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Article(id=1149768943260319858, tenantId=1146029695717560320, journalId=1146123166801305609, issueId=1149768937925165147, articleNumber=null, orderNo=null, doi=10.12404/j.issn.1671-1815.2406789, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1725897600000, receivedDateStr=2024-09-10, revisedDate=1734883200000, revisedDateStr=2024-12-23, acceptedDate=null, acceptedDateStr=null, onlineDate=1752055877747, onlineDateStr=2025-07-09, pubDate=1748361600000, pubDateStr=2025-05-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1752055877747, onlineIssueDateStr=2025-07-09, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1752055877747, creator=13701087609, updateTime=1752055877747, updator=13701087609, issue=Issue{id=1149768937925165147, tenantId=1146029695717560320, journalId=1146123166801305609, year='2025', volume='25', issue='15', pageStart='6155', pageEnd='6586', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1752055876475, creator=13701087609, updateTime=1768456822194, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1218559490207699090, tenantId=1146029695717560320, journalId=1146123166801305609, issueId=1149768937925165147, language=EN, specialIssueTitle=, coverIllustrator=, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1218559490211893395, tenantId=1146029695717560320, journalId=1146123166801305609, issueId=1149768937925165147, language=CN, specialIssueTitle=, coverIllustrator=, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=6261, endPage=6267, ext={EN=ArticleExt(id=1149768943935602817, articleId=1149768943260319858, tenantId=1146029695717560320, journalId=1146123166801305609, language=EN, title=Data Mining-based Study on Traditional Chinese Medicine Syndromes and Syndrome Elements in Patients with Chronic Kidney Disease, columnId=1156262732384031076, journalTitle=Science Technology and Engineering, columnName=Papers·Medicine, runingTitle=null, highlight=null, articleAbstract=

In order to summarize the distribution characteristics of traditional Chinese medicine (TCM) syndromes and syndrome elements in chronic kidney diseases (CKD). The studies related to TCM syndromes in patients with CKD were searched for in CNKI, WANFANG DATA, VIP, SinoMed, Pubmed, Embase and Cochrane Library from the inception dates to August 21th, 2024, and extracted the relevant information. WPS Excel was used to count the frequency of basic characteristics, syndrome types, and syndrome elements in the literature for establishing a database. The distribution characteristics of syndrome elements were explored by association rule analysis and systematic clustering techniques within data mining. The results show that a total of 126 articles are enrolled, including 45 382 patients with CKD. There are 129 TCM syndrome types and 37 syndrome elements (23 disease nature elements and 14 disease location elements). There are 7 syndrome element combinations types. The 6 common TCM syndrome types of CKD with a composition ratio ≥5% are spleen and kidney qi deficiency syndrome, blood stasis syndrome, damp-heat syndrome, damp turbidity syndrome, qi and yin deficiency syndrome, and spleen and kidney yang deficiency syndrome. Disease nature elements: 16 substantial and 7 insubstantial syndrome elements are included. The 6 disease nature elements with a composition ratio ≥5% are qi deficiency, dampness, yin deficiency, blood stasis, heat, yang deficiency. There are 61 syndrome element combinations types of disease nature elements, with 7 combinations with a composition ratio ≥5%, which are: qi deficiency, blood stasis, dampness + heat, yang deficiency, dampness, yin deficiency, and a combination of qi deficiency + yin deficiency. Disease location elements: the 3 disease location elements with a composition ratio ≥5% are kidney, spleen, and liver. There are 23 syndrome element combinations types with a composition ratio ≥5% are spleen + kidney, kidney, liver + kidney. Syndrome element combinations types: one, two, three, four, five, six, and seven syndrome elements are included, with the two-syndrome element combinations being the most common (46.36%). Correlation analysis indicates that the support for the spleen-stomach is the highest, with the highest confidence in spleen-dampness-heat, meridians-tendons and bones, spleen-fluid retention-qi deficiency, and spleen-stomach-dampness. There are 4 clusters group can be obtained results of the system clustering analysis. It is concluded that the TCM syndromes of CKD is deficienc-excess complex. Spleen-kidney qi deficiency syndrome is the most common syndrome in chronic kidney disease (CKD). The main disease location of CKD are kidney, spleen, and liver. Qi deficiency, dampness, yin deficiency, blood stasis, heat, and yang deficiency are common disease nature elements.

, correspAuthors=Mo-yan QIU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Xue QIAO, Mo-yan QIU), CN=ArticleExt(id=1149768954412974292, articleId=1149768943260319858, tenantId=1146029695717560320, journalId=1146123166801305609, language=CN, title=基于数据挖掘技术的慢性肾脏病患者中医证型及证素分布规律, columnId=1156262732526637414, journalTitle=科学技术与工程, columnName=论文·医药、卫生, runingTitle=null, highlight=null, articleAbstract=

