活血化瘀类复方防治高脂血症的临床研究热点与趋势——基于VOSviewer的可视化分析

Clinical research hotspots and trends of activating blood and removing blood stasis compound prescriptions in prevention and treatment of hyperlipidemia——visual analysis based on VOSviewer

目的综合分析活血化瘀类复方防治高脂血症的研究现状与发展方向,绘制研究热点与重点知识图谱,聚类呈现常用方剂、药材,探索各研究之间的横向关联,评价整体研究质量,为其临床应用与研究方向提供借鉴。方法检索7大常用中英文数据(CNKI、Wanfang、VIP、SinoMed、Web of Science、PubMed、EMbase)2006—2020年收录的相关文献,采用文献计量法进行数据挖掘,通过VOSviewer软件呈现可视化图谱,采用Cochrane文献质量评价表对研究质量进行独立评价。结果初步检索共获得1895篇文献,其中245篇符合纳入标准。近15年内该领域的研究热点呈现迁移性,逐渐由自拟方转为古方研究;不同区域的研究热度不一,文献报道较多的省份依次为河南、河北、广东等;常用中药材依次为丹参(139次)、泽泻(103次)、山楂(102次)等;常用复方依次为血府逐瘀汤(17次)、活血降脂汤(10次)、补阳还五汤(8次)等;研究团队之间的合作较少,需进一步加强学术联系;整体研究质量有待提高,大部分研究设计不规范,证据力度不够;同名方剂不同临床研究间的配伍组成、剂量与疗程等差异较大,而各自意义不明。结论 (1)活血化瘀类复方防治高脂血症的临床研究趋于多元化与细致化。研究范围逐渐扩大,包括病因、病机、中西医结合等众多热点。研究对象疾病谱更具针对性,逐渐由单一高脂血症研究转向高脂血症与其他疾病的合并症研究。(2)当前该研究领域存有地域局限性与合作局限性。此类研究以中东部区域为主,鲜见来自西北部地区的报道。团队之间的合作较少,学术交流合作有待加强。(3)该领域临床研究质量总体偏低。文献源自权威数据库及学位毕业论文的比率低;大部分研究设计存在方法学缺陷;同名方剂不同研究间异质性大而区别意义不明、针对性不清。建议后期研究注重方法设计的科学性,开展规范的、大规模的、多中心的随机对照试验,提升研究结果的可信度;同时建议增加合作交流,探讨同名方剂在防治高脂血症中的最佳方案或明确不同方案的针对性,为其临床应用提供确切指导。

Objective To analyze and discuss the research status and development direction of compound prescriptions for clinical prevention and treatment of hyperlipidemia with activating blood and removing blood stasis,draw the knowledge map of research hotspots and key knowledge,clustering present commonly used traditional Chinese medicinal prescriptions and herbs,explore the correlation between studies with similar topic,evaluate the overall research quality,so as to provide reference and guidance for clinical application and research in future.Methods Relevant articles on compound prescriptions for clinical prevention and treatment of hyperlipidemia with activating blood and removing blood stasis were retrieved from seven major Chinese and English database(CNKI,Wanfang,VIP,Sinomed,WOS,Pub Med,EMBASE).The retrieval time was from January 2006 to December 2020.The data mining was conducted using bibliometrics,the visual maps were presented through VOSviewer,and the quality of studies were assessed independently by the Cochrane literature quality assessment form.Results A total of 1895 literatures were retrieved,of which 245 met the inclusion criteria.Analyses over these literatures in recent 15 years showed that the research hotspot of this field has moved from self-made decoction to ancient decoction.The provinces with more literature reports were Henan,Hebei,Guangdong,etc.;Commonly used herbs were Danshen(Salviae Miltiorrhizae Radix et Rhizoma,139 times),Zexie(Alismatis Rhizoma,103 times)and Shanzha(Crataegi Fructus,102 times),etc.;Commonly used traditional Chinese medicines compounds were Xuefuzhuyu Decoction(血府逐瘀汤,17 times),Huoxue Jiangzhi Decoction(活血降脂汤,10 times),Buyang Huanwu Decoction(补阳还五汤,eight times)etc.;Little cooperation was made by different research teams,and academic ties needed to be further strengthened;The overall research quality needed to be improved.Most of the research designs were not standardized and the evidence was not strong enough;The compatibility composition,dosage and course of treatment between different clinical studies of the same name prescriptions were quite different,and their respective meanings were unknown.Conclusions(1)The clinical research on the prevention and treatment of hyperlipidemia with activating blood and removing blood stasis compound prescriptions tends to be diversified and detailed.The research scope has gradually expanded to include many hot spots such as etiology,pathogenesis,and integration of traditional Chinese and western medicine.The disease spectrum of the research subjects is more targeted,gradually shifting from the study of single hyperlipidemia to the study of comorbidities of hyperlipidemia and other diseases.(2)The current research field has geographical limitations and cooperation limitations.Such studies were mainly in the central and eastern regions,and there were few reports from the northwest and there was less cooperation between teams,therefore,academic exchanges and cooperations need to be strengthened.(3)The quality of clinical research in this field is generally low.The proportion of literature sources from authoritative databases and degree dissertations is low;most of the research designs have methodological flaws;the heterogeneity between different studies of the same name prescriptions is large,the meaning of them is unknown,and the pertinence is unknown.It is recommended that later studies pay attention to the scientific nature of method design,carry out standardized,large-scale,multi-center randomized controlled trials to improve the credibility of the research results;At the same time,it is recommended to increase cooperation and exchanges to explore the best use of the same name prescription in the prevention and treatment of hyperlipidemia or clarify the pertinence of different plans,and provide precise guidance for its clinical application.