近40年冠心病中医证候特征研究文献分析

Literature Analysis of Studies on the TCM Syndromes of Coronary Heart Disease in the Recent 40 Years

目的对冠心病辨证分型的相关文献进行分时段研究,以揭示冠心病中医证候特征的变化规律。方法对1970-2010年中国期刊全文数据库(CNKI)及维普资讯(VIP)中文科技期刊数据库发表的冠心病中医证候相关文献进行全面检索,对其中冠心病中医证型、证候要素分布及不同时期变化规律进行统计分析。结果纳入文献308篇,总病例数34 640例。冠心病证候分布以心血瘀阻、痰阻心脉、气阴两虚、气虚血瘀、心气不足、气滞血瘀、阳气亏虚、寒凝心脉、痰瘀互结等为常见证型,相关证候要素以血瘀、气虚、痰浊、阴虚、气滞、阳虚为多见,本虚中以气虚为首(18 949例次占24.10%),标实中以血瘀为首(22 101例次占28.10%)。心血瘀阻及痰浊内阻证在1970-1989年、1990-1999年、2000-2010年3个时间段所占比例呈逐步增高趋势,气阴两虚证则逐步降低。结论冠心病本虚以气虚、阴虚为主,标实以血瘀、痰浊、气滞多见,血瘀、痰浊等标实证候要素及相关的证候类型近年来所占比例在不断增加。

Objective To reveal the changing law of TCM syndromes of coronary heart disease through an analysis on its related literature in different period of time.Methods A comprehensive retrieval of the TCM syndromes of coronary heart disease published in CNKI and VIP from 1970 to 2010 was carried out.Related TCM syndromes,syndrome factors,and changing law in different period of time were analyzed.Results Totally 308 articles were enrolled and 34 640 cases were analyzed.The common TCM syndromes of coronary heart disease were retention of heart blood stasis,phlegm blocking the heart vessels,both qi and yin deficiency,qi deficiency with blood stasis,heart qi deficiency,qi stagnation with blood stasis,yang qi insufficiency,cold stagnating in the heart vessels,and phlegm combining with blood stasis.The related syndrome factors were blood stasis,qi deficiency,phlegm turbidity,yin deficiency,qi stagnation,and yang deficiency.Of the Ben-root deficiency type,qi deficiency was the first（18 949 cases occupying 24.10%）;In the Biao-symptom excess type,blood stasis was the first（22 101 cases occupying 28.10%）.The proportion of retention of heart blood stasis and retention of phlegm turbidity syndromes was gradually increased in 1970-1989,1990-1999,and 2000-2010,while that of both qi and yin deficiency syndrome was slowly decreased.Conclusion The Ben-root deficiency type of coronary heart disease was mainly of qi deficiency and yin deficiency.The Biao-symptom excess type was mainly of blood stasis,phlegm turbidity,and qi stagnation.The proportion of syndrome factors of Biao-symptom excess type including blood stasis and phlegm turbidity and their related syndromes was increasing in recent years.