中医体质类型与高血压前期相关性研究的单个率Meta分析  

Associations between Traditional Chinese Medicine Constitution Types and Prehypertension:Single Rate Meta-analysis

作　　者：陈洁玲 陈雄森 廖荣鑫[1,2] 孙晓敏 赵晓山[1,3] 陈洁瑜[1,3] CHEN Jieling;CHEN Xiongsen;LIAO Rongxin;SUN Xiaomin;ZHAO Xiaoshan;CHEN Jieyu(School of Traditional Chinese Medicine,Southern Medical University,Guangzhou 510515,China;Hospital of Integrated Traditional Chinese and Western Medicine,Southern Medical University,Guangzhou 510315,China;Department of Traditional Chinese Medicine,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学中医药学院,广州510515 [2]南方医科大学中西医结合医院,广州510315 [3]南方医科大学南方医院中医科,广州510515

出　　处：《世界中医药》2024年第19期2931-2941,2957,共12页World Chinese Medicine

基　　金：国家重点研发计划项目(2020YFC2003100,2020YFC2003101);广东省中医药局科研课题项目(20241208);南方医科大学大学生创新创业训练计划项目(201912121395)。

摘　　要：目的:系统评价高血压前期中医体质类型分布规律,并确定该病的高危体质类型,为高血压前期的中医药防治提供循证医学证据。方法:检索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)、中国生物医学文献数据库(CBM)以及外文数据库PubMed、Web of Science核心合集、Cochrane Library,纳入所有评价中医体质类型与高血压前期相关的临床研究文献,按照纳入标准选择文献,提取数据。用纽卡斯尔-渥太华量表(NOS)对病例对照研究和队列研究进行质量评价,用美国卫生保健质量和研究机构(AHRQ)推荐的评价标准对横断面研究、随机对照试验研究进行质量评价。用Stata软件进行单个率的Meta分析并与王琦教授发表的中国一般人群体质分布情况进行比较。采用Review Manager5.3软件进行对照研究的Meta分析。以率(rate)或比值比(OR)及其95%置信区间(CI)描述效应值。结果:最终纳入文献28篇,共涉及高血压前期患者13455例,对照组(即非高血压前期患者)4133例。所有纳入评价的文献均未完全符合NOS或AHRQ条目要求,但文献质量评价总分均较高,总体质量较高。痰湿质、阴虚质、湿热质和血瘀质在高血压前期患者占比较高,分别为17.2%、16.6%、10.9%和9.4%。含健康对照人群的Meta分析显示,痰湿质、湿热质、阴虚质、血瘀质、郁质、平和质、阳虚质、特禀质发生高血压前期风险的OR值分别为8.39(2.18~32.36)、2.11(1.46~3.06)、2.02(1.44~2.83)、1.82(1.57~2.11)、0.81(0.61~1.06)、0.78(0.57~1.08)、0.31(0.21~0.47)、0.71(0.52~0.99)、0.55(0.40~0.76)湿质、阴虚质、湿热质和血瘀质是高血压前期患者的主要体质类型,也是导致高血压前期发病的危险因素,其中以痰湿质与高血压前期关系最为密切;而平和质、阳虚质、特禀质在高血压前期患者的体质分布中是相对保护因素。Objective:To systematically evaluate the distribution patterns of traditional Chinese medicine(TCM)constitution types in individuals with prehypertension and identify high-risk constitution types associated with this condition,providing evidence-based support for TCM prevention and treatment of prehypertension.Methods:Databases including Chinese National Knowledge Infrastructure(CNKI),China Academic Journal Database(CSPD),Chinese Sci-tech Journal Database(CCD),China Biology Medicine(CBM),PubMed,Web of Science Core Collection,and Cochrane Library were searched to identify clinical research literature evaluating the relationship between TCM constitution types and prehypertension.Studies meeting inclusion criteria were selected,and relevant data were extracted.The Newcastle-Ottawa Scale(NOS)was used to assess the quality of case-control and cohort studies,while the quality of cross-sectional and randomized controlled trials was evaluated using standards recommended by the Agency for Healthcare Research and Quality(AHRQ).Meta-analysis of single rates was performed using Stata software and compared with the constitution distribution of the general Chinese population as reported by Professor Wang Qi.Meta-analysis of controlled studies was conducted using Review Manager 5.3.Effect sizes were expressed as rates or odds ratios(OR)with 95%confidence intervals(CI).Results:A total of 28 studies were included,involving 13455 prehypertensive patients and 4133 controls(non-prehypertensive individuals).None of the included studies fully met the criteria of NOS or AHRQ,but all had relatively high-quality scores overall,indicating high quality.The distribution of phlegm-dampness,yin-deficiency,dampness-heat,and blood-stasis constitutions was higher in prehypertensive patients,accounting for 17.2%,16.6%,10.9%,and 9.4%,respectively.Meta-analysis including healthy controls showed that the ORs for developing prehypertension for different constitutions were as follows:phlegm-dampness(8.39,2.18 to 32.36),dampness-heat(2.11,1.46 to 3.06)

关 键 词：中医体质 高血压前期 治未病 单个率 META分析 系统评价 危险因素 保护因素 偏颇体质 

分 类 号：R242[医药卫生—中医临床基础] R256[医药卫生—中医学]