Associations between Traditional Chinese Medicine Constitution Types and Prehypertension:Single Rate Meta-analysis
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维普
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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13 455例,对照组(即非高血压前期患者)4 133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 Infra-structure(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 eval-uating 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 13 455 prehypertensive patients and 4 133 controls(non-prehypertens-ive individuals).None of the included studies fully met the criteria of NOS or AHRQ,but all had relatively high-quality scores o-verall,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),yin-deficiency(2.02,1.44 to 2.83),blood-stasis(1.82,1.57 to 2.11),qi-deficiency(0.81,0.61 to 1.06),qi-stagnation(0.78,0.57 to 1.08),balanced(0.31,0.21 to 0.47),yang-deficiency(0.71,0.52 to 0.99),and special diathesis(0.55,0.40 to 0.76).Conclusion:Phlegm-dampness,yin-deficiency,dampness-heat,and blood-stasis constitutions are the primary types in prehypertensive patients and significant risk factors for developing prehyper-tension,with phlegm-dampness being the most closely associated.In contrast,balanced,yang-deficiency,and special diathesis con-stitutions appear to act as protective factors against prehypertension.
Traditional Chinese medicine constitutionPrehypertensionPreventive treatment of diseasesSingle rateMeta-anal-ysisSystematic reviewRisk factorProtective factorBiased constitution
维普
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