基于文献研究探讨糖尿病肾病的证候分布规律  

Exploration of TCM pattern distribution of diabetic kidney disease based on literature review

作　　者：尹继瑶 陈志永 沈霞[1] 王漱非 张楠 李现成 于丽丽[4] 王俊文[5] 于小勇 许建秦 屈凯[1,2] YIN Jiyao;CHEN Zhiyong;SHEN Xia;WANG Shufei;ZHANG Nan;LI Xiancheng;YU Lili;WANG Junwen;YU Xiaoyong;XU Jianqin;QU Kai(Shaanxi University of Chinese Medicine,Xianyang 712083;Shaanxi Provincial Hospital of Chinese Medicine;Shaanxi Academy of Traditional Chinese Medicine;Macao University of Science and Technology;China Academy of Chinese Medical Sciences)

机构地区：[1]陕西中医药大学,咸阳712083 [2]陕西省中医医院 [3]陕西省中医药研究院 [4]澳门科技大学 [5]中国中医科学院

出　　处：《现代中医临床》2022年第5期72-76,共5页Modern Chinese Clinical Medicine

基　　金：国家中医药管理局中医药科学技术研究专项课题(No.GZY-KJS-2021-005);国家自然科学基金项目(No.81603454);全国中医临床特色技术传承骨干人才项目(No.国中医药人教函[2019]36号);陕西省中医药中青年科技骨干人才项目(No.11610000MB29656749/2020-00894)。

摘　　要：目的 分析糖尿病肾病(DKD)中医证候相关文献,总结并探讨DKD中医证候分布规律。方法 检索中国知网(CNKI)、万方数据知识服务平台、维普中文科技期刊数据库和PubMed数据库,自2016年1月1日至2021年1月1日收录的相关文献,筛选符合纳入标准的文献,进行证候提取、名称规范及拆分以及证候要素提取。对证候和证候要素的频次及百分率进行描述性分析;对证候要素进行关联规则分析。结果 共检索文献1 498篇,最终纳入127篇,109篇有中医证候诊断标准,共提取175个中医证候,规范统一为33个中医证候,以气阴两虚证、血瘀证、阴阳两虚证、痰浊证和脾肾气虚证最为常见。从脏腑辨证角度分析上述33种证候,以肾为主、虚证多见;虚证均与肾虚相关。127篇文献共提取20个病性类证候要素、9个病位类证候要素。对20个病性类证候要素进行关联规则分析,共得到证候要素组合6种,“血瘀—气虚”“湿—气虚”组合支持度最高,此证候要素组合最为常见;置信度与提升度均最高的病性证候要素组合为“血瘀—湿”,其次是“气虚—湿”组合。结论 DKD中医证候以虚实夹杂为主;虚证多见于气阴两虚证、阴阳两虚证、脾肾气虚证,实证以血瘀证、痰浊证为主;阴虚、气虚等证候要素贯穿疾病始终。Objective To analyze the related literature on TCM syndromes of diabetic kidney disease(DKD), and summarize and discuss the distribution characteristics of DKD TCM patterns.Methods Relevant literatures from January 1, 2016 to January 1, 2021 were retrieved in CNKI, Wanfang Data, VIP, and PubMed, and those that meet the inclusion criteria were screened and a database was created for syndrome extraction, name standardization and separation, and syndrome element extraction.Results We retrieved a total of 1,498 papers, 109 of the 127 papers included have TCM diagnostic criteria, and a total of 175 patterns were extracted, which were then standardized into 33 TCM patterns. The top five are: qi-yin deficiency, blood stasis, deficiency of both yin and yang, phlegm-turbidity, deficiency of spleen and kidney qi. From the perspective of zang-fu pattern differentiation, kidney accounted for the largest proportion of the 33 types, and deficiency patterns is also considerably common, which are all related to kidney deficiency. We extracted 20 pattern elements related to the nature of the disease and 9 associated with disease locations. The association rule analysis of the 20 property-related elements revealed 6 syndrome element combinations. “Blood stasis-qi deficiency” and “dampness-qi deficiency”, which are the most common ones, have top support, and “dampness-blood stasis” combinations have top confidence and improvement and the second is “qi deficiency-dampness” combinations.Conclusions The TCM patterns of DKD were characterized by a mixture of deficiency and excess;deficiency patterns were dominated by qi-yin deficiency, deficiency of both yin and yang, and deficiency of spleen and kidney qi;excessive patterns mainly include blood stasis and phlegm-turbidity;yin deficiency and qi deficiency were the main pathological factors for the disease.

关 键 词：糖尿病肾病 中医证候 证候要素 文献研究 

分 类 号：R256.5[医药卫生—中医内科学]