为总结慢性肾脏病(chronic kidney disease, CKD)患者中医证型、证素分布规律,通过检索中国知网、万方数据知识服务平台、维普资讯中文期刊服务平台、中国生物医学文献服务系统、PubMed、Embase、Cochrane Library数据库自建库至2024年8月21日公开发表的CKD中医证型相关研究,提取相关信息。采用WPS Excel软件建立数据库,统计文献基本特征、证型及证素出现的频率。运用数据挖掘技术中的关联规则分析、系统聚类分析方法研究了其证素分布规律。结果表明:共纳入文献126篇,涉及CKD患者45 382例;涉及证型129种,证素37种(其中病性证素23个,病位证素14个),证候要素组合形式7种。频率>5%的6个证型依次为脾肾气虚证、血瘀证、湿热证、湿浊证、气阴两虚证、脾肾阳虚证。病性证素:包含实性证素16个,虚性证素7个。频率>5%的6个病性证素依次为气虚、湿、阴虚、血瘀、热、阳虚。病性证素组合分布形式共61种,频率>5%的7种组合为气虚、血瘀、湿+热、阳虚、湿、阴虚、气虚+阴虚;病位证素:频率>5%的3个病位证素依次为肾、脾、肝。病位组合分布形式共23种,频率>5%的3种病位证素为脾+肾、肾、肝+肾;证候要素组合形式:包括一、二、三、四、五、六、七证素7大类,以二证素组合为多(46.36%)。关联分析显示脾-胃支持度最高,湿-热-脾、经络-筋骨、脾-水停-气虚、脾-胃-湿置信度最高;系统聚类分析结果可得到4个聚类组。可见CKD证候表现为虚实夹杂,脾肾气虚证是CKD最常见的证候类型。CKD病位主要在肾、脾、肝,气虚、湿、阴虚、血瘀、热、阳虚是常见病性证素。

, correspAuthors=邱模炎, authorNote=null, correspAuthorsNote=
* 邱模炎(1966—),男,汉族,福建三明人,博士,主任医师,教授。研究方向:肾脏病的中医基础与临床。E-mail:。
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乔雪(1997—),女,蒙古族,内蒙古赤峰人,博士研究生。研究方向:肾脏病的中医基础与临床。E-mail:。

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乔雪(1997—),女,蒙古族,内蒙古赤峰人,博士研究生。研究方向:肾脏病的中医基础与临床。E-mail:。

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乔雪(1997—),女,蒙古族,内蒙古赤峰人,博士研究生。研究方向:肾脏病的中医基础与临床。E-mail:。

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Chinese Remedies & Clinics, 2021, 21(21): 3624-3625., articleTitle=Retrospective study on TCM syndrome differentiation of chronic kidney disease, refAbstract=null)], funds=[Fund(id=1172923747163058655, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, awardId=2023YFC3503003, language=CN, fundingSource=国家重点研发计划(2023YFC3503003), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1172923743971193265, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, xref=1, ext=[AuthorCompanyExt(id=1172923743979581874, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, companyId=1172923743971193265, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1 Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China), AuthorCompanyExt(id=1172923743983776179, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, companyId=1172923743971193265, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1 中国中医科学院望京医院, 北京 100102)]), AuthorCompany(id=1172923744038302132, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, xref=2, ext=[AuthorCompanyExt(id=1172923744046690741, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, companyId=1172923744038302132, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2 Blood Purification Center, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China), AuthorCompanyExt(id=1172923744050885046, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, companyId=1172923744038302132, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2 中国中医科学院望京医院血液净化中心, 北京 100102)])], figs=[ArticleFig(id=1172923745527280075, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=EN, label=Fig.1, caption=Flowchart of literature search, figureFileSmall=3cZQsGQoKCpPN3rKciKMWQ==, figureFileBig=d3Lui+X2iy8Pd4z/5BnSfw==, tableContent=null), ArticleFig(id=1172923745586000332, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=CN, label=图1, caption=文献筛选流程图, figureFileSmall=3cZQsGQoKCpPN3rKciKMWQ==, figureFileBig=d3Lui+X2iy8Pd4z/5BnSfw==, tableContent=null), ArticleFig(id=1172923745644720589, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=EN, label=Fig.2, caption=Association rule analysis network graph of syndrome element, figureFileSmall=QqOLf1aXD250rIp0D+E/qQ==, figureFileBig=9z0eLxhwsTZxDNuLqau6iw==, tableContent=null), ArticleFig(id=1172923745703440846, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=CN, label=图2, caption=证素关联规则网络图, figureFileSmall=QqOLf1aXD250rIp0D+E/qQ==, figureFileBig=9z0eLxhwsTZxDNuLqau6iw==, tableContent=null), ArticleFig(id=1172923745783132623, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=EN, label=Fig.3, caption=CKD high-frequency syndrome element cluster analysis chart, figureFileSmall=tI3HTmebTwUl8ar7BYL7+A==, figureFileBig=2gimSk+jX83TdIpln+pwlA==, tableContent=null), ArticleFig(id=1172923745837658576, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=CN, label=图3, caption=CKD高频证素聚类分析图, figureFileSmall=tI3HTmebTwUl8ar7BYL7+A==, figureFileBig=2gimSk+jX83TdIpln+pwlA==, tableContent=null), ArticleFig(id=1172923745887990225, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=EN, label=Table 1, caption=

