基于文献挖掘的咳嗽变异性哮喘患者中医基础证候特征分析

Analysis of Basic Syndrome Characteristics of Cough Variant Asthma Based on Literature Mining

目的探讨咳嗽变异性哮喘(CVA)中医基础证候分布规律及特征,为临床辨证和证候规范研究提供依据。方法检索建库至2020年9月26日中国期刊全文数据库、万方数据知识服务平台、中文科技期刊全文数据库、中国生物医学文献数据库中CVA证候或症状相关文献。应用SPSS 25.0软件,提取纳入文献相关信息建立数据库并进行统计描述;应用SPSS Modeler 14.1软件,通过Apriori算法对证素进行关联规则分析;应用Cytoscape 3.7.2软件构建证素间关联网状图;应用Lantern 5.0软件,通过LTM-EAST算法对症状进行隐结构分析。结果纳入文献577篇,包含基础证候29个,证素19个,症状117个。构成比≥5.0%的基础证候有肺气虚证、肺阴虚证、风邪犯肺证、风寒证、痰热证、痰湿证;关联规则分析得到强关联规则7条,推断出痰热证、热邪壅肺证、风邪犯肺证、风热证、风寒证5个基础证候;对频次>3的症状通过隐结构分析,得到隐变量26个、隐类52个。对25个隐变量(隐变量Y4可单独列为血瘀证,故除外)进行综合聚类,并结合隐变量Y4共推断出10个基础证候,分别为肺气虚证、肺阴虚证、肾阳虚证、风寒证、风邪犯肺证、风热证、痰湿证、痰热证、肝火炽盛证、血瘀证。综合以上结果,最终得到7个常见基础证候,包括肺气虚证、肺阴虚证、风邪犯肺证等。结论CVA病位主要在肺,病因以风、痰、热为主,基础证候为肺气虚证、肺阴虚证、风邪犯肺证、风寒证、风热证、痰湿证、痰热证,各基础证候具备一定症状特征。

Objective To explore the distribution rules and basic characteristics of traditional Chinese medicine(TCM)syndromes of cough variant asthma(CVA),thereby providing evidence for clinical syndrome differentiation and syndrome standardization.Methods The databases including CNKI,Wanfang,VIP and SinoMed were searched for studies involving CVA related syndromes or symptoms from the inception dates till September 26th,2020.The data of the included studies were extracted to established the database,and SPSS 25.0 software was used for descriptive analysis.SPSS Modeler 14.1 software was used to analyze the association rules of syndrome elements through Apriori algorithm.Cytoscape 3.7.2 software was used to construct the network diagram of associations be⁃tween syndrome elements.Lantern 5.0 software was used to analyze the latent structure of symptoms through LTMEAST algorithm.Results Totally,577 studies were included,involving 29 basic syndromes,19 syndrome ele⁃ments and 117 symptoms.The basic syndromes with ratio≥5.0%were lung qi deficiency syndrome,lung yin defi⁃ciency syndrome,pathogenic wind invading the lung syndrome,wind-cold syndrome,phlegm-heat syndrome,and phlegm-dampness syndrome.Seven strong association rules were obtained,deducing five basic syndromes including phlegm-heat syndrome,pathogenic heat obstructing the lung syndrome,pathogenic wind invading the lung syndrome,wind-heat syndrome,and wind-cold syndrome.The analysis of the latent structure regarding the symptoms with fre⁃quency>3 identified 26 latent variables and 52 latent categories.By performing comprehensive clustering analysis of the 25 latent variables(latent variable Y4 was excluded as it can be separately listed as blood stasis syndrome)and re ferring to the latent variable Y4,10 basic syndromes were inferred which were lung qi deficiency syndrome,lung yin deficiency syndrome,kidney yang deficiency syndrome,wind-cold syndrome,pathogenic wind invading the lung syn⁃drome,wind-heat syndrome,phlegm-dampness syndrome,phlegm-heat syndrome,intense liver fire syndrome,and blood stasis syndrome.Based on the above results,seven common basic syndromes were finalized such as lung qi defi⁃ciency syndrome,lung yin deficiency syndrome,and pathogenic wind invading the lung syndrome.Conclusion The location of CVA is mainly in the lung,and the pathogenesis is mainly involved with wind,phlegm and heat.The basic syndromes include lung qi deficiency syndrome,lung yin deficiency syndrome,pathogenic wind invading the lung syndrome,wind-cold syndrome,wind-heat syndrome,phlegm-dampness syndrome,and phlegm-heat syndrome,and each syndrome have certain symptom features.