数字中医药（英文）2023，Vol.6Issue(3)：245-256,12.DOI:10.1016/j.dcmed.2023.10.001
基于中医证素原理构建原发性高血压病风险预警Nomogram模型
A Nomogram model for the early warning of essential hypertension risks based on the principles of traditional Chinese medicine syndrome elements
摘要
Abstract
Objective To construct a Nomogram model for the prediction of essential hypertension(EH)risks with the use of traditional Chinese medicine(TCM)syndrome elements principles in conjunction with cutting-edge biochemical detection technologies. Methods A case-control study was conducted,involving 301 patients with essential hyperten-sion in the hypertensive group and 314 without in the control group.Comprehensive data,in-cluding the information on the four TCM diagnoses,general data,and blood biochemical in-dicators of participants in both groups,were collected separately for analysis.The differentia-tion principles of syndrome elements were used to discern the location and nature of hyper-tension.One-way analysis was carried out to screen for potential risk factors of the disease.Least absolute shrinkage and selection operator(LASSO)regression was used to identify fac-tors that contribute significantly to the model,and eliminate possible collinearity problems.At last,multivariate logistic regression analysis was used to both screen and quantify inde-pendent risk factors essential for the prediction model.The"rms"package in the R Studio was used to construct the Nomogram model,creating line segments of varying lengths based on the contribution of each risk factor to aid in the prediction of risks of hypertension.For inter-nal model validation,the Bootstrap program package was utilized to perform 1 000 repeti-tions of sampling and generate calibration curves. Results The results of the multivariate logistic regression analysis revealed that the risk fac-tors of EH included age,heart rate(HR),waist-to-hip ratio(WHR),uric acid(UA)levels,fami-ly medical history,sleep patterns(early awakening and light sleep),water intake,and psycho-logical traits(depression and anger).Additionally,TCM syndrome elements such as phlegm,Yin deficiency,and Yang hyperactivity contributed to the risk of EH onset as well.TCM syn-drome elements liver,spleen,and kidney were also considered the risk factors of EH.Next,the Nomogram model was constructed using the aforementioned 14 risk predictors,with an area under the curve(AUC)of 0.868 and a 95%confidence interval(CI)ranging from 0.840 to 0.895.The diagnostic sensitivity and specificity were found to be 80.7%and 85.0%,respective-ly.Internal validation confirmed the model's robust predictive performance,with a consistency index(C-index)of 0.879,underscoring the model's strong predictive ability. Conclusion By integrating TCM syndrome elements,the Nomogram model has realized the objective,qualitative,and quantitative selection of early warning factors for developing EH,resulting in the creation of a more comprehensive and precise prediction model for EH risks.关键词
原发性高血压病/中医/证素/危险因素/预警模型/治未病Key words
Essential hypertension(EH)/Traditional Chinese medicine(TCM)/Syndrome elements/Risk factor/Prediction models/Preventive treatment of disease引用本文复制引用
卓泽伟,张斐,杨丞玮,高碧珍,李灿东..基于中医证素原理构建原发性高血压病风险预警Nomogram模型[J].数字中医药（英文）,2023,6(3):245-256,12.基金项目
National Famous Old Chinese Medicine Experts Inheri-tance Studio Construction Project(Chinese Medicine Ed-ucation Letter[2022]No.75),National Natural Science Foundation of China Joint Fund Project(U1705286),and Fujian Provincial Science and Technology Program for University-Industry Cooperation Project(2020Y4017). （Chinese Medicine Ed-ucation Letter[2022]No.75）
