基于隐结构模型结合关联规则分析高脂血症合并高血压病的方药规律

Analysis of prescription rules for hyperlipidemia comorbid with hypertension based on latent structure model and association rules

基于隐结构模型和关联规则分析高脂血症合并高血压病的方药规律,并推测中医证型,为临床辨证论治及指南的制订提供参考依据。系统检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献服务系统(SinoMed)中医药治疗高脂血症合并高血压病的文献,提取相关信息,应用Microsoft Excel 2019建立数据库,对高频中药进行频次和性味归经的统计,应用Lantern 5.0、RStudio软件进行隐结构模型与关联规则分析,探讨用药规律并推测中医证型。共纳入中医药处方97篇,涉及中药104味,累计频次1189次,高频中药有茯苓、天麻、白术、半夏、陈皮等,功效以补虚药、活血化瘀药、平肝息风药为主。隐结构分析共获得13个隐变量、42个隐类、5个综合聚类模型、17个核心方剂,推测高脂血症合并高血压病的常见证候共5种,分别是痰湿瘀阻证、痰瘀互结证、肝火亢盛证、阴虚阳亢证和肝肾亏虚证。关联规则分析获得26条强关联规则,其中支持度最高的是天麻→茯苓。高脂血症合并高血压病属本虚标实之证,与机体肝、肾、脾三脏功能失调存在密切关联,痰湿瘀阻、肝肾阴虚为该病的主要发病机制,治疗应以平肝、化痰及健脾原则为主,随证配合气血阴阳,泻其痰、瘀等实邪,辅以降肝火、息肝风等治法。

Based on the latent structure model and association rule analysis,the regularity of prescription for hyperlipidemia comorbid with hypertension was explored,and traditional Chinese medicine(TCM)pattern type was speculated to provide a reference for clinical pattern differentiation and treatment,and guideline establishment.The literature on the treatment of hyperlipidemia comorbid with hypertension by TCM was systematically searched on CNKI,Wanfang,VIP,and SinoMed academic platforms.The relevant information was extracted and a database was established using Microsoft Excel 2019.The frequency and properties of high-frequency TCM were statistically analyzed using Lantern 5.0 and RStudio software.The latent structure model and association rule analysis were applied to explore the medication regularity and speculate TCM pattern type.A total of 97 TCM prescriptions involving 104 TCM were included,with a cumulative frequency of 1189 times.The high-frequency TCM included Poria,Gastrodiae Rhizoma,Atractylodis Macrocephalae Rhizoma,Pinelliae Rhizoma,Citri Reticulatae Pericarpium.The efficacy was mainly based on tonifying deficiency drugs,activating blood circulation drugs,and calming liver wind drugs.A total of 13 latent variables,42 latent classes,and 5 comprehensive clustering models were obtained from the latent structure analysis.A total of 17 core formulas were obtained,suggesting that there were 5 common patterns in hyperlipidemia comorbid with hypertension,namely phlegm-dampness and blood stasis pattern,phlegm-blood stasis pattern,liver-fire hyperactivity pattern,Yin deficiency and Yang hyperactivity pattern,and liver and kidney deficiency pattern.Association rule analysis obtained 26 strong association rules,among which the highest support degree was Gastrodiae Rhizoma→Poria.Hyperlipidemia comorbid with hypertension belongs to the pattern of deficiency in the root and excess in the branch,which is closely related to the dysfunction of the liver,kidney,and spleen in the body.Phlegm-dampness and blood stasis,liver and kidney Yin deficiency are the main pathogenesis of this disease.The treatment should be based on the principles of calming liver fire,resolving phlegm,and strengthening spleen function.According to the pattern,Qi and blood as well as Yin and Yang should be coordinated to eliminate phlegm,blood stasis,etc.,supplemented by treatments such as calming liver fire and eliminating wind from the liver.