1970-2021年冠心病中医证候特征演变规律文献研究  

Literature Study on the Evolution Law of Traditional Chinese Medicine Syndrome Characteristics of Coronary Heart Disease from 1970 to 2021

作　　者：黄湘龙 李霄 杨丰文[1,2] 江丰 毕颖斐[4] 王贤良[4] 毛静远[4] 张伯礼[1] HUANG Xianglong;LI Xiao;YANG Fengwen;JIANG Feng;BIYingfei;WANG Xianliang;MAO Jingyuan;ZHANG Boli(Institute of Traditional Chinese Medicine,Tianjin University of Traditional Chinese Medicine,Tianjin,301617;Center for Evidence-Based Medicine,Tianjin University of Traditional Chinese Medicine;International Education College,Tianjin University of Traditional Chinese Medicine;First Teaching Hospital of Tianjin University of Traditional Chinese Medicine)

机构地区：[1]天津中医药大学中医药研究院,301617 [2]天津中医药大学循证医学中心 [3]天津中医药大学国际教育学院 [4]天津中医药大学第一附属医院

出　　处：《中医杂志》2023年第10期1058-1063,共6页Journal of Traditional Chinese Medicine

基　　金：国医大师传承工作室建设项目;国家中医药管理局中医药创新团队及人才支持计划(ZYYCXTD-C-202203);全国示范性劳模和工匠人才创新工作室项目。

摘　　要：目的 通过文献挖掘2010-2021年冠心病中医证候特征,并结合团队前期对1970-2010年冠心病中医证候特征演变的研究,总结1970-2021年冠心病中医证候特征演变规律。方法 检索2010年7月1日至2021年6月30日间中国知网(CNKI)及维普中文期刊数据库(VIP)中公开发表的冠心病中医证候临床研究相关文献,对最终纳入文献中冠心病中医证候类型和证候要素分布特征进行统计分析;并结合团队前期1970-2010年冠心病中医证候特征研究结果,总结分析1970-2021年冠心病中医证候特征演变规律。结果最终纳入129篇文献,包括52 090例患者,其中有107篇明确报告中医复合证型的文献,共36 224例患者。2010-2021年临床中医证候类型排名前10位的依次为痰浊内阻证8519例(23.52%)、心血瘀阻证5094例(14.06%)、气虚血瘀证5022例(13.86%)、气阴两虚证4432例(12.23%)、气滞血瘀证2285例(6.31%)、阳气亏虚证1683例(4.65%)、心气不足证1474例(4.07%)、寒凝心脉证1271例(3.51%)、气虚痰瘀证1243例(3.43%)、心肾阴虚证771例(2.13%);累计提取证候要素102 965例次,共包含10种证候要素,依次为血瘀27 825例次(27.02%)、气虚23 872例次(23.18%)、痰浊19 493例次(18.93%)、阴虚11249例次(10.93%)、阳虚5602例次(5.44%)、气滞5584例次(5.42%)、热(毒) 3615例次(3.51%)、寒凝2367例次(2.30%)、水饮2135例次(2.07%)、血虚1223例次(1.19%)。结合1970-2010年冠心病中医证候类型及证候要素分布情况,结果显示,1970-2021年,痰浊内阻证、气虚血瘀证所占比例呈逐步升高趋势;心血瘀阻证所占比例在1990-1999年、2000-2010年较1970-1989年明显升高,但在2010-2021年明显降低;气滞血瘀证所占比例1990-2021年较1970-1989年均降低;单纯虚证(气阴两虚证、心气不足证、阳气亏虚证)总占比呈逐步降低趋势。痰浊、血瘀等标实证候要素所占比例呈明显升高趋势,气虚、阴虚、阳虚等本虚证候要素所占比例总体呈�Objective To mine the characteristics of traditional Chinese medicine(TCM)syndromes of coronary heart disease(CHD)from 2010 to 2021 through literature,and to summarize the evolution law of the TCM syndromes of CHD in 1970—2021 based on the previous study.Methods Databases including CNKI and VIP were searched for relevant literature on TCM syndromes of CHD published between July 1st,2010 and June 30th,2021,and the distribution characteristics of TCM syndromes and syndrome elements of the included literature were statistically analyzed.Based on the team's previous research,the evolution law of TCM syndrome characteristics of CHD in 1970—2021 was summarized.Results A total of 129 papers involving 52090 patients were eventually included,of which 107 papers reported compound TCM syndromes involving 36224 patients.From 2010 to 2021,the top 10 clinical TCM syndrome types were internal obstruction of phlegm-turbidity(8519 cases,23.52%),heart blood stasis obstruction(5094 cases,14.06%),qi deficiency and blood stasis(5022 cases,13.86%),both qi and yin deficiency(4432 cases,12.23%),qi stagnation and blood stasis(2285 cases,6.31%),yang qi depletion(1683 cases,4.65%),heart qi insufficiency(1474 cases,4.07%),cold congealing in the heart vessel(1271 cases,3.51%),qi deficiency and phlegm stasis(1243 cases,3.43%),and yin deficiency of heart and kidney(771 cases,2.13%).A total of 102965 cases of syndrome elements were extracted,including 10 syndrome elements,which were 27825 cases of blood stasis(27.02%),23872 cases of qi deficiency(23.18%),19493 cases of turbid phlegm(18.93%),11249 cases of yin deficiency(10.93%),5602 cases of yang deficiency(5.44%),5584 cases of qi stagnation(5.42%),3615 cases of heat(toxin)(3.51%),2367 cases of cold congealing(2.30%),2135 cases(2.07%)of fluid rheum,and 1223 cases(1.19%)of blood deficiency.Combined with the characteristics of TCM syndromes and syndrome elements of CHD from 1970 to 2010,the results showed that the proportion of internal obstruction of phlegm-turbidity syndrome and qi deficien

关 键 词：冠心病 中医证候 证候要素 阳微阴弦 痰浊 血瘀 

分 类 号：R259[医药卫生—中西医结合] G353.1[医药卫生—中医内科学]