高血压病中医证型的聚类分析

Cluster analysis of Chinese medicine evidence patterns of hypertensive diseases

关键词:  聚类分析  高血压病  中医证型  分布研究

Key words:  cluster analysis  hypertension  Chinese medicine evidence  distribution study

摘要:

[目的] 探索高血压病患者的证型分布及基本信息与证型的相关性。[方法] 通过天津中医药大学第二附属医院内分泌科及心内科的高血压病患者,进行临床流行病学调查,收集4 942例高血压病患者的基本信息和症状等,分析高血压病患者中医证候类型分布特点。[结果] 高血压病是一种临床上常见的慢性疾病,青年组不容易患此病,且青年组主要证型为肝火亢盛证,此病最高发人群为中老年人。中老年人身体各项机能逐渐衰退。研究发现:在肝肾阴虚证、肝火亢盛证、气虚痰浊证与瘀热互结证4组证型中,男性与女性有差异。在阴阳两虚证与瘀热互结证两组证型中,汉族与非汉族之间有差异。在肝肾阴虚证与气虚痰浊证两组证型中,青年组与中年组这两组都与老年组有差异;在肝火亢盛证中,青年组、中年组与老年组互相之间都有差异。最后在瘀热互结证中,青年组与老年组有差异。[结论] 研究显示:高血压病更多以"热"象为主,主要涉及肝、肾、脾3脏,以头晕、疲倦、乏力、烦躁易怒、目干涩、视物昏花等为主症。且根据数据临床可分为五大证型,分别为阴阳两虚证、肝肾阴虚证、肝火亢盛证、气虚痰浊证、瘀热互结证。其中肝肾阴虚证和肝火亢盛证居临床多数。

Abstract:

[Objective] To explore the distribution of evidence patterns of hypertensive patients and the correlation between basic information and evidence patterns. [Methods] A clinical epidemiological survey was conducted to collect the basic information and symptoms of 4 942 hypertensive patients in the Department of Endocrinology and the Department of Cardiology of the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine to analyse the distribution characteristics of Chinese medicine evidence types in hypertensive patients. [Result] Hypertension is a common chronic disease in clinic,the youth group is not prone to this disease,and the main evidence of the youth group is the evidence of liver fire hyperactivity,the highest incidence of this disease in the population of middle-aged and old people. The highest incidence of this disease is among the middle-aged and the elderly. The body functions of the middle-aged and the elderly are gradually declining. There were differences between males and females in liver and kidney yin deficiency,liver-fire hyperactivity,qi deficiency and phlegm turbidity,and stasis-heat interconnection. There were differences between Han Chinese and non-Han Chinese in the yin-yang deficiency syndrome and the stasis-heat syndrome. In the liver and lidney yin deficiency and qi deficiency and phlegm turbidity syndromes,there were differences between the young and middle-aged groups and the elderly group;in the liver fire excessive syndromes,there were differences between the young,middle-aged and elderly groups. Finally,in the syndrome of stasis-heat interconnection,there was a difference between the young group and the elderly group. [Conclusion] This study shows that hypertension is mainly caused by "heat",which mainly involves the liver,kidney and spleen organs,and is characterized by dizziness,tiredness,fatigue,irritability,dryness of the eyes and blurred vision,etc. According to the data,it can be clinically classified into five major syndromes. According to the clinical data,it can be classified into five major types,namely,yin and yang deficiency,liver and kidney yin deficiency,liver fire hyperactivity,qi deficiency and phlegm turbidity,and stasis and heat interconnection. Among them,liver and kidney yin deficiency and liver fire hyperactivity are the clinical majority.