近20年心律失常中医证候分布规律的文献分析  

Literature Analysis of TCM Syndrome Distribution of Arrhythmia in Last Two Decades

作　　者：李悦 朱灵妍 裘福荣[3] 姚成增[3,4] LI Yue;ZHU Lingyan;QIU Furong;YAO Chengzeng(Emergency Department,Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China;Central Hospital of Xuhui District,Shanghai 200031,China;Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China;Shanghai Branch of National Clinical Research Center for Chinese Medicine Cardiology,Shanghai 200021,China)

机构地区：[1]北京中医药大学第三附属医院急诊科,北京100029 [2]上海市徐汇区中心医院,上海200031 [3]上海中医药大学附属曙光医院,上海200021 [4]国家中医心血管病临床医学研究中心上海分中心,上海200021

出　　处：《世界中医药》2023年第17期2474-2479,共6页World Chinese Medicine

基　　金：国家自然科学基金项目(81273959)——MicroRNAs/PI3-K/PKB/GLUT-4信号途径对慢性心衰时骨骼肌糖代谢异常的调控及坎离颗粒干预研究;上海市临床重点专科(中医心病科)(shslczdzk05301);上海市卫健委项目(202040220)——基于“因时制宜”理论的上海市区慢性心衰中医证候分布的流行病学调查研究;国家中医药管理局第六批全国老中医药专家学术经验继承工作项目{国中医药人教发[2017]29号}。

摘　　要：目的:本研究通过对国内近20年内心律失常相关中医证型、证素的地域和时间变迁的文献进行系统性分析,探讨和总结心律失常的证候规律,揭示心律失常相关证型、证素分布的变化,以期为心律失常的辨证论治提供参考依据。方法:检索2000-2020年国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)数据库收录的快速性(型)心律失常及缓慢性(型)心律失常中医证候特征的文献,并进行统计分析。结果:本研究共纳入文献986篇,病例42077例,其中,快速性(型)心律失常18944例,缓慢性(型)心律失常23133例。快速性(型)心律失常的常见证型有气阴两虚、血瘀阻络、阴虚火旺、痰瘀互阻等;证素以阴虚、气虚、血瘀多见;缓慢性(型)心律失常的常见证型有心肾阳虚、阳虚血瘀、气阴两虚,证素以阳虚、血瘀、气虚为主。结论:快速性(型)心律失常病机以本虚标实多见,本虚以阴虚、气虚为主,标实以血瘀、痰湿为主;缓慢性(型)心律失常以心肾阳虚为主,兼标实血脉瘀阻或挟痰挟湿。近年来虚性证素所占比例较高,实性证素所占比例相对降低。Objective:To systematically review the literature on the regional and temporal changes of TCM syndromes and syndrome elements of arrhythmia in the last two decades in China,so as to reveal the distribution changes of TCM syndromes and syndrome elements of arrhythmia and provide a reference for the treatment of arrhythmia based on syndrome differentiation in the future.Methods:The articles about the TCM syndromes of tachyarrhythmia and bradyarrhythmia were retrieved from the China National Knowledge Infrastructure(CNKI),China Science Periodical Database(CSPD),and Chinese Citation Database(CCD)with the time interval from 2000 to 2020 for statistical analysis.Results:Totally 986 articles were enrolled,involving 42077 patients(18944 patients with tachyarrhythmia and 23133 patients with bradyarrhythmia).The common TCM syndromes of tachyarrhythmia were qi and yin deficiency,blood stasis blocking collaterals,yin deficiency leading to fire hyperactivity,and obstruction by phlegm and blood stasis,in which the main syndrome elements were yin deficiency,qi deficiency,and blood stasis.The common TCM syndromes of bradyarrhythmia were heart and kidney yang deficiency,yang deficiency and blood stasis,and qi and yin deficiency,in which the main syndrome elements were yang deficiency,blood stasis,and qi deficiency.Conclusion:Tachyarrhythmia was mainly caused by interior deficiency(yin or qi)with exterior excess(blood stasis or phlegm).Bradyarrhythmia was mainly caused by heart and kidney yang deficiency,together with blood stasis blocking vessels or phlegm and dampness.In recent years,the proportion of the patients with interior deficiency was high,and that of the patients with exterior excess was low.

关 键 词：快速性(型)心律失常 缓慢性(型)心律失常 中医 证型 证素 因时制宜 因地制宜 辨证论治 

分 类 号：R256.2[医药卫生—中医内科学]