基于文献挖掘探讨难治性心力衰竭中医证候特征

Literature Analysis on the Characteristics of Chinese Medicine Syndromes of Refractory Heart Failure

目的:基于文献总结难治性心力衰竭的中医证候特征。方法:通过检索中国期刊全文数据库、万方数据库、中文生物医学文献数据库、中文科技期刊数据库纳入的中医药治疗难治性心力衰竭相关文献,提取中医证候类型及证候要素,对其进行统计分析。结果:根据纳入排除标准共筛选文献34篇,纳入病例2299例。虚性证候要素以阳虚为首,气虚、阴虚为辅,兼见津亏,少见血虚;实性证候要素以血瘀为首,依次为水饮、痰浊、热蕴。证候类型多以虚实夹杂证为主(占比57.24%),本虚证以阳气亏虚证为首;标实证以心血瘀阻证为首;虚实夹杂证以气虚血瘀证、阳虚血瘀证、阳虚水停证多见。不同地域证候要素分布存在差异,西北地区以气虚、阴虚多见;华南、西南地区多见水饮、痰浊。结论:难治性心力衰竭中医证候特征为本虚标实、虚实夹杂,本虚以阳虚为主,标实以血瘀、水饮为主。不同地域难治性心力衰竭患者证候要素分布具有差异性。

Objective:To summarize the characteristics of TCM syndromes of refractory heart failure(RHF) based on the literature.Methods:By searching the CNKI,WANFANG,CBM and VIP Data, the literature related to Chinese medicine for RHF was included, and the types of TCM syndromes and TCM elements were extracted and statistically analyzed.Results:A total of 34 papers were screened according to the nadir criteria, and 2 299 cases were included.The deficiency TCM elements were mainly Yang deficiency, supplemented by Qi deficiency and Yin deficiency, as well as fluid deficiency and rarely Blood deficiency;the actual TCM elements were mainly Blood stasis, followed by Water-drink, Phlegm and Heat.The type of TCM syndromes is mostly mixed with deficiency and reality(57.24%),with deficiency of Yang Qi leading the syndromes;stasis of the heart and blood leading the symptoms;and mixed syndromes of deficiency and reality with Qi deficiency and blood stasis, Yang deficiency and blood stasis, and Yang deficiency and water retention.There are differences in the distribution of TCM elements between different regions, with Qi deficiency and Yin deficiency being more common in northwest China, and water-drinking and phlegm-deficiency being more common in south and southwest China.Conclusion:The TCM syndromes of RHF are characterized by deficiency of the root and syndromes of the syndromes, with Yang deficiency dominating the root deficiency and blood stasis and water retention dominating the syndromes of the syndromes of the root deficiency.The distribution of TCM syndromes in patients with RHF varies from region to region.