Liu Yan-Ze, Wang Xin-Lu, Han Wen-Jie, Li Lan-Xin, Wu Rui-Peng, Wang Yong-Xia, Zhu Ming-Jun
Heart Center/National Regional (Traditional Chinese Medicine) Cardiovascular Diagnosis and Treatment Center,the First Affiliated Hospital of Henan University of Chinese Medicine Zhengzhou 450000, China the First Clinical Medical College of Henan University of Chinese Medicine Zhengzhou 450000, China.
Heart Center/National Regional (Traditional Chinese Medicine) Cardiovascular Diagnosis and Treatment Center,the First Affiliated Hospital of Henan University of Chinese Medicine Zhengzhou 450000, China.
Zhongguo Zhong Yao Za Zhi. 2024 Sep;49(18):5045-5054. doi: 10.19540/j.cnki.cjcmm.20240604.501.
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 1 189 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.
基于潜在结构模型和关联规则分析，探讨高脂血症合并高血压的用药规律，推测中医证型，为临床辨证论治及制定指南提供参考。通过中国知网、万方、维普、中国生物医学文献服务系统等学术平台，系统检索中医治疗高脂血症合并高血压的文献。提取相关信息，并用Microsoft Excel 2019建立数据库。运用中医传承辅助平台V5.0及RStudio软件，对高频中药的频次及属性进行统计分析，应用潜在结构模型和关联规则分析，探索用药规律并推测中医证型。共纳入97首中药方剂，涉及104味中药，累计频次1189次。高频中药有茯苓、天麻、白术、半夏、陈皮。功效以补虚药、活血化瘀药、平肝息风药为主。潜在结构分析共得到13个潜在变量、42个潜在类别、5个综合聚类模型。共得到17个核心方剂，提示高脂血症合并高血压存在5种常见证型，即痰湿血瘀证、痰瘀互结证、肝火亢盛证、阴虚阳亢证、肝肾亏虚证。关联规则分析得到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属本虚标实之证，与机体肝、肾、脾功能失调密切相关。痰湿血瘀、肝肾阴虚是本病的主要病机。治疗应以平肝泻火、化痰、健脾为原则，根据证型协调气血、阴阳，消除痰瘀等病理产物，辅以平肝泻火、清肝息风等治法。