Traditional Chinese medicine syndromes in CKD patients among 126 literature

, figureFileSmall=null, figureFileBig=null, tableContent=
编号 证型 频次(占比/%)
1 脾肾气虚证 7 525(15.56)
2 血瘀证 6 454(13.34)
3 湿热证 5 545(11.46)
4 湿浊证 3 834(7.93)
5 气阴两虚证 3 314(6.85)
6 脾肾阳虚证 2 921(6.04)
7 肾气虚证 1 745(3.61)
8 肝肾阴虚证 1 712(3.54)
9 水湿证 1 231(2.54)
10 气虚证 1 203(2.49)
11 湿毒证 1 144(2.37)
12 水气证 975(2.02)
13 阴阳两虚证 898(1.86)
14 阳虚证 729(1.51)
15 脾肾阴虚证 689(1.42)
16 脾肾两虚证 671(1.39)
17 阴虚证 666(1.38)
18 毒证 618(1.28)
19 肾阴虚证 590(1.22)
), ArticleFig(id=1172923745946710482, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=CN, label=表1, caption=

126篇文献中CKD患者证型分布情况

, figureFileSmall=null, figureFileBig=null, tableContent=
编号 证型 频次(占比/%)
1 脾肾气虚证 7 525(15.56)
2 血瘀证 6 454(13.34)
3 湿热证 5 545(11.46)
4 湿浊证 3 834(7.93)
5 气阴两虚证 3 314(6.85)
6 脾肾阳虚证 2 921(6.04)
7 肾气虚证 1 745(3.61)
8 肝肾阴虚证 1 712(3.54)
9 水湿证 1 231(2.54)
10 气虚证 1 203(2.49)
11 湿毒证 1 144(2.37)
12 水气证 975(2.02)
13 阴阳两虚证 898(1.86)
14 阳虚证 729(1.51)
15 脾肾阴虚证 689(1.42)
16 脾肾两虚证 671(1.39)
17 阴虚证 666(1.38)
18 毒证 618(1.28)
19 肾阴虚证 590(1.22)
), ArticleFig(id=1172923746026402259, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=EN, label=Table 2, caption=

Disease nature elements in CKD patients among 126 literature

, figureFileSmall=null, figureFileBig=null, tableContent=
编号 病性证素 频次(占比/%)
1 气虚 15 540(23.86)
2 湿 12 732(19.55)
3 阴虚 8 097(12.43)
4 血瘀 7 552(11.59)
5 热 6 204(9.52)
6 阳虚 5 883(9.03)
7 毒 2 473(3.80)
8 水停 2 323(3.57)
9 精亏 958(1.47)
10 气滞 767(1.18)
11 血虚 722(1.11)
12 风 608(0.93)
13 痰 359(0.55)
14 火 269(0.41)
15 动风 249(0.38)
16 阳亢 171(0.26)
17 饮 101(0.16)
18 寒 67(0.10)
19 燥 27(0.04)
20 暑 26(0.04)
21 气逆 3(0.00)
22 津伤 2(0.00)
23 液伤 1(0.00)
), ArticleFig(id=1172923746152231380, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=CN, label=表2, caption=

126篇文献中CKD患者病性证素分布情况

, figureFileSmall=null, figureFileBig=null, tableContent=
编号 病性证素 频次(占比/%)
1 气虚 15 540(23.86)
2 湿 12 732(19.55)
3 阴虚 8 097(12.43)
4 血瘀 7 552(11.59)
5 热 6 204(9.52)
6 阳虚 5 883(9.03)
7 毒 2 473(3.80)
8 水停 2 323(3.57)
9 精亏 958(1.47)
10 气滞 767(1.18)
11 血虚 722(1.11)
12 风 608(0.93)
13 痰 359(0.55)
14 火 269(0.41)
15 动风 249(0.38)
16 阳亢 171(0.26)
17 饮 101(0.16)
18 寒 67(0.10)
19 燥 27(0.04)
20 暑 26(0.04)
21 气逆 3(0.00)
22 津伤 2(0.00)
23 液伤 1(0.00)
), ArticleFig(id=1172923746248700373, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=EN, label=Table 3, caption=

Disease nature elements combination in CKD patients among 126 literature

, figureFileSmall=null, figureFileBig=null, tableContent=
编号 病性证素 频次(占比/%)
1 气虚 11 242(23.24)
2 血瘀 6 844(14.15)
3 湿、热 5 609(11.60)
4 阳虚 4 001(8.27)
5 湿 3 940(8.15)
6 阴虚 3 757(7.77)
7 气虚、阴虚 3 314(6.85)
), ArticleFig(id=1172923746315809238, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=CN, label=表3, caption=

126篇文献中CKD患者病性证素组合分布情况

, figureFileSmall=null, figureFileBig=null, tableContent=
编号 病性证素 频次(占比/%)
1 气虚 11 242(23.24)
2 血瘀 6 844(14.15)
3 湿、热 5 609(11.60)
4 阳虚 4 001(8.27)
5 湿 3 940(8.15)
6 阴虚 3 757(7.77)
7 气虚、阴虚 3 314(6.85)
), ArticleFig(id=1172923746408083927, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=EN, label=Table 4, caption=

Disease location elements in CKD patients among 126 literature

, figureFileSmall=null, figureFileBig=null, tableContent=
编号 病位证素 频次(占比/%)
1 肾 17 562(48.43)
2 脾 12 447(34.32)
3 肝 1 821(5.02)
4 肺 1 491(4.11)
5 心 1 119(3.09)
6 经络 866(2.39)
7 肌肤 397(1.09)
8 筋骨 332(0.92)
9 小肠 49(0.14)
10 大肠 49(0.14)
11 胞宫 49(0.14)
12 膀胱 49(0.14)
13 胃 32(0.09)
14 脑 1(0.00)
), ArticleFig(id=1172923746470998488, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=CN, label=表4, caption=

