从母病及子角度探究慢性肾脏病患者肝肾功能指标与中医证型的关联规则

Exploring the Association Rules between Hepatorenal Function Indicators and Traditional Chinese Medicine Syndrome Types in Patients with Chronic Kidney Disease Based on the Theory of Mother Organ Affecting Child Organ

摘要: 目的：从母病及子的角度出发，探究慢性肾脏病中医证型与肾功能，肝功能实验室指标之间的关联规则，为慢性肾脏病中医临床辨证提供一定帮助。方法：使用SPSS Modeler18.0软件对57例东北地区慢性肾脏病患者肾功能，肝功能实验室指标与中医证型进行Apriori关联规则分析。结果：共找到559组关联组合，根据增益排名，在包含证型的关联组合中，增益排名第一的分别是总蛋白降低→脾肾气虚(1.163)；γ-谷氨酰基转移酶正常→脾肾阳虚 + 二氧化碳结合力降低(1.14)；总蛋白正常→阴阳两虚(1.461)；肌酐升高→水湿 + 乳酸脱氢酶正常(1.096)；肌酐升高→血瘀 + 尿素升高(1.096)。其余四个证型肝肾阴虚、气阴两虚、湿热、溺毒没有出现相关关联组合。结论：CKD患者脾肾气虚证常与总蛋白降低关联出现，血瘀证常与肌酐升高、尿素升高关联出现。

Abstract: Objective: From the perspective of the theory of “mother organ affecting child organ,” this study aimed to explore the association rules between Traditional Chinese Medicine (TCM) syndrome types and laboratory indicators of renal and hepatic function in patients with chronic kidney disease (CKD), in order to provide some assistance for TCM clinical syndrome differentiation in CKD. Methods: SPSS Modeler 18.0 software was used to conduct Apriori association rule analysis on the laboratory indicators of renal and hepatic function, as well as TCM syndrome types, in 57 CKD patients from the Northeast region. Results: A total of 559 association combinations were identified. Based on the gain ranking, among the association combinations that included syndrome types, the top-ranked ones were as follows: decreased total protein → spleen-kidney qi deficiency (1.163); normal gamma-glutamyl transferase → spleen-kidney yang deficiency + decreased carbon dioxide combining power (1.14); normal total protein → yin-yang deficiency (1.461); increased creatinine → dampness-retention + normal lactate dehydrogenase (1.096); increased creatinine → blood stasis + increased urea (1.096). No relevant association combinations were found for the other four syndrome types: liver-kidney yin deficiency, qi-yin deficiency, dampness-heat, and urinary toxin retention. Conclusion: In CKD patients, the spleen-kidney qi deficiency syndrome is often associated with decreased total protein, while the blood stasis syndrome is frequently linked to increased creatinine and urea levels.