基于文献系统评价探讨胃肠气滞证诊断条目  

Discussion on Diagnostic Items of Gastrointestinal Qi Stagnation Syndrome Based on Systematic Evaluation of Literature

作　　者：范星宇 方格 钟森杰 廖晓倩 邱宏 胡志希 FAN Xingyu;FANG Ge;ZHONG Senjie;LIAO Xiaoqian;QIU Hong;HU Zhixi(College of Traditional Chinese Medicine,Hunan University of Chinese Medicine,Changsha 410208,China)

机构地区：[1]湖南中医药大学中医学院,长沙410208

出　　处：《中国中医基础医学杂志》2022年第10期1632-1636,1657,共6页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：广东省重点领域研发计划项目(2020B1111100001)-气滞证辨证标准的系统研究;国家自然科学基金资助项目(81774208)-基于TGF-β/Smad通路探讨高血压心衰证候本质及心肾纤维化机制;湖南省自然科学基金资助项目(2019JJ50447)-基于代谢调控网络探讨高血压心力衰竭证候本质;湖南省自然科学基金资助项目(2020JJ4062)-基于“心肾不交”探讨高血压心衰肾纤维化的病理机制;湖南省自然科学基金资助项目(2020JJ5408)-基于miR-378探讨耐力运动对高血压心衰心肌纤维化的作用与机制。

摘　　要：目的探讨胃肠气滞证的诊断条目为临床诊断提供指导。方法通过检索有关胃肠气滞证数据库文献及国家标准、行业标准、教材、学会标准等建立数据库,运用文献系统评价、因子分析降维处理和聚类分析以及网络图关联分析得出最终核心诊断条目。结果共检索出11626篇文献,筛选后共有合格文献98篇,得到120条主要症状群,54条症状条目池,通过分析得出胃肠气滞证诊断条目中的核心辨证症状:“主症:胃脘或腹部胀满疼痛、嗳气、肠鸣、矢气,次症:纳呆、大便不调、嗳腐吞酸、恶心呕吐,舌象:舌淡红、苔薄白、苔腻、苔白;脉象:脉弦”。待补充条目为胁肋胀痛、烦躁易怒、胸闷、症状因情绪诱发或加重、脉细、脉沉、脉滑、舌红、舌质暗。结论在胃肠气滞证初步诊断条目研究结果中,核心症状涵盖了已发表的诊断标准,还有一些待补充参考条目,可为形成胃肠气滞证中医诊断量表奠定基础。Objective:To explore the diagnostic items of gastrointestinal Qi stagnation syndrome and provide guidance for clinical diagnosis.Methods:The database was established by searching the documents,national standards,industry standards,textbooks,academic standards,those related to gastrointestinal Qi stagnation syndrome.And the final core diagnostic items of gastrointestinal Qi stagnation syndrome were obtained through literature system evaluation,factor analysis,dimension reduction processing,cluster analysis,and network graph association analysis.Results:A total of 11626 documents were retrieved.After screening,a total of 98 qualified research documents,120 main syndrome groups and 54 symptom entry pools were obtained.Through analysis,the core syndromes in the diagnosis items of gastrointestinal Qi stagnation syndrome were:"Main symptoms:stomach or abdominal fullness,pain,belching,bowel sounds,and break wind.Second symptoms:poor appetite,irregular stool,belching,nausea and vomiting.Tongue image:greasy,white coating.Pulse image:string pulse."The items to be added are flank pain,irritability,chest tightness,symptoms induced or aggravated by emotion,heavy pulse,slippery pulse,pale red tongue,thin white fur,red tongue,dark tongue.Conclusion:In the research results of preliminary diagnosis items of gastrointestinal Qi stagnation syndrome,the core symptoms cover the published diagnostic criteria,and there are some reference items to be supplemented.This study can lay the foundation for the formation of gastrointestinal Qi stagnation syndrome TCM diagnostic scale.

关 键 词：胃肠气滞证 文献系统评价 诊断 

分 类 号：R256.3[医药卫生—中医内科学]