慢性心力衰竭中医辨证规律的文献分析

Literature Analysis of Syndrome Differentiation on Traditional Chinese Medicine of Chronic Heart Failure

目的:通过对近20年中医药治疗心力衰竭相关文献的分析研究,总结心力衰竭的常见证候要素、证候类型及其分布规律。方法:对符合纳入标准的文献进行分析研究。结果:入选文献22篇,合计病例1975例,包括10个证候要素,所占比例大于20%的证候要素是:气虚、阳虚、血瘀、阴虚、水饮,其中气虚995例(55.43%),阳虚704例(39.22%),血瘀558例(31.09%),阴虚468例(26.07%),水饮407例(22.67%);证候类型共计24种,所占比例大于10%的是:阳虚271例(15.10%)、气阴两虚256例(14.26%)、阳虚水泛250例(13.93%)、气虚血瘀217例(12.09%);气(阳)虚兼瘀血和/或水饮涵盖已检出的9个证候类型,包含病例1060例(59.05%),气阴两虚兼血瘀和/或水停涵盖5个证候类型,涉及病例360例(20.06%),结论:气阳亏虚、气阴两虚是心力衰竭的两大本虚证候类型,血瘀和水饮是两大标实兼证,把握气(阳)虚兼瘀血和/或水停、气阴两虚兼血瘀和/或水停两大本虚标实复合证候类型,有利于中医药在心力衰竭治疗中的更好应用。

Objective：To summarize distribution regularity of syndrome element and syndrome types of heart failure by analyzed related literature in 20 years.Methods：To analyze the literature met the inclusion criteria.Results：22 literature were selected and contained a total 1975cases.Including 10 syndromes elements,the proportion of which more than 20%are：Qi deficiency,Yang deficiency,blood stasis,Yin deficiency and excessive fluid,which Qi deficiency are 995 cases（55.43%）,Yang deficiency are 704 cases（39.22%）,blood stasis are 558 cases（31.09%）,Yin deficiency are 468 cases（26.07%）,excessive fluid are 407 cases（22.67%）;Including 24 syndromes types,the proportion of which more than 10%are：271 cases of Yang deficiency（15.10%）,256 cases of deficiency of both Qi and Yin（14.26%）,250 cases of edema due to Yang deficiency（13.93%）and 217 cases of Qi deficiency and blood stasis（12.09%）;Qi（Yang）deficiency and blood stasis and（or）excessive fluid including nine syndromes types which involving 1060 cases（59.05%）,Qi and Yin deficiency and blood stasis and（or）excessive fluid including five syndromes types which involving 360 cases（20.06%）,Conclusion：The deficiency of both Qi and Yang and deficiency of both Qi and Yin are two main syndrome types of deficiency in root,blood stasis and excessive fluid are the two main syndrome types of excess in branch,it is helpful for application of Traditional Chinese Medicine in heart failure to master syndrome type of Qi（Yang）deficiency and blood stasis and（or）excessive fluid and Qi and Yin deficiency and blood stasis and（or）excessive fluid in favor of Chinese medicine in heart failure.