基于中医问诊信息的上海地区肥胖高血压的中医证候分类模型

TCM Syndrome Classification Model of Obesity Hypertension in Shanghai Based on TCM Inquiry Information

目的肥胖高血压证候识别模型相关研究较少,本研究基于隐结构模型分析上海地区肥胖高血压中医证候特点,为临床辨证提供依据。方法本研究收集427例上海地区肥胖高血压患者的中医问诊信息,结合频数分析及专家意见,筛选主要症状,采用双重爬山法,以Lantern 5.0软件构建肥胖高血压中医问诊信息隐结构模型,对隐变量进行综合聚类分析,分析肥胖高血压中医证候分布,建立证候分类模型。结果427例上海地区肥胖高血压患者的中医问诊信息中,出现最多的5种症状为眩晕(79.3%)、口干口渴(61.2%)、心悸怔忡(60.0%)、急躁易怒(56.9%)、头痛(54.0%),30个显变量构建隐结构模型,得到6个隐变量Y0、Y1、Y2、Y3、Y4、Y5。结论上海地区肥胖高血压患者的临床证候虚实夹杂,基于隐结构模型将该病主要证候分为肝阳上亢证、阴阳两虚证、心肾阴虚证,痰浊、血瘀为肥胖高血压重要的病理因素。隐结构模型对肥胖高血压证候分析的结果与该病的中医临床特点基本吻合,可以反映其主要病因病机。

Objective There are few relevant studies about the identification model of obesity hypertension syndrome.This study analyzed the characteristics of traditional Chinese medicine(TCM)syndrome of obesity hypertension in Shanghai area to provide evidence for clinical differentiation based on the latent structure model.Methods TCM inquiry information of 427 patients with obesity hypertension in Shanghai was collected.The main symptoms were selected by combining frequency analysis and experts'opinions.The latent structure model of TCM consultation information of obesity hypertension patients was constructed by double climbing method and Lantern 5.0.The latent variables were comprehensively cluster analyzed,which helped to analyze the distribution of TCM syndromes of obesity hypertension patients and establish a syndrome recognition model.Results Among 427 cases of obesity hypertensive patients in Shanghai,the top five symptoms are dizziness(79.3%),dry mouth and thirst(61.2%),palpitation(60.0%),impatience and irritability(56.9%),headache(54.0%).The study acquired 6 hidden variables using 30 observable variables,including Y0,Y1,Y2,Y3,Y4 and Y5.Conclusion The clinical syndromes of obesity hypertension patients in Shanghai are mixed with deficiency and excess.The latent structure model divides the main syndromes into hyperactivity of liver Yang,deficiency of Yin and Yang,deficiency of heart and kidney Yin,and phlegm-blood stasis.Phlegm turbidity and blood stasis were the important pathological factors of obesity hypertension.The results of the classification of obesity hypertension syndromes by the latent structure model are basically consistent with the clinical characteristics of the disease and can reflect the main etiology and pathogenesis.