目的 研究真实世界中高血压病住院患者的临床特征以及各中医证型分布特点及中药处方用药规律。方法 基于回顾性研究的方法，选择本院2018年1月-2019年12月信息系统（hospital information systerm，HIS）中主诊断为高血压的住院患者，采集其入院及治疗过程中的信息，使用频数分析和关联规则分析方法进行分析。结果 共纳入2064例高血压患者，其中男性1007人（49%），女性1057人（51%）；以3级高血压最多见（54%）；证型分布上以痰瘀互结最多见（47%）；各证型发病的平均年龄以肝火亢盛年龄最低（58岁），肾气虚证型最高（68岁）。高血压第2诊断常见合并病/症以冠心病为主（40%），其次为脑梗死（20%）；住院时间的节气分布方面，总体上看以小满发病人数最多，其次是立夏、处暑、芒种、小暑等，各证型又不相同。中药使用方面：处方中共包括了235种中药材，各个证型高频用药以川芎使用的频次最高，其他使用频次较多的包括天麻、当归、半夏、丹参等。5个证型共计产生核心药对44对，肝火亢盛证以天麻配伍川牛膝、杜仲置信度最高；肾气虚证以川芎配伍山药、当归置信度最高；痰瘀互结证以川芎配伍当归、地龙置信度最高；阴虚阳亢证以川芎配伍半夏、酸枣仁置信度最高。结论 基于临床特征及处方用药分析，高血压的基本病理因素以瘀、痰、虚为主，用药主要为活血通络、平肝补肾之品，常用核心药物为川芎，根据不同证型常以天麻、山药、当归、半夏等与之相配伍应用。

Objective To study the clinical characteristics of hospitalized patients with hypertension in the real world, the distribution characteristics of different syndromes and the prescription rule of Chinese herbal medicine. Methods Based on retrospective study, inpatients with hypertension in hospital information systerm (HIS) system in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 1 2018 to December 12 2019 were selected, and information about their admission and treatment process was collected. Frequency analysis and association rule analysis were used for analysis. Results A total of 2064 patients with hypertension were collected, including 1007 males (49%) and 1057 females (51%). Grade 3 hypertension was the most common (54%). On the distribution of TCM syndromes, phlegm and blood stasis syndrome was the most common (47%); The age of onset of each syndrome type was the lowest (58) with liver-fire excess syndrome and the age of onset of kidney qi deficiency syndrome type was the highest (68). Coronary heart disease (40%) was the most common complication in the second diagnosis of hypertension, followed by cerebral infarction (20%). In Solar Term of the distribution of hospitalization time, the number of patients with Grain Buds was the largest in general, followed by the Start of Summer, End of Heat, Grain in Ear, Minor Heat, etc., and the syndrome types were different. In terms of the use of Chinese herbal medicine, there were a total of 235 kinds of Chinese herbal medicine in the prescription. Chuanxiong Rhizoma was the most frequently used high frequency medicine for each syndrome type, while Gastrodiae Rhizoma, Angelicae Sinensis Radix, Pinelliae Rhizoma, Salviae Miltiorrhizae Radix et Rhizoma and so on were used more frequently. Five card models produced 44 core medicine pairs in all. For liver-fire excess syndrome, Gastrodiae Rhizoma combined with Cyathulae Radix, Eucommiae Cortex had the highest confidence degree; In the syndrome of kidney qi deficiency, the confidence of Chuanxiong Rhizoma combined with Dioscoreae Rhizoma and Angelicae Sinensis Radixs was the highest. In the syndromes of phlegm and blood stasis syndrome, Chuanxiong Rhizoma combined with Angelicae Sinensis Radix and Pheretima had the highest confidence. The syndrome of yin deficiency and yang hyperactivity was characterized by Chuanxiong Rhizoma combined with Pinelliae Rhizoma and Ziziphi Spinosae Semen with highest confidence.Conclusion Based on the analysis of clinical characteristics and prescription medication, the basic pathological factors of hypertension are mainly stasis, phlegm and deficiency, and the medication is mainly used for activating blood and dredging collaterals, smoothing liver and tonifying kidney. The core drugs of Chuanxiong Rhizoma, and Gastrodiae Rhizoma, Dioscoreae Rhizoma, Angelicae Sinensis Radix, Pinelliae Rhizoma, and so on are commonly used in combination according to different syndromes.

R285.64

国家重点研发计划“中医药现代化研究”重点专项（2017YFC1703506）；山东省科技创新基地专项（鲁科字[2018]103号）