基于量表等级化法对缺血性中风证候要素及治法的研究

Syndrome Elements and Treatment Methods for Ischemic Stroke Based on Scale Grading Method

目的运用量表等级化方法研究分析缺血性中风证候要素治法,评估其临床分布及疗效价值。方法检索1978年1月—2018年12月中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方数据库(Wanfang Data)、中国生物医学文献数据库(Sino Med)。于四大数据库内检索有关中医药、中西医结合治疗缺血性中风临床观察、研究文献。对各个文献证候、治法、方药等信息进行规范化、等级化采集处理后建立缺血性中风证候要素与治法数据库。运用量表评价和等级化赋分方法分析证候要素和治法,描述其在缺血性中风中的分布情况。结果通过异质性分析结果显示纳入文献具有同质性,可进行统计量的合并,故开展后续统计研究。本研究共纳入450条证候、治法,经统一规范化拆分后得到1287个单一证候要素、1562个单一治法。对其等级化赋分后进行频数统计,证候要素降序排列依次为:血瘀、气虚、痰湿、内风、火热等;治法降序排列依次为:活血化瘀、益气、祛痰湿、熄风、通络等。证候要素和治法的等级化赋分统计结果可互相印证,表明此方法具有可行性。结论活血化瘀治法在缺血性中风治法中频数最高,体现活血化瘀法在临床具有较重要的疗效价值。

Objective To study the distribution of ischemic stroke(IS)treatment with data mining technology and to evaluate its clinical efficacy.Methods China National Knowledge Infrastructure Database(CNKI),China Science and Technology Reader’s Digest Database(VIP),Wanfang Data,Chinese Biomedical Literature Database(Sino Med)were retrieved from January 1978 to December 2018 on clinical observation and research literature on the treatment of IS with the combination of traditional Chinese medicine(TCM)and Western medicine(WM).After standardized and hierarchical collection and processing of all literature syndromes,treatment methods,prescriptions,and other information,a database of syndrome elements and treatment of IS was established.Scale evaluation and hierarchical classification were used to analyze the syndrome elements and treatment methods to describe their distribution in ischemic stroke.Results The results of heterogeneity analysis showed that included literatures were homogeneous and could be combined statistically,so subsequent statistical studies were allowed.Totally 450 syndromes and treatment methods were included in this study,and 1287 single syndrome elements and 1562 single treatment methods were obtained after unified and standardized separation.Frequency statistics were carried out after grading,and the descending order of syndrome elements was:blood stasis,qi deficiency,phlegm dampness,internal wind,fire heat,etc.The descending order of treatment is:promoting blood circulation and removing blood stasis,invigorating qi,eliminating phlegm and dampness,extinguishing wind,and clearing collaterals,etc.The statistical results of hierarchical classification of syndrome elements and treatment could be mutually verified,indicating that this method was feasible.Conclusions The method of activating blood circulation and removing blood stasis occurred most frequently in treatment of IS.It occupied an important position in the process,manifesting it had very important efficacy value.