肝郁脾虚证中医证候要素分布特点的文献研究

Literature Review of Distribution Characteristics of TCM Syndrome Elements of Liver Depression and Spleen Deficiency Syndrome

目的:探讨肝郁脾虚证中医证候要素分布规律。方法:通过对近5年肝郁脾虚证文献资料的统计分析,遵循循证医学原则,应用Microsoft Office Excel 2007建立数据库,将符合纳入标准的文献进行录入并核对,应用SPSS 20.0统计软件对证候要素进行频次分析。结果:与肝郁脾虚证相关的疾病以肠道疾病、肝胆疾病、胃部疾病、精神类疾病、内分泌疾病、癌症等多见;病位证候要素以肝、脾、肾、胃、心、乳、胆等为主;病性证候要素可见气虚、气郁、痰邪、瘀血、气滞、火热、毒等;诱因除情绪刺激外,外邪疫毒、饮食劳倦、外感、久病等均可诱发;治法涉及疏肝、健脾、化痰祛湿、补肾、活血化瘀、解毒等。结论:肝郁脾虚证中医证候要素多样、诱因复杂、治法灵活,目前亟须以证候要素为突破口创新其病机,以期更有效指导临床。

Objective:To explore the distribution characteristics of traditional Chinese medicine(TCM)syndrome elements of liver depression and spleen deficiency syndrome.Methods:The literature about liver depression and spleen deficiency syndrome in the past five years was collected.On the basis of the principle of evidence-based medicine,the database was established with Microsoft Office Excel 2007,and the literature meeting the inclusion criteria was recorded and checked.The SPSS 20.0 statistics was adopted to analyze the frequency of syndrome elements.Results:The diseases associated with liver depression and spleen deficiency syndrome are mainly intestinal diseases,hepatobiliary diseases,stomach diseases,mental diseases,endocrine diseases,and cancers.In terms of disease location,the syndrome elements are mainly distributed in the liver,spleen,kidney,stomach,heart,breast,and gallbladder.In terms of disease nature,elements of liver depression and spleen deficiency syndrome are qi deficiency,qi depression,phlegm,blood stasis,qi stagnation,fire,and toxin.In addition to emotional stimulation,external pathogen,epidemic pathogen,dietary irregularities,overexertion and fatigue,external sensation,and chronic illness can also serve as inducing factors.The treatment methods include soothing the liver,invigorating the spleen,resolving phlegm,dispelling dampness,tonifying the kidney,activating blood,resolving stasis,and removing the toxin.Conclusion:Liver depression and spleen deficiency syndrome is characterized by diverse TCM elements,complex inducing factors,and flexible treatment methods.At present,it is urgent to innovate its pathogenesis with syndrome elements as a breakthrough to efficiently guide clinical practice.