基于文献分析探讨强直性脊柱炎中医证型及证素分布

Discussion on TCM Syndrome Types and Distribution of Syndrome Elements of Ankylosing Spondylitis Based on Literature Analysis

目的:基于文献分析探讨我国强直性脊柱炎患者的中医证型及证素分布规律。方法:检索中国知网2014年2月至2023年2月有关强直性脊柱炎的中医临床研究文献,筛选文献后,通过Excel软件对文献数据进行统计分析。结果:共纳入12篇文献,涉及强直性脊柱炎患者1871例,分布于多个省(市)。中医证型主要为湿热痹阻证(23.89%)、肾虚督寒证(22.29%)和肝肾不足证(20.58%)3种,共包括1249例患者,占总病例数的66.76%。病位证素频次最高的是肾、督脉和肝,占病位证素总量的97.99%;病性证素中,虚、湿、寒、热和瘀5种证素共占总病性证素的92.35%。病位证素出现频率由高到低依次为肾、督脉、肝、胆、肢节、肺、脾;病性证素出现频率前5位由高到低依次为虚、湿、寒、热、瘀。结论:强直性脊柱炎中医证候分型标准尚未统一,并且存在一定的地域差异。研究结果所揭示的证型和证素分布规律对强直性脊柱炎的中医证型标准化有一定促进作用,能够为中医辨证施治提供理论参考。

Objective:Based on literature analysis to explore the TCM syndrome types and the distribution of syndrome elements of patients with ankylosing spondylitis in China.Methods:The clinical research literature of TCM about ankylosing spondylitis from February 2014 to February 2023 in CNKI was searched,and the literature data were statistically analyzed by Excel software after screening the searched literature.Results:Totally 12 articles were included,involving 1871 patients with ankylosing spondylitis,which distributed in many provinces(cities).There are three main types of TCM syndromes:dampness heat obstruction syndrome(23.89%),kidney deficiency and Du cold syndrome(22.29%),and liver and kidney deficiency syndrome(20.58%),including 1249 patients,accounting for 66.76%of the total number of the cases.The highest frequency of disease location syndrome elements is found in the kidneys,governor vessels,and the liver,accounting for 97.99%.Among the pathogenic syndrome elements,deficiency,dampness,cold,heat,and blood stasis account for 92.35%of the total.The frequency of occurrence of disease location syndrome elements from high to low is in order of kidney,governor vessel,liver,gallbladder,limb joint,lung,and spleen.The frequency of the top five disease related syndrome elements,from high to low,is in order of deficiency,dampness,cold,heat,and blood stasis.Conclusion:The TCM syndrome classification standard of ankylosing spondylitis has not yet been unified,and there are certain regional differences.The syndrome types and the distribution of syndrome elements revealed by the research results have a certain role in promoting the standardization of TCM syndrome types of ankylosing spondylitis,and can provide theoretical reference for TCM treatment based on syndrome differentiation.