126篇文献中CKD患者病位证素分布情况

, figureFileSmall=null, figureFileBig=null, tableContent=
编号 病位证素 频次(占比/%)
1 肾 17 562(48.43)
2 脾 12 447(34.32)
3 肝 1 821(5.02)
4 肺 1 491(4.11)
5 心 1 119(3.09)
6 经络 866(2.39)
7 肌肤 397(1.09)
8 筋骨 332(0.92)
9 小肠 49(0.14)
10 大肠 49(0.14)
11 胞宫 49(0.14)
12 膀胱 49(0.14)
13 胃 32(0.09)
14 脑 1(0.00)
), ArticleFig(id=1172923746546495961, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=EN, label=Table 5, caption=

Disease location elements combination in CKD patients among 126 literature

, figureFileSmall=null, figureFileBig=null, tableContent=
编号 病位证素 频次(占比/%)
1 脾、肾 11 856(59.72)
2 肾 3 069(15.46)
3 肝、肾 1 753(8.83)
), ArticleFig(id=1172923746626187738, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=CN, label=表5, caption=

126篇文献中CKD患者病位证素组合分布情况

, figureFileSmall=null, figureFileBig=null, tableContent=
编号 病位证素 频次(占比/%)
1 脾、肾 11 856(59.72)
2 肾 3 069(15.46)
3 肝、肾 1 753(8.83)
), ArticleFig(id=1172923746705879515, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=EN, label=Table 6, caption=

Elements combination in CKD patients among 126 literature

, figureFileSmall=null, figureFileBig=null, tableContent=
证素组
合形式		 证素 组合
证型		 频次
(占比/%)
一证素 血瘀 血瘀证 6 454(42.97)
湿 湿浊证 3 938(26.22)
湿邪证
湿浊内蕴证
气虚 气虚证 1 203(8.01)
毒 毒证 1 188(7.91)
浊毒证
溺毒证
二证素 阴虚、阳虚 阴阳两虚证 898(5.35)
水停、湿 水湿证 1 231(7.34)
湿、热 湿热证 5 549(33.08)
湿热外感证
湿、毒 湿毒证 1 144(6.82)
气虚、阴虚 气阴两虚证 3 314(19.76)
肾、气虚 肾气虚证 1 745(10.40)
三证素 脾、肾、气虚 脾肾气虚证 7 525(53.79)
脾、肾、阳虚 脾肾阳虚证 2 921(20.88)
肝、肾、阴虚 肝肾阴虚证 1 749(12.50)
肝肾两虚证
四证素 心、肺、水停、阳虚 水气证 975(45.99)
脾、肾、精亏、气虚 脾肾两虚证 671(31.65)
湿、热、血瘀、气滞 湿热瘀滞证 202(9.53)
五证素 脾、气虚、血虚、阴虚、阳虚 脾虚证 31(7.95)
肝、动风、阳亢、热、痰 肝风内动证 25(6.41)
肌肤、经络、筋骨、血瘀、气滞 瘀血阻滞证 320(82.05)
六证素 风、寒、暑、湿、燥、火 外感证 26(81.25)
肝、脾、肌肤、湿、热、毒 湿热蕴结证 5(15.63)
), ArticleFig(id=1172923746785571292, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=CN, label=表6, caption=

126篇文献中CKD患者证素组合分布情况

, figureFileSmall=null, figureFileBig=null, tableContent=
证素组
合形式		 证素 组合
证型		 频次
(占比/%)
一证素 血瘀 血瘀证 6 454(42.97)
湿 湿浊证 3 938(26.22)
湿邪证
湿浊内蕴证
气虚 气虚证 1 203(8.01)
毒 毒证 1 188(7.91)
浊毒证
溺毒证
二证素 阴虚、阳虚 阴阳两虚证 898(5.35)
水停、湿 水湿证 1 231(7.34)
湿、热 湿热证 5 549(33.08)
湿热外感证
湿、毒 湿毒证 1 144(6.82)
气虚、阴虚 气阴两虚证 3 314(19.76)
肾、气虚 肾气虚证 1 745(10.40)
三证素 脾、肾、气虚 脾肾气虚证 7 525(53.79)
脾、肾、阳虚 脾肾阳虚证 2 921(20.88)
肝、肾、阴虚 肝肾阴虚证 1 749(12.50)
肝肾两虚证
四证素 心、肺、水停、阳虚 水气证 975(45.99)
脾、肾、精亏、气虚 脾肾两虚证 671(31.65)
湿、热、血瘀、气滞 湿热瘀滞证 202(9.53)
五证素 脾、气虚、血虚、阴虚、阳虚 脾虚证 31(7.95)
肝、动风、阳亢、热、痰 肝风内动证 25(6.41)
肌肤、经络、筋骨、血瘀、气滞 瘀血阻滞证 320(82.05)
六证素 风、寒、暑、湿、燥、火 外感证 26(81.25)
肝、脾、肌肤、湿、热、毒 湿热蕴结证 5(15.63)
), ArticleFig(id=1172923746873651677, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=EN, label=Table 7, caption=

