高血压病中医症状国际社区医疗分类特点关联规则分析

Association Rules Analysis of International Classification of Primary Care of Chinese Medicine Symptoms in Hypertension

目的探索高血压病的临床症状分布以及中西医对症状认识的异同,为高血压病临床诊治提供参考依据。方法以"高血压病""症状""中医"等为关键词检索中国知网、万方、维普已发表的文献,并由两名研究人员独立提取高血压病临床证型数据并建立数据库。将证型分词后,采用国际社区医疗分类(ICPC)对数据进行两级分类,用频次统计、CytoHubba算法、关联规则方法分析数据,并使用Cytoscape3.7.2进行可视化处理。结果最终纳入1 026篇文献,提取高血压病中医证型311例,分词后获得高血压病相关症状3 387个。ICPC一级分类下高频系统(症状>250次)出现在神经(561次)、精神心理(528次)等6个方面,关联规则分析显示精神/心理与神经系统之间关联程度最高;ICPC二级分类下高频组分(症状>130次)出现在眩晕/头晕(266次)、头痛(209次)等7个方面,关联规则分析显示睡眠障碍与眩晕/头晕之间关联程度最高。高血压病的临床症状分布涉及ICPC下88.2%的人体器官系统,对频次排序前20的症状进行关联规则分析后发现,腰膝酸软、健忘、五心烦热与耳鸣症状关联密切,口苦、面红、目赤与易怒相关。眩晕、耳鸣、口苦是高血压病的核心症状。结论高血压病中医症状涉及西医多个系统,与神经、精神心理、消化、皮肤等系统联系密切,中医更关注口苦、面红、目赤、耳鸣、五心烦热、腰膝酸软等五官、皮肤及非特异性的症状。

Objective To explore the distribution of clinical symptoms of hypertension and the similarities and differences of symptom recognition between Chinese and Western medicine,so as to provide a basis for the clinical diagnosis and treatment of hypertension. Methods Literature search of the Chinese National Knowledge Infrastructure(CNKI),Wanfang and VIP databases was conducted using the keywords "hypertension" "symptoms",and"Chinese medicine",and two researchers independently extracted clinical data on hypertension and established a database. After word segmentation of syndromes,the data was classified into two classes according to the International Classification of Primary Care(ICPC),and analyzed by frequency statistics,Cyto Hubba algorithm,and association rule method. Cytoscape 3.7.2 was used for visual processing. Results A total of 1 026 articles were finally included,311 Chinese medicine(CM) syndromes with CM certificate type of hypertension were extracted,and 3 387 symptoms related to hypertension were obtained after word segmentation. High frequency systems under ICPC Class Ⅰ(symptoms with > 250 hits)were identified in 6 areas including nervous(561 hits)and metal/psychological(528 hits),and association rules analysis showed the highest degree of correlation between mental/psychological and nervous systems. High-frequency groups under ICPC Class Ⅱ(symptoms with > 130 hits) were identified in 7 areas including vertigo/dizziness(266 hits)and headache(209 hits),and the analysis of association rules showed the highest degree of correlation between sleep disorders and vertigo/dizziness. The distribution of clinical symptoms of hypertension involved 88.2% of the human organ systems under the ICPC classification and association rules analysis of the top 20 most frequent symptoms found that weakness in waist and knees,forgetfulness,dysphoria with vexing heat in chest,palms and soles,and tinnitus were closely related. bitter taste in the mouth,reddened complexion,red eyes,and irritability were related. Dizziness,tinnitus,and bitterness in the mouth were identified as core symptoms of hypertension. Conclusions CM symptoms of hypertension involve multiple systems,and are closely related to nerves,psychology,digestion,skin and other systems. CM pays more attention to the facial features and skin such as bitter taste in the mouth,reddened complexion,red eyes,irritability,vexing heat in chest,palms and soles,and weakness in waist and knees and non-specific symptoms.