糖尿病性视网膜病变高风险患者中医体质类型关联规则分析

Analysis of Association Rules between Traditional Chinese Medicine Constitutional Types and High-Risk Patients with Diabetic Retinopathy

摘要: 目的：从中医体质辨识角度出发，探讨糖尿病性视网膜病变(DR)高风险患者的中医体质类型，并挖掘其关联规则。方法：以合并有至少一种增殖性DR发病危险因素的2型糖尿病患者为DR高风险患者，采用横断面研究设计，共纳入906名DR高风险患者，采用Apriori算法对中体体质类型进行关联规则分析。结果：近三分之二的DR高风险患者具痰湿质，且与阴虚质形成中等强度链接。DR高风险患者在湿热质(或气虚质)体质条件下，同时具有痰湿质(或对应为阴虚质)体质的可能性最大；气虚质与阴虚质存在较强的正向关联。结论：DR高风险患者的中医体质类型及组合有较强的规律性，为从中医“治未病”角度，通过饮食生活和作息起居等方面调摄以提升DR防控效果，提供了研究证据参考。

Abstract: Objective: To explore the body constitution types in traditional Chinese medicine and to elucidate its association rules in patients at high risk of diabetic retinopathy (DR). Methods: Type 2 diabetic patients with at least one risk factor of proliferative DR were considered as the target population who are at high risk of DR. A total of 906 patients were included in this cross-sectional study. The Apriori algorithm was employed for association rule mining in the co-occurrence of body constitutions in the study sample. Results: Nearly two-thirds of patients at high risk of DR manifested a body constitution of phlegm-and-dampness type, while demonstrating strong co-occurrence with the yin deficient type. The presence of an antecedent body constitution of damp heat type (or qi deficient type) was predictive of a consequent body constitution of phlegm-and-dampness type (or yin deficient type). A strong positive correlation was identified between qi-deficient and yin-deficient body constitution types. Conclusion: These findings provide novel findings that patients at high risk of DR exhibited distinct body constitution typologies with identifiable patterns. The association rules found in the study offer practical implications for developing traditional Chinese medicine-informed preventive strategies through body constitution-specific dietary modifications and lifestyle interventions targeting body constitution clusters, and thereby enhancing current DR prevention paradigms.