Association rule analysis of syndrome element in CKD

, figureFileSmall=null, figureFileBig=null, tableContent=
后项 前项 支持度/% 置信度/%
脾 胃 7.75 80
肾 精亏 5.43 85.71
经络 肌肤 4.65 66.67
湿 热-脾 3.88 100
气虚 水停-脾 3.1 75
肌肤 筋骨 2.33 66.67
经络 筋骨 2.33 100
热 筋骨 2.33 66.67
肌肤 筋骨-经络 2.33 66.67
热 筋骨-经络 2.33 66.67
湿 毒-脾 2.33 66.67
脾 毒-湿 2.33 66.67
肾 肺-阴虚 2.33 66.67
阴虚 肺-肾 2.33 66.67
气虚 肺-肾 2.33 66.67
脾 水停-气虚 2.33 100
肾 经络-血瘀 2.33 66.67
经络 血瘀-肾 2.33 66.67
热 胃-湿 2.33 66.67
脾 胃-湿 2.33 100
气虚 阳虚-阴虚 2.33 66.67
阳虚 阴虚-气虚 2.33 66.67
热 肾-湿 2.33 66.67
), ArticleFig(id=1172923746965926366, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149768943260319858, language=CN, label=表7, caption=

CKD证素关联规则分析

, figureFileSmall=null, figureFileBig=null, tableContent=
后项 前项 支持度/% 置信度/%
脾 胃 7.75 80
肾 精亏 5.43 85.71
经络 肌肤 4.65 66.67
湿 热-脾 3.88 100
气虚 水停-脾 3.1 75
肌肤 筋骨 2.33 66.67
经络 筋骨 2.33 100
热 筋骨 2.33 66.67
肌肤 筋骨-经络 2.33 66.67
热 筋骨-经络 2.33 66.67
湿 毒-脾 2.33 66.67
脾 毒-湿 2.33 66.67
肾 肺-阴虚 2.33 66.67
阴虚 肺-肾 2.33 66.67
气虚 肺-肾 2.33 66.67
脾 水停-气虚 2.33 100
肾 经络-血瘀 2.33 66.67
经络 血瘀-肾 2.33 66.67
热 胃-湿 2.33 66.67
脾 胃-湿 2.33 100
气虚 阳虚-阴虚 2.33 66.67
阳虚 阴虚-气虚 2.33 66.67
热 肾-湿 2.33 66.67
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基于数据挖掘技术的慢性肾脏病患者中医证型及证素分布规律
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乔雪 1 , 邱模炎 2, *
科学技术与工程 | 论文·医药、卫生 2025,25(15): 6261-6267
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科学技术与工程 | 论文·医药、卫生 2025, 25(15): 6261-6267
基于数据挖掘技术的慢性肾脏病患者中医证型及证素分布规律
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乔雪1 , 邱模炎2, *
作者信息
  • 1 中国中医科学院望京医院, 北京 100102
  • 2 中国中医科学院望京医院血液净化中心, 北京 100102

    • 乔雪(1997—),女,蒙古族,内蒙古赤峰人,博士研究生。研究方向:肾脏病的中医基础与临床。E-mail:。

通讯作者:

* 邱模炎(1966—),男,汉族,福建三明人,博士,主任医师,教授。研究方向:肾脏病的中医基础与临床。E-mail:。
Data Mining-based Study on Traditional Chinese Medicine Syndromes and Syndrome Elements in Patients with Chronic Kidney Disease
Xue QIAO1 , Mo-yan QIU2, *
Affiliations
  • 1 Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
  • 2 Blood Purification Center, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
出版时间: 2025-05-28 doi: 10.12404/j.issn.1671-1815.2406789
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摘要
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为总结慢性肾脏病(chronic kidney disease, CKD)患者中医证型、证素分布规律,通过检索中国知网、万方数据知识服务平台、维普资讯中文期刊服务平台、中国生物医学文献服务系统、PubMed、Embase、Cochrane Library数据库自建库至2024年8月21日公开发表的CKD中医证型相关研究,提取相关信息。采用WPS Excel软件建立数据库,统计文献基本特征、证型及证素出现的频率。运用数据挖掘技术中的关联规则分析、系统聚类分析方法研究了其证素分布规律。结果表明:共纳入文献126篇,涉及CKD患者45 382例;涉及证型129种,证素37种(其中病性证素23个,病位证素14个),证候要素组合形式7种。频率>5%的6个证型依次为脾肾气虚证、血瘀证、湿热证、湿浊证、气阴两虚证、脾肾阳虚证。病性证素:包含实性证素16个,虚性证素7个。频率>5%的6个病性证素依次为气虚、湿、阴虚、血瘀、热、阳虚。病性证素组合分布形式共61种,频率>5%的7种组合为气虚、血瘀、湿+热、阳虚、湿、阴虚、气虚+阴虚;病位证素:频率>5%的3个病位证素依次为肾、脾、肝。病位组合分布形式共23种,频率>5%的3种病位证素为脾+肾、肾、肝+肾;证候要素组合形式:包括一、二、三、四、五、六、七证素7大类,以二证素组合为多(46.36%)。关联分析显示脾-胃支持度最高,湿-热-脾、经络-筋骨、脾-水停-气虚、脾-胃-湿置信度最高;系统聚类分析结果可得到4个聚类组。可见CKD证候表现为虚实夹杂,脾肾气虚证是CKD最常见的证候类型。CKD病位主要在肾、脾、肝,气虚、湿、阴虚、血瘀、热、阳虚是常见病性证素。

