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

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".