基于文献的老年人群常见证候分布特征研究

Study on the distribution characteristics of syndromes in the elderly based on Literature

目的了解我国老年人中医证候分布特征,为中医药辨治老年人提供参考依据。方法系统检索中国知识基础设施(CNKI)、中文科技期刊数据库(CCD)、万方数据资源系统数据库(CSPD),纳入研究对象为老年人的临床流行病学调查研究文献,对其调查目的、调查疾病及调查结果等进行描述统计。结果(1)最终纳入168篇文献,其中2010至2020年之间发表138篇(82.14%);调查地区涵盖全国28个省市自治区,共纳入43948例老年人,累计覆盖340个研究中心;(2)主要研究结果显示,老年人中医证候阴虚阳亢证(10.05%)>血瘀证(9.5%)>痰浊(湿)证(8.91%)>阴阳两虚证(4.98%)>痰瘀互结证(4.96%);单元证分布阴虚证(14.70%)>痰证(11.22%)>气虚证(7.15%)>肾虚证(4.72%)>血瘀证(4.18%);涉及病变脏腑肾>肝>脾>肺>心。结论根据统计结果,可以看出老年人证候分布虚证多于实证,虚证中又以阴虚证、气虚证最为多见,实证常见血瘀证、痰浊(湿)证等,且多见痰瘀互结证;老年人五脏皆损,其中又以肾、肝、脾功能失调最为突出。

Objective To understand the distribution characteristics of Traditional Chinese medicine(TCM) syndromes of the elderly in China, and to provide a reference basis for the syndrome differentiation and treatment of the elderly with TCM. Methods Chinese Knowledge Infrastructure(CNKI), Chinese Citation Database(CCD) and China Science Periodical Database(CSPD) were systematically searched, and the clinical epidemiological investigation literature of the elderly was included, and the purpose, disease and results of the investigation were described.Results(1)168 articles were finally included, which 138(82.14%) were published between 2010 and 2020. The survey area covered 28provinces, municipalities and autonomous regions in China, including 43948 elderly people, covering a total of 340research centers.(2)The main investigation results showed that the TCM syndromes of elderly: syndrome of hyperactivity of yang due to yin deficiency(10.05%) > syndrome of blood stasis(9.5%) > phlegm turbidity(dampness) syndrome(8.91%) > syndrome of deficiency of both yin and yang(4.98%) > syndrome of intermin-gled phlegm and blood stasis(4.96%). Unit syndrome distribution: yin deficiency syndrome(14.70%) > phlegm syndrome(11.22%) > syndrome of qi deficiency(7.15%) > kidney deficiency syndrome(4.72%) > syndrome of blood stasis(4.18%);involving diseased viscera: kidney > liver > spleen > lung > heart.Conclusion According to the statistical results, it can be seen that the distribution of deficiency syndrome of the elderly is more than excess syndrome, and yin deficiency syndrome and syndrome of qi deficiency are the most common in deficiency syndrome, syndrome of blood stasis and phlegm turbidity(dampness) syndrome are most common in excess syndrome;the five internal organs of the elderly are damaged, among which the dysfunction of kidney, liver and spleen is the most prominent.