慢性肾脏病  /  证型  /  证素  /  数据挖掘  /  文献研究

In order to summarize the distribution characteristics of traditional Chinese medicine (TCM) syndromes and syndrome elements in chronic kidney diseases (CKD). The studies related to TCM syndromes in patients with CKD were searched for in CNKI, WANFANG DATA, VIP, SinoMed, Pubmed, Embase and Cochrane Library from the inception dates to August 21th, 2024, and extracted the relevant information. WPS Excel was used to count the frequency of basic characteristics, syndrome types, and syndrome elements in the literature for establishing a database. The distribution characteristics of syndrome elements were explored by association rule analysis and systematic clustering techniques within data mining. The results show that a total of 126 articles are enrolled, including 45 382 patients with CKD. There are 129 TCM syndrome types and 37 syndrome elements (23 disease nature elements and 14 disease location elements). There are 7 syndrome element combinations types. The 6 common TCM syndrome types of CKD with a composition ratio ≥5% are spleen and kidney qi deficiency syndrome, blood stasis syndrome, damp-heat syndrome, damp turbidity syndrome, qi and yin deficiency syndrome, and spleen and kidney yang deficiency syndrome. Disease nature elements: 16 substantial and 7 insubstantial syndrome elements are included. The 6 disease nature elements with a composition ratio ≥5% are qi deficiency, dampness, yin deficiency, blood stasis, heat, yang deficiency. There are 61 syndrome element combinations types of disease nature elements, with 7 combinations with a composition ratio ≥5%, which are: qi deficiency, blood stasis, dampness + heat, yang deficiency, dampness, yin deficiency, and a combination of qi deficiency + yin deficiency. Disease location elements: the 3 disease location elements with a composition ratio ≥5% are kidney, spleen, and liver. There are 23 syndrome element combinations types with a composition ratio ≥5% are spleen + kidney, kidney, liver + kidney. Syndrome element combinations types: one, two, three, four, five, six, and seven syndrome elements are included, with the two-syndrome element combinations being the most common (46.36%). Correlation analysis indicates that the support for the spleen-stomach is the highest, with the highest confidence in spleen-dampness-heat, meridians-tendons and bones, spleen-fluid retention-qi deficiency, and spleen-stomach-dampness. There are 4 clusters group can be obtained results of the system clustering analysis. It is concluded that the TCM syndromes of CKD is deficienc-excess complex. Spleen-kidney qi deficiency syndrome is the most common syndrome in chronic kidney disease (CKD). The main disease location of CKD are kidney, spleen, and liver. Qi deficiency, dampness, yin deficiency, blood stasis, heat, and yang deficiency are common disease nature elements.

