世界中医药2025，Vol.20Issue(18)：3329-3336,8.DOI:10.3969/j.issn.1673-7202.2025.18.022
1110例儿童免疫性血小板减少性紫癜的中医证素隐结构研究
Hidden Structure of TCM Syndrome Elements in 1 110 Children with Immune Thrombocytopenia
摘要
Abstract
Objective:To investigate the patterns of syndrome elements and syndrome types in pediatric immune thrombocytopenia(ITP)based on a hidden structure model,and to provide a reference for clinical syndrome differentiation of pediatric ITP.Meth-ods:First-visit medical records of children with ITP treated at the First Affiliated Hospital of Henan University of Chinese Medicine from January 1,2012 to December 31,2023 were collected.Symptom-to-syndrome element conversion was performed with reference to the syndrome element differentiation scale in Theory of Syndrome Element Differentiation,and a syndrome element database was constructed.SPSS Modeler 18.0 and Cytoscape 3.8.0 were used for association rule mining and complex network analysis,while Lantern 5.0 was applied for hidden structure analysis.Core syndrome elements(frequency>10)were systematically clustered to determine the distribution of syndrome types in children with ITP.Results:A total of 1 110 pediatric ITP cases were included.The predominant disease-nature syndrome elements were blood movement,blood deficiency,and qi deficiency,while the main disease-location elements were the spleen,exterior,and lung.At the graded level,Grade Ⅰ syndrome elements were mainly spleen and qi deficiency;Grade Ⅱ were mainly blood movement and blood deficiency;and Grade Ⅲ were mainly blood movement.Across differ-ent age groups,syndrome elements were still mainly characterized by the overall distribution.However,after the age of 1 to 3 years,syndrome elements involving the spleen,exterior,lung,external wind,heat,and yin deficiency became prominent.With increasing age,the frequencies of exterior,lung,and external wind decreased,while the frequency of yin deficiency increased.Association rule and complex network analyses revealed that the core syndrome element combination consisted of blood movement,blood deficiency,and qi deficiency.Hidden structure comprehensive clustering showed that the distribution of ITP syndrome types mainly included qi failing to control blood,qi and blood deficiency,and wind pathogen damaging the collaterals.Conclusion:The overall disease loca-tion of pediatric ITP lies in the collaterals.The pathogenesis is characterized by excessive pathogenic factors with deficiency of healthy qi,collateral damage,and blood extravasation.Deficiency syndromes are mainly qi failing to control blood and qi-blood defi-ciency;excess syndromes involve wind-heat damaging the collaterals and blood heat causing reckless movement of blood;mixed deficiency-excess syndromes correspond to yin deficiency with hyperactive fire.关键词
隐结构/关联规则/真实世界/免疫性血小板减少性紫癜:儿童/证素/证型/病机特点Key words
Latent structure model/Association rule/Real world/Immune thrombocytopenia:Children/Syndrome element/Syn-drome type/Pathogenesis characteristics分类
医药卫生引用本文复制引用
李宇迪,丁樱,徐炎,孟浩基,刘文博,杜昊雨..1110例儿童免疫性血小板减少性紫癜的中医证素隐结构研究[J].世界中医药,2025,20(18):3329-3336,8.基金项目
国家自然科学基金面上项目(81873343) （81873343）
国家自然科学基金青年科学基金项目(82205190) （82205190）
中国博士后科学基金面上项目(2023M731027) （2023M731027）
中国博士后科学基金第17批特别资助(2024T170253) （2024T170253）
国医大师工作室建设项目(丁樱国医大师传承工作室) （丁樱国医大师传承工作室）
河南省博士后项目(HN2022096) （HN2022096）
河南省卫健委国家中医药传承创新中心科研专项(2023ZXZX1073) （2023ZXZX1073）
河南省中医学"双一流"创建科学研究专项(HSRP-DFCTCM-2023-8-21) （HSRP-DFCTCM-2023-8-21）
