基于文献研究的难治性癫痫中医证候要素分布

Distribution of Traditional Chinese Medicine Syndrome Elements in Intractable Epilepsy Based on Literature Research

目的对难治性癫痫的中医证候要素进行分析研究,从循证医学角度探讨其中医证候要素分布规律及特点。方法采用"文献归纳分析方法",检索中国生物医学数据库、中国知网、维普、万方数据库中1996-2016年期间发表的难治性癫痫中医证候分型明确的文献,从文章中所涉及的难治性癫痫中医证型、证素、患者例数进行分布规律分析。结果难治性癫痫病位证素包括肝、神、心、脾、肾、经络/脑络;病性证素包括痰、火、气滞、血虚、气虚、血瘀、动风、闭、阴虚、精亏。结论病位证素中肝病位证素出现频率为第一位;病性证素中在发作期以风为主要表现;虚实证素中,实证大于虚证及虚实夹杂证总和,说明难治性癫痫因实动风多于因虚生风。

Objective To investigate the distribution of traditional Chinese Medicine(TCM)syndrome elements in intractable epilepsy and its distribution patterns and characteristics according to evidence-based medicine.Methods Literature analysis was performed by searching CBM,CNKI,VIP,and Wanfang Data for the papers that pointed out the definite TCM syndrome types of intractable epilepsy and were published from1996to2016.Distribution patterns were analyzed according to TCM syndrome types,syndrome elements,and the number of patients reported in the papers.Results Syndrome elements of disease location in intractable epilepsy included the liver,nerve,heart,spleen,kidney,and channels/brain channels;syndrome elements reflecting the nature of disease included phlegm,fire,Qi stagnation,deficiency of Qi and blood,blood stasis,stirring wind,stasis,Yin deficiency,and deficiency of essence.Conclusion The liver is the most frequently seen syndrome element of disease location;wind is the main syndrome element reflecting the nature of disease during the ictal period;in analysis of deficiency and excess syndrome elements,excess syndrome occurs more frequently than deficiency syndrome and deficiency and excess combined syndrome,which indicates that stirring wind due to excess causes more intractable epilepsy compared with deficiency generating wind.