chronic kidney disease  /  syndrome  /  syndrome element  /  data mining  /  literature research
乔雪, 邱模炎. 基于数据挖掘技术的慢性肾脏病患者中医证型及证素分布规律. 科学技术与工程, 2025 , 25 (15) : 6261 -6267 . DOI: 10.12404/j.issn.1671-1815.2406789
Xue QIAO, Mo-yan QIU. Data Mining-based Study on Traditional Chinese Medicine Syndromes and Syndrome Elements in Patients with Chronic Kidney Disease[J]. Science Technology and Engineering, 2025 , 25 (15) : 6261 -6267 . DOI: 10.12404/j.issn.1671-1815.2406789
正文
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慢性肾脏病(chronic kidney disease, CKD)是指肾脏结构或功能异常>3个月,具有患病率高、知晓率低、预后差、医疗费用高等特点[1]。全球一般患病率为14.3%[2],中国18岁以上人群患病率为10.8%[3],其发病率呈现逐年上升趋势[4]。初步估算,到2040年因CKD死亡的患者将高达220万人[5]。文献[6]表明,CKD患者普遍存在饮食、用药依从性不理想,焦虑、抑郁发病率高等问题,住院次数及死亡风险因此大大提升。过去20年间,全球CKD相关死亡人数上升了82.3%[7]。CKD 4-5期2年生存率仅为62%,年均死亡率超20%[3]。CKD已成为全球性的公共卫生问题。
CKD无对应的中医病名,根据其症状及体征,多将其归属于“关格”“癃闭”“水肿”“溺毒”“肾劳”“虚劳”等范畴。中医药在防治CKD具有独特的疗效和优势,尤其是保护肾功能、降低尿蛋白、延缓疾病进展、缓解相关并发症等方面[8]。中医以辨证论治为核心,精准辨证是中医药发挥疗效的关键。证素是朱文锋等[9]、李明珠等[10]根据中医理论提炼形成的具体诊断单元,是构成证名的要素。文献[11-12]表明,CKD中医证候总体分布以本虚为主,部分患者兼有标实之证,但其证候仍分类繁多,缺乏统一、规范的辨证标准,在一定程度上影响了CKD中医规范诊疗及中医药疗效的发挥。
通过系统检索并汇总分析CKD中医证候研究文献,总结CKD中医证候分型及证素,整理其常见证候分型,规范证候名称,同时结合现代数据挖掘技术,探讨其常见中医证型及证素分布特点,为CKD中医辨证治疗提供依据。
1 资料与方法
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1.1 资料来源
检索中国知网(CNKI)、万方数据知识服务平台(WANFANG DATA)、维普资讯中文期刊服务平台(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、Embase、Cochrane Library数据库。检索时间自建库至2024年8月21日。语种限定为中文或英文。
1.2 纳入标准
(1)研究对象:CKD患者。
(2)研究类型:临床试验、中医证候研究等。
(3)有明确的中医证型,且报告了各证型病例数。
1.3 排除标准
(1)非CKD研究。
(2)行透析治疗的CKD 5D期患者。
(3)针对某一或某些特定证型的研究。
(4)实验研究、个案报道、专家经验、理论研究、护理、综述、系统评价、Meta分析、会议、科技成果。
(5)重复发表。
(6)研究对象为同一批患者的文献,取期刊影响因子最高的1篇。
(7)无法获取全文。
(8)文献研究对象合并其他疾病。
(9)数据不完整或出现明显错误。
1.4 检索策略
由2名研究者独立开展文献检索。检索词包括“慢性肾脏病”“CKD”“证候”“证型”“辨证”“证素”“chronic kidney disease”“Syndrome”“Chinese Medicine”“Medicine, Chinese Traditional”“Zhong Yi Xue”“Chung I Hsueh”“Hsueh, Chung I”“Traditional Medicine, Chinese”“Chinese Traditional Medicine”“Traditional Chinese Medicine”“Chinese Medicine, Traditional”。
以CNKI为例的检索式:主题“慢性肾脏病”或主题“CKD”和主题“证候”或主题“证型”或主题“辨证”或主题“证素”。
1.5 证型规范
对于意义相近而名称不同的证型,参照《中医临床诊疗术语 第2部分:证候》(修订版)[13]进行规范。对于复杂证型,如脾肾亏虚湿毒瘀血内阻证,以脾肾亏虚证和湿毒瘀血内阻证计。上述情况仍无法规范统一的证型,按原文献名称进行保留,如浊阴上逆证。
1.6 证素拆解
依据《证素内容的辨析》[14]提取CKD患者的病位证素及病性证素,如脾肾气虚证可拆解为脾、肾、气虚;气阴两虚证可拆解为气虚、阴虚。
1.7 统计学方法
采用WPS Excel软件建立CKD中医证候数据库,主要内容包括:第一作者、发表年份、中医证型、证素等信息,并进行频次及频率的统计。运用IBM SPSS Modeler 18.0软件的Apriori算法、Cytoscape 3.10.1软件进行证素的关联规则分析,运用OriginPro 2024b软件对证素进行系统聚类分析。
2 结果
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2.1 文献检索及筛选结果
初步检索得到CKD证候研究文献4 979篇,经NoteExpress V4.X软件剔重后得到文献3 475篇,根据文献纳排标准,阅读文章摘要和全文后,最终纳入文献126篇,计CKD病例45 382例。如图1所示。
2.2 CKD患者证型分布情况
126篇文献涉及证型214种,按上述证型规范方法整理归纳为129种。频次>5%的6个证型依次为脾肾气虚证、血瘀证、湿热证、湿浊证、气阴两虚证、脾肾阳虚证。如表1所示。
2.3 病性证素
按上述证素拆解方法将证候拆分为证素,提取病性证素23个,其中实性证素16个,虚性证素7个。频次>5%的病性证素有6个,依次为气虚、湿、阴虚、血瘀、热、阳虚,如表2所示。组合分布形式共61种,频次>5%的病性证素有7种,如表3所示。
2.4 病位证素
按上述证素拆解方法将证候拆分为证素,提取病性证素14个,频次>5%的病位证素有3个,依次为肾、脾、肝,如表4所示。组合分布形式共23种,频次>5%的病位证素有3种,如表5所示。
