【摘要】 目的：分析原发性高血压患者的核心症状集，探讨核心症状集与理化指标、量表评分的相关性。方法：选取135例原发性高血压患者进行前瞻性分析，采用聚类分析提取患者的核心症状集，以二元Logistic回归及ROC曲线分析核心症状集与理化指标、量表评分的相关性。结果：结合系统聚类结果及中医理论，将症状分为7类，其中肝肾阴虚夹痰瘀型症状集出现频率最多（54.26%,1 083/1 996），判定为原发性高血压患者的核心症状集。与非核心症状组比较，核心症状组患者年龄较高，女性占比更多，肌酐值较低，焦虑自评表与抑郁自评表（SDS）评分、中医症状积分、高血压症状积分、头痛评分较高，入院舒张压及24 h平均舒张压较低，差异均有统计学意义（P<0.05,P<0.01）。年龄、高血压症状积分、头痛评分、SDS评分的回归系数>0,OR值>1(P<0.05,P<0.01)，四者联合的ROC曲线下面积（AUC）最大（AUC=0.865），可较好区分患者是否为核心症状集状态。结论：原发性高血压患者以健忘、耳鸣、眩晕、急躁易怒、腰膝酸软等肝肾阴虚夹痰瘀证相关表现为核心症状集。年龄、高血压症状积分、头痛评分、SDS评分较高是诊断核心症状集的危险因素。更多还原

【Abstract】 Objective: To analyze the core symptom set of patients with essential hypertension. To discuss the correlation between the core symptom and physical and chemical indexes. Methods: A total of 135 patients with essential hypertension were selected for prospective analysis. Cluster analysis was used to extract the core symptom set of hypertension patients. Binary Logistic regression and ROC curve were used to analyze the correlation between core symptom set with physical and chemical indicators and scale scores. Results: The symptoms were divided into 7 categories according to the systematic clustering results and the theory of traditional Chinese medicine. Among them, the symptom set of liver and kidney yin deflciency and phlegmstasis appeared the most(54.26%, 1 083/1 996), which was the core symptom set of essential hypertension patients. Intergroup analysis showed that the core symptom group had higher age, self-rating anxiety scale(SAS), self-rating depression scale(SDS), traditional Chinese medicine symptom score, hypertension symptom score, headache score, more females and lower creatinine, diastolic blood pressure and 24 h average diastolic blood pressure than the non-core symptom group, the difference was statistically signiflcant(P<0.05, P<0.01). The regression coefflcients of age, hypertension symptom scores, headache scorse and SDS scores were >0, and the OR value was was >1(P<0.05, P<0.01). The combined area under ROC curve of the four groups was the largest(AUC=0.865), which could distinguish whether the patient was in the core symptom set state well. Conclusion: The core symptom sets of essential hypertension patients are forgetfulness, tinnitus, vertigo, irritability, waist and knee tenderness and other syndromic manifestations of liver and kidney yin deflciency and phlegm-stasis. Higher age, hypertension symptom scores,headache scores and SDS scores are risk factors for the diagnosis of core symptom group.更多还原