哮喘与中医体质关联性研究的系统评价与Meta分析

Systematic review and meta-analysis on the relationship between asthma and TCM constitution

目的系统评价哮喘与中医体质的关联性。方法通过对中国生物医学文献数据库(SinoMed)、中国知网(CNKI)、万方数据库(WanFang Database)、重庆维普中文科技期刊数据库(VIP)、PubMed及Web of Science数据库进行检索,搜集关于哮喘与中医体质关联性的横断面研究及病例对照研究等,检索时限均从建库至2021年11月12日。由2名研究者分别依照纳入、排除标准对文献进行筛选、数据提取以及质量评价。采用Stata 16.0统计软件对纳入文献进行数据分析。结果共纳入20项研究,包括15项横断面研究和5项病例对照研究。样本量总计5920例,其中哮喘患者5497例,对照组423例。20项哮喘与中医体质关联性研究的Meta分析结果显示:气虚质0.22(0.17,0.26)、特禀质0.18(0.12,0.24)、阳虚质0.16(0.13,0.20)及痰湿质0.16(0.13,0.19)是我国哮喘患者人群中分布比率超过10%的体质类型。5项病例对照研究的Meta分析结果显示,以9种体质作为暴露因素,特禀质OR值为5.46(3.04,9.84)、痰湿质OR值为2.18(1.30,3.66),气虚质OR值为2.03(1.51,2.73),阳虚质OR值为1.33(0.56,3.12)。华东地区哮喘患者的中医体质类型分布以阳虚质、气虚质和特禀质居多;华南及华北地区哮喘患者的中医体质类型分布以气虚质、阳虚质和痰湿质居多。不同性别的哮喘患者中医体质类型分布差异无统计学意义。结论气虚质、特禀质、阳虚质和痰湿质是哮喘患者主要的中医体质类型,也是导致哮喘发病的危险因素。不同地区哮喘常见的中医体质类型分布具有一定差异,不同性别哮喘患者中医体质分布无明显差异。

Objective To systematically evaluate the relationship between asthma and TCM constitution.Methods SinoMed,CNKI,WanFang Database,VIP,PubMed,and Web of Science databases were searched for cross-sectional studies and case-control studies on the association between asthma and traditional Chinese medicine,with the search time limit from the establishment of the databases to November 12,2021.Two researchers were used to screen the literature,extract data,and evaluate the quality according to the inclusion and ranking criteria.Statistical software stata 16.0 was used to analyze the data of the included studies.Results A total of 20 studies were included,including 15 cross-sectional studies and 5 case-control studies.The total sample size was 5,920 cases,including 5,497 cases of asthma and 423 cases of control group.The meta-analysis results of 20 studies on the association between asthma and TCM constitutions showed:qi deficiency 0.22(0.17,0.26),special endowment 0.18(0.12,0.24),yang-deficiency 0.16(0.13,0.20)and phlegm-dampness 0.16(0.13,0.19)were more than 10%in the population of asthma patients in China.The meta-analysis results of 5 case-control studies showed that nine TCM constitutions were used as exposure factors to compare with the general population.The OR value of inherited-special was 5.46(3.04,9.84),and the OR value of phlegm-dampness was 2.18(1.30,3.66),Qi-deficiency OR value was 2.03(1.51,2.73),yang-deficiency OR value was 1.33(0.56,3.12).The distribution of TCM constitution types of asthma patients in East China were mostly yang-deficiency,qi-deficiency and special endowment;The distribution of TCM constitutions of asthma patients in South China and North China were mostly qi-deficiency,yang-deficiency and phlegm-dampness.There was no statistically significant difference in the distribution of TCM constitution types in asthma patients of different genders.Conclusions Qi-deficiency,special endowment,yang-deficiency,and phlegm-dampness constitutions were the main TCM constitution types for asthma patients,and they were also risk factors for asthma.The distribution of common TCM constitution types for asthma in different regions was different,and asthma patients of different genders.There was no significant difference in the constitution distribution of TCM.