支气管扩张缓解期中医证素及证候分型特点的文献研究

Distribution of TCM Syndrome Elements and Syndrome Types of Bronchiectasis in Remission Stage based on Literature Research

目的:采用文献研究的方法探讨支气管扩张缓解期的证素分布与组合规律及证候分型特点。方法:检索中国知网(CNKI)、维普(VIP)、万方、中国生物医学文献数据库(CBM)及中国中医文献检索系统数据库,建立支气管扩张缓解期证候文献研究数据库,采用SPSS 22.0统计软件进行统计。结果:35篇文献纳入的442例患者中共提取证素18个,病位证素中肺出现频次最高(52.86%),其次为脾(22.86%)、肾(14.29%)。病性证素中气虚出现频次最高(34.51%),其次为阴虚(27.43%)、痰(12.39%)。组合形式以两证素(47.44%)和三证素(42.31%)组合居多。442例患者中,原辨证分型共20种,其中肺脾气虚证(40.72%)、痰热阻肺证(17.42%)、气阴两虚证(9.50%)、阴虚火旺证(6.33%)、肝火犯肺证(2.94%)等5种证型最为常见,所有证型中单纯实证77例(17.42%),单纯虚证112例(25.34%),虚实夹杂证253例(57.24%)。结论:支气管扩张缓解期以肺脾肾气虚、阴虚为本,痰、热、血瘀等病理因素为标,病性虚实夹杂,复杂多变。

Objective: To discuss the distribution law and internal characteristics of syndrome manifestations of bronchiectasis in remission stage, and to provide a base for standardized study of syndrome manifestations by using literature research. Methods: CNKI, VIP, Wanfang, CBM and TCM literature retrieval system databases were retrieved, and the literature research database of bronchiectasis remission period was established. SPSS 22.0 statistical software was used for statistics. Results: Among 442 patients included in 35 literatures, 18 syndrome elements were extracted. Lung was the most frequent disease location syndrome element (52.86%), followed by spleen (22.86%) and kidney (14.29%). The frequency of Qi deficiency was the highest (34.51%), followed by Yin deficiency (27.43%) and phlegm (12.39%). The combination of two syndrome elements (47.44%) and three syndrome elements (42.31%) was the most common. Among the 442 patients, there were 20 types of original syndrome differentiation, and lung -spleen deficiency syndrome (40.72%), phlegm -heat obstruction syndrome (17.42%), Qi-Yin deficiency syndrome (9.50%), Yin deficiency and fire excess syndrome (6.33%) and liver-fire offending lung syndrome (2.94%) were the most common. Among all syndromes, 77 cases (17.42%) were simple sufficiency syndrome, 112 cases (25.34%) were simple deficiency syndrome, and 253 cases (57.24%) were mixed deficiency and sufficiency syndrome. Conclusion: Bronchiectasis has the root pathogenesis of Qi-Yin deficiency of lung, spleen and kidney, and the pathological factors of phlegm, heat, and blood stasis contribute to its branch pathogenesis;the combination and interaction of the pathological factors make the pathogenesis of bronchiectasis more complex.