heart-yang and kidney-yin,8.9%;Yang deficiency of kidney,insufficiency of heart and spleen,8.6%.According to proportion of sorting,the Traditional Chinese Medicine syndromes was divided into 7 categories with cluster analysis and finally classified as:excessive accumulation of the phlegm-dampness,deficiency of Yin and yang,blood stasis due to Qi deficiency,hyperactivity of liver fire,insufficiency of splenogastric Qi,yin deficiency and yang excess,Yang deficiency of kidney.Conclusion Excessive accumulation of the phlegm-dampness(21.2%)has the highest proportion in the investigated patients,while Yang deficiency of kidney(8.6%)has the least proportion.It may be associated with the regional climate of the case collection.