2.5 证素组合分布规律
CKD的证素组合形式共7种,分别为一、二、三、四、五、六、七证素组合方式,以二证素组合为多,占46.36%。一证素组合以血瘀致病多见(42.97%),二证素组合以湿、热相兼致病最为常见(33.08%),三证素组合以脾、肾、气虚相兼致病多见(53.79%),四证素组合以心、肺、水停、阳虚相兼致病多见(45.99%),五证素组合以肌肤、经络、筋骨、血瘀、气滞相兼致病多见(82.05%),六证素组合以风、寒、暑、湿、燥、火相兼致病多见(81.25%),七证素组合表现为肾、膀胱、胞宫、大肠、小肠、湿、热相兼致病(0.13%)。频次>5%的证素组合分布情况如表6所示。
2.6 证素关联规则分析
运用IBM SPSS Modeler 18.0软件的Apriori算法进行证素关联规则分析,设置弱链接上限为3,强链接下限为5,链接大小显示强/正常/弱类别,最低条件支持度(频数/出现的次数)为2.0,最小规则置信度为65.0%,最大前项数为2,结果如表7所示。运用Cytoscape 3.10.1软件优化的证素关联规则网络图包含29个证素节点,159条边,如图2所示。
2.7 系统聚类分析
对证素频次>5%的气虚、湿、阴虚、血瘀、热、阳虚6个病性证素和肾、脾、肝3个病位证素进行系统聚类分析,结果显示,本研究涉及的高频证素可分为4大类:①阳虚、阴虚、肾、肝;②湿、热;③血瘀;④气虚、脾。如图3所示。
3 讨论
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辨证论治是中医诊治疾病的基本原则,也是中医诊断与论治疾病的核心[15]。以湖南中医药大学朱文锋教授为代表的中医研究者主张建立“证素辨证”新体系。证素辨证在一定程度上克服了中医证候分类、证型名称不统一等问题,利于临床辨证的规范性。
CKD患者大多临床证候不典型[16],缺乏统一的评价标准[17]。本研究通过梳理126篇CKD证候研究文献,对CKD患者的证型进行规范化处理并提取病性、病位证素,采用频次、频次统计、聚类分析等统计学方法及数据挖掘技术获取CKD中医证型及证素分布规律。
本研究结果显示,脾肾气虚证、血瘀证、湿热证、湿浊证、气阴两虚证、脾肾阳虚证是CKD的常见中医证型。高国栋等[18]分析1 445例CKD患者的证型分布特点,发现脾肾气虚证、血瘀证、湿浊证、湿热证、湿毒证是CKD的临床常见证型。贺忆培等[19]分析322例CKD患者的中医证候分布,发现脾肾气虚证(42.8%)、脾肾气阴两虚证(18.6%)、阴阳两虚证(18.6%)、湿热证(12.9%)是临床常见证型。李瑞等[20]对182例CKD患者的中医证候进行调查研究,发现脾肾气虚证(44.44%)、血瘀证(41.03%)是其主要证型。张然等[21]对133例慢性肾脏病中医证候进行分析,发现山西中医药大学附属医院就诊的CKD(非透析)患者临床常见证型依次为瘀血证、浊毒证、湿热证、气阴两虚证、脾肾气虚证、脾肾阳虚证、阴阳两虚证。上述研究结果与本研究基本一致。
本研究对证素的提取结果显示,涉及的14个病位证素中,肾、脾、肝是CKD患者的常见病位证素。组合分布形式共23种,常见组合形式包括脾+肾、肾、肝+肾。由此可见,CKD病位主要在肾,随着病情发展,渐及脾、肝等脏腑。本研究提取病性证素23个,其中实性证素16个,虚性证素7个。常见病性证素包括气虚、湿、阴虚、血瘀、热、阳虚。病性证素组合分布形式共61种,气虚、血瘀、湿+热、阳虚、湿、阴虚、气虚+阴虚是常见的形式。CKD的证素组合形式共7种,分别为一、二、三、四、五、六、七证素组合方式。结果显示,二证素是CKD患者最常见的证素组合形式。一证素组合以血瘀致病多见,二证素组合以湿、热相兼致病最为常见,三证素组合以脾、肾、气虚相兼致病多见,四证素组合以心、肺、水停、阳虚相兼致病多见,五证素组合以肌肤、经络、筋骨、血瘀、气滞相兼致病多见,六证素组合以风、寒、暑、湿、燥、火相兼致病多见,七证素组合表现为肾、膀胱、胞宫、大肠、小肠、湿、热相兼致病。CKD证素组合较为复杂,存在虚实夹杂,但仍以实性证素居多。由关联规则分析可知,湿、热、肾、脾、气虚、阴虚这5种证素之间关系较密切,以脾-胃支持度最高,湿-热-脾、经络-筋骨、脾-水停-气虚、脾-胃-湿置信度最高。对高频证素进行系统聚类分析,可得出CKD的4种证素组合规律:①肝肾两虚证:患者久病劳伤肝肾,阴虚及阳,或阳损及阴,导致体内阳气及津液精血等阴液俱不足,滋润、温煦、推动等功能减退,从而形成肝肾两虚型CKD;②湿热证:CKD患者湿热内侵、蕴蓄脏腑,化燥、伤阴、瘀阻气血,从而形成湿热型CKD;③血瘀证:患者体内瘀血凝结,阻滞气血,导致相关组织及脏腑器官功能障碍,从而形成血瘀型CKD;④脾气虚证:患者久病伤脾,导致脾气不足,脾失健运,从而形成脾气虚型CKD。
4 结论
收起
综上,CKD患者证型错综复杂,为临床辨证论治带来了困难。本研究基于数据挖掘技术探讨CKD患者中医证型及证素分布规律,以期为中医证候诊断的规范化和科学化提供依据,进一步提高临床医师的辨证论治水平。本文作为文献分析研究,尚存在未全面检索所有数据库、研究纳入的文献质量参差不齐等局限性。因此,在今后的研究中可开展大样本、多中心的临床流行病学调查或横断面研究,进一步深入研究CKD患者证型、证素分布规律,以期得到更加客观、科学的结论。
基金
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  • 国家重点研发计划(2023YFC3503003)
文献
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2025年第25卷第15期
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doi: 10.12404/j.issn.1671-1815.2406789
  • 接收时间：2024-09-10
  • 首发时间：2025-07-09
  • 出版时间：2025-05-28
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  • 收稿日期：2024-09-10
  • 修回日期：2024-12-23
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作者信息
    1 中国中医科学院望京医院, 北京 100102
    2 中国中医科学院望京医院血液净化中心, 北京 100102

通讯作者:

* 邱模炎(1966—),男,汉族,福建三明人,博士,主任医师,教授。研究方向:肾脏病的中医基础与临床。E-mail:。
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