基于关联规则的焦虑抑郁共病中医证候规律研究

发布时间：2017-12-31 01:04

  本文关键词：基于关联规则的焦虑抑郁共病中医证候规律研究　出处：《北京中医药大学》2017年硕士论文　论文类型：学位论文

  更多相关文章： 关联规则 焦虑抑郁共病 聚类分析 中医证候

【摘要】：研究目的:采用数据挖掘技术中的关联规则方法对焦虑抑郁共病的中医证候进行主要分析并应用聚类分析作为辅助对结果进行系统验证。通过探索焦虑抑郁共病中医症状间的相互联系,并分析相关主要证候要素,深入总结证候要素间的关联关系,最终归纳焦虑抑郁共病的中医核心病机和证候分布规律。研究方法:本课题采用横断面研究,在2014年10月至2016年10月期间在北京安定医院、北京回龙观医院、北京中医药大学第三附属医院、连云港市中医院等4家医院收集焦虑抑郁共病患者。通过焦虑自评量表和抑郁自评量表对可疑患者进行筛选,对符合焦虑抑郁共病纳入条件的患者,完成中医证候观察表,并通过汉密尔顿焦虑量表和抑郁量表记录患者的严重程度。将课题观察表的相关资料通过Microsoft Excel 2010建立数据库,通过SPSS 21.0和数据挖掘软件SPSS Modeler14.1对数据进行关联规则分析和系统聚类分析,在中医理论的指导下,对焦虑抑郁共病的证候规律进行研究。研究结果:(1)523例符合纳入标准的焦虑抑郁共病患者中,年龄最低21岁,最高65岁,男女比例为1:1.58。其中40-60岁是本病的高发病年龄阶段,约占56%。在41-50岁之间男女比例为1:1.02,说明在本年龄阶段男性的患病比例明显提高。(2)通过汉密尔顿焦虑量表和抑郁量表对疾病的严重程度研究,结果表明研究人群以轻度焦虑和抑郁为主,所占比例在70%-80%之间。中度焦虑抑郁和重度焦虑抑郁的比例均在10%左右;30-40岁之间,中度和重度焦虑所占比例较高,达到25%和16.7%,重度抑郁所占比例为22.6%,同样高于平均值。提示30-40岁之间的共病患者的焦虑和抑郁程度普遍较重;不同性别患者中,焦虑和抑郁程度都以轻度为主,所占比例在80%左右,但中度和重度焦虑抑郁以男性所占比例较高。提示男性共病患者焦虑和抑郁程度更重。(3)关联规则研究发现焦虑抑郁共病的常见中医症状为担忧、心烦易怒、紧张、神疲乏力、善食易饥、入睡困难、多梦、兴趣索然等。根据关联规则和中医理论提取出14项证候要素,即肝气郁,肝火旺,心气虚,心血虚,心阴虚,心阳虚,心火亢盛,脾气虚,脾阳虚,肾阴虚,肾阳虚,胆气虚,痰湿和血瘀。采用关联规则对14项证候要素的关系进行分析,并用聚类分析辅助验证,在中医理论的指导下,归纳出焦虑抑郁共病5个中医证型,分别为:肝郁化火证、肾虚肝郁证、肝郁脾虚证、心胆气虚证、脾肾阳虚证。(4)对焦虑抑郁共病的5项证型的主症、次症归纳结果为:①肝郁化火证,主症:口干口苦,胁肋胀痛,入睡困难,多梦,头晕。次症:面部烘热,多疑,头痛,耳鸣,早醒,便秘。②肾虚肝郁证,主症:精神萎靡,胁肋胀痛,善太息,头晕,恐惧,腰酸背痛。次症:足膝酸软,腹胀,胸闷气短,畏寒肢冷。③肝郁脾虚证,主症:神思不聚,胁肋胀痛,善叹息,暖气,腹泻。次症:畏寒肢冷,胸闷气短,梅核气,纳差,腹胀,腹痛。④心胆气虚证,主症:精神萎靡,胆怯易惊,心悸,恐惧,多疑,入睡困难,悲伤欲哭。次症:口干口苦,早醒,胸闷气短,胸痛,自汗,畏寒肢冷。⑤脾肾阳虚证,主症:精神萎靡,神思不聚,恐惧,头晕,腹泻,腰酸背痛,足膝酸软。次症:纳差,暖气,腹胀,畏寒肢冷,性欲低下。研究结论:(1)本研究采用关联规则和聚类分析等数据挖掘方法对焦虑抑郁共病的中医证候分布规律进行探索。归纳出5个焦虑抑郁共病的中医证候:肝郁化火证、肾虚肝郁证、肝郁脾虚证、心胆气虚证、脾肾阳虚证。通过证候因子的评分,发现本病的病位要素与心、肝、胆关系密切,病性要素与火热、气虚、气郁等关系密切。(2)本研究证实关联规则在证候降维、降阶和升阶方面均具有良好的作用,能够较准确的反映疾病的证候规律特征,可以用于中医证候研究。
[Abstract]:Objective: To study TCM syndrome using association rule mining method of comorbid anxiety and depression are mainly analyzed and application of clustering analysis as the auxiliary system to verify the results. Through the exploration of comorbid anxiety and depression related symptoms among, and the analysis of the relevant main elements of syndrome, syndrome relationship in-depth summary elements of the core, the TCM pathogenesis and syndrome distribution induced comorbid anxiety and depression. Methods: a cross-sectional study of this topic, in the period from October 2014 to October 2016 in Beijing Anding Hospital, Beijing Hui Long Guan Hospital, Third Affiliated Hospital of Beijing University of Chinese Medicine, Lianyungang Hospital of Traditional Chinese Medicine and 4 hospitals were collected. Patients with comorbid anxiety and depression by self rating Anxiety Scale and self rating Depression Scale for suspected patients were screened for with comorbid anxiety and depression conditions included patients completed Medicine syndrome observation table, and the Hamilton anxiety scale and depression scale, the severity of the patients records. The relevant information subject observation table by Microsoft Excel 2010 database, SPSS Modeler14.1 software to analyze the data association rules analysis and system clustering and data mining by SPSS 21, under the guidance of Chinese medicine theory, for study on the regularity of TCM syndrome of comorbid anxiety and depression. The results of the study: (1) 523 patients met the inclusion criteria of comorbid anxiety and depression in patients with a minimum age of 21 years old, 65 years old, male to female ratio of 1:1.58. which is a high incidence of 40-60 years old age stage of the disease, accounting for about 56%. in the proportion of men and women between the ages of 41-50 for 1:1.02, that increase in the proportion of patients in this age of men. (2) research on disease severity by Hamilton anxiety scale and depression scale, the research results show that people with mild coke Worry and depression, the proportion between 70%-80%. Moderate anxiety depression and severe anxiety and depression proportion were about 10%; age between 30-40, moderate and severe anxiety accounted for a higher proportion, reached 25% and 16.7%, severe depression accounted for 22.6%, higher than the same average. In between the ages of 30-40 co patients with anxiety and depression generally heavier; patients with different gender, anxiety and depression are mainly mild, the proportion is about 80%, but the moderate and severe anxiety and depression in men accounted for a higher proportion of male patients. It is suggested that anxiety and depression more serious. (3) the research of association rules discovery the common symptoms of comorbid anxiety and depression anxiety, irritability, tension, lassitude, bulimia, sleep difficulties, dreaminess, interest and so on. According to the association rules and the theory of traditional Chinese medicine extract 14 syndrome factors, namely liver qi depression, anger ,蹇冩皵铏，

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