首页|基于文献研究的原发性骨质疏松症中医证型及证素分布规律研究

基于文献研究的原发性骨质疏松症中医证型及证素分布规律研究

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目的:探讨原发性骨质疏松症患者的中医证候以及证素分布规律.方法:检索中国知网以及万方数据库中有关原发性骨质疏松症中医证型的相关文献,检索时间为数据库建立至 2023 年 5 月.应用Excel表提取原发性骨质疏松症患者的中医证型信息,将文献中证型的名称规范化处理,对中医证型进行证素提取,建立数据库,采用SPSS 27.0.1 软件进行频数分析.结果:共纳入 79 篇符合标准的文献,病例18 251例,经规范化处理后共纳入41种中医证型,16种证素,其中病位证素4种,病性证素12种.在总的证型分布中频率>3%的证型有8种,其中肝肾阴虚证居首位,4017例(22.05%),其余是脾肾阳虚证3236例(17.77%)、气滞血瘀证1733例(9.51%)、肾阳虚证1631例(8.95%)、肾虚血瘀证1433例(7.87%)、脾肾两虚证1087例(5.97%)、气虚血瘀证594例(3.26%)、脾肾气虚证549例(3.01%).在总的证素分布中,病位证素分别是肾13 700例(56.00%)、脾5720例(23.26%)、肝4454例(18.11%)、胃646例(2.63%);病性证素分别是阳虚5301例(27.92%)、阴虚4851例(25.55%)、血瘀4139例(21.80%)、气滞 1759 例(9.26%)、气虚 1700 例(8.95%)、精亏 606 例(3.19%),其余 6 个病性证素出现频率较小(频率均<3.00%).结论:原发性骨质疏松症的病位主要分布在肾、脾、肝、胃,其证素分布虚实夹杂,虚证以阳虚、阴虚、气虚为主,实证则以血瘀、气滞为主,中医证型以肝肾阴虚证、脾肾阳虚证、气滞血瘀证、肾阳虚证最为常见.原发性骨质疏松症的病机、证候复杂多样,而中医证型有时难以完全体现患者的具体情况,证素的合理搭配能有效地应对复杂的病机及证候.
Research on the TCM Syndrome Types and the Distribution Patterns of Syndrome Elements of Primary Osteoporosis Based on Literature Study
Objective:To explore the TCM syndromes and the distribution patterns of syndrome elements in patients with primary osteoporosis.Methods:Relevant literature on the TCM syndrome types of primary osteoporosis was retrieved from the databases CNKI and Wanfang(the retrieval time was from the establishment of the databases to May 2023).Excel tables were used to extract the TCM syndrome type information of different patients with primary osteoporosis.The names of the syndrome types in the literature were standardized,syndrome elements were extracted from the TCM syndrome types,a database was established,and frequency analysis was performed using software SPSS 27.0.1 respectively.Results:A total of 79 eligible literatures were included,with 18 251 cases.After standardization,a total of 41 TCM syndrome types and 16 syndrome elements were included,including 4 disease location syndrome elements and 12 disease nature syndrome elements.Among the total syndrome type distribution,there were 8 syndrome types with a frequency more than 3%.Among them,the liver-kidney yin deficiency syndrome ranked first,with 4017 cases(22.05%),followed by the spleen-kidney yang deficiency syndrome with 3236 cases(17.77%),the qi stagnation and blood stasis syndrome with 1733 cases(9.51%),the kidney yang deficiency syndrome with 1631 cases(8.95%),the kidney deficiency and blood stasis syndrome with 1433 cases(7.87%),the spleen-kidney deficiency syndrome with 1087 cases(5.97%),the qi deficiency and blood stasis syndrome with 594 cases(3.26%),and the spleen-kidney qi deficiency syndrome with 549 cases(3.01%).Among the total syndrome element distribution,the disease location syndrome elements were the kidney in 13 700 cases(56.00%),the spleen in 5720 cases(23.26%),the liver in 4454 cases(18.11%),and the stomach in 646 cases(2.63%);the disease nature syndrome elements were yang deficiency in 5301 cases(27.92%),yin deficiency in 4851 cases(25.55%),blood stasis in 4139 cases(21.80%),qi stagnation in 1759 cases(9.26%),qi deficiency in 1700 cases(8.95%),essence deficiency in 606 cases(3.19%),and the frequencies of the other 6 disease nature syndrome elements were low(all frequencies less than 3.00%).Conclusion:The disease locations of primary osteoporosis are mainly distributed in the kidney,spleen,liver,and stomach.The distribution of syndrome elements is a mixture of deficiency and excess.The deficiency syndromes are mainly yang deficiency,yin deficiency,and qi deficiency,while the excess syndromes are mainly blood stasis and qi stagnation.The most common TCM syndrome types are the liver-kidney yin deficiency syndrome,the spleen-kidney yang deficiency syndrome,the qi stagnation and blood stasis syndrome,and the kidney yang deficiency syndrome.The pathogenesis and syndromes of primary osteoporosis are complex and diverse,and TCM syndrome types sometimes cannot fully reflect the specific situation of patients.The reasonable combination of syndrome elements can effectively deal with the complex pathogenesis and syndromes.

primary osteoporosisTCM syndrome typessyndrome elementdisease locationdisease natureliterature study

李坤健、章晓云、柴源、曾浩

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广西中医药大学,广西 南宁 530001

广西中医药大学附属瑞康医院,广西 南宁 530011

原发性骨质疏松症 中医证型 证素 病位 病性 文献研究

2024

风湿病与关节炎
中华中医药学会

风湿病与关节炎

影响因子:1.216
ISSN:2095-4174
年,卷(期):2024.13(8)
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