基于数据挖掘的扩张型心肌病中医证候学研究

Study on the Traditional Chinese Medicine Syndrome of Dilated Cardiomyopathy Based on Data Mining

目的 研究扩张型心肌病的中医证型特点以及证候要素分布规律,为扩张型心肌病的中医证候规范化提供依据。方法 检索中国学术期刊全文数据库(CNKI)2000年1月—2020年12月发表的与扩张型心肌病中医证型相关的文献,根据纳入与排除标准筛选合格文献,进一步对其中提到的中医证型及证候要素进行统计分析。结果 纳入符合要求的文献15篇,涉及2 101例病人,总结12种主要中医证型,统计各证型频数及百分比。扩张型心肌病中占比最高的6种中医证型分别是气阴两虚(24.56%)、心气虚弱(14.52%)、心肾阳虚(13.90%)、气虚血瘀(11.80%)、阳虚水泛(8.14%)、痰浊痹阻(7.28%)。在证候要素方面,气虚是最主要的虚性证素,实性证素包括痰浊、瘀血、水饮。结论 扩张型心肌病在临床上多属虚证,最常见气虚,也可与阴虚、阳虚并为患,因虚致实进一步发展,兼有痰浊、瘀血等病理产物可演变为虚实夹杂,故扩张型心肌病发展至后期,其病性属本虚标实。

Objective To study the characteristics of traditional Chinese medicine(TCM) syndrome types of dilated cardiomyopathy and provide a basis for the standardization of TCM syndromes of dilated cardiomyopathy.Methods The literatures related to TCM syndrome types of dilated cardiomyopathy published from January 2000 to December 2020 were retrieved from China Academic Journal Full-text Database(CNKI).The qualified literatures were screened according to the inclusion and exclusion criteria, and the TCM syndrome types and syndrome elements were further statistically analyzed.Results Fifteen papers meeting the requirements were included.There were 2 101 patients with dilated cardiomyopathy.Twelve main TCM syndrome types were summarized. The common syndrome types included deficiency of both Qi and Yin(24.56%), weakness of heart Qi(14.52%),and deficiency of heart and kidney yang(13.90%),Qi deficiency and blood stasis(11.80%),Yang deficiency and flooding(8.14%),and phlegm-turbid obstruction syndrome(7.28%).In terms of syndrome elements, Qi deficiency was the main deficiency syndrome, while phlegm, blood stasis, and drinking water were the main solid syndromes.Conclusion Qi deficiency is the most common syndrome of dilated cardiomyopathy in clinical practice.It is often combination of Yin deficiency and Yang deficiency.When deficiency develops, phlegm, blood stasis, and other pathological products can turn the disease into a mixture of deficiency and excess, thus, dilated cardiomyopathy progresses into the later stage, with deficiency in essence and excess in manifestations.