血瘀质与疾病的相关性研究——基于135项临床研究的文献计量分析

The Correlation between Blood Stasis Constitution and Diseases:A Bibliometric Analysis of 135 Clinical Studies

目的基于“体病相关”临床中医体质研究文献,探讨血瘀质与疾病的相关性。方法全面检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed和Embase 6个中英文数据库,筛选并纳入从2009年4月1日《中医体质分类与判定》标准发布以来至2022年12月31日,国内外所有应用该标准开展的体质与疾病相关性临床研究,且研究对象与血瘀质相关的文献,通过分析文献作者、发表单位、文献类型、研究对象及结果等文献特征,总结研究对象中血瘀质占比最高、或经回归分析发现血瘀质为其发病危险因素或保护因素的研究,探讨血瘀质与疾病的相关性。结果共纳入135篇与血瘀质高相关疾病的临床研究文献,总样本量为71172例,其中出现3次以上的关键词有27个,包括老年人、腰椎间盘突出症、冠心病、心血管疾病以及子宫内膜异位症等;作者聚类中则以北京中医药大学深圳医院、广州中医药大学第二附属医院、温州市中心医院为主。在血瘀质体病相关方面,81项研究显示血瘀质为研究的疾病人群中所占比例最高的体质类型,涉及病种或疾病状态48种,有3篇以上报告疾病人群中血瘀质占比最高的疾病及其中位比例为:冠心病(28.80%)、子宫内膜异位症(31.30%)、神经认知障碍(26.35%)、腰椎间盘突出症(26.00%)、缺血性脑卒中(25.00%)、子宫腺肌病(34.70%)、子宫内膜息肉(25.00%)。58项研究发现血瘀质为疾病状态的危险因素,其中3篇以上同一病种研究(OR值中位数)包括高血压病(OR值中位数=2.956)、2型糖尿病及并发症(OR值中位数=3.436)、骨质疏松(OR值中位数=5.171)、突发性耳聋(OR值中位数=3.827)、子宫内膜异位症(OR值中位数=5.412);1项研究认为血瘀质是大肠侧向发育型肿瘤的保护因素(OR=0.161)。结论血瘀质与循环系统疾病、泌尿生殖系统疾病、肌肉骨骼系统疾病等有着较为密切的联系。

Objective To explore the correlation between blood stasis constitution(BSC)and diseases based on constitution literature involving“constitution-diseases correlation”.Methods A comprehensive search was conducted on six Chinese and English electronic databases including CNKI,Wanfang,VIP,SinoMed,PubMed and Embase to find all clinical researches on the correlation between constitution and diseases using the Classification and Identification of Chinese Medicine Constitution standard from April 1st,2009 to December 31st,2022,and the participants of the research were BSC related.By analyzing the characteristics of the literature,such as authors,publication institutes,participants,and results,the disease with the highest proportion of BSC distribution or BSC as their risk factors or protective factors were summarized to explore the correlation between BSC and diseases.Results Totally 135 clinical studies on diseases highly related to BSC were included,with a total sample size of 71172 cases.There were 27 keywords in the articles appeared more than 3 times,including the elderly,lumbar disc herniation,coronary heart disease,cardiovascular disease,and endometriosis.In the author's clustering,included studis were mainly from Shenzhen Hospital of Beijing University of Chinese Medicine,Second Affiliated Hospital of Guangzhou University of Chinese Medicine,and Wenzhou Central Hospital.In terms of blood stasis related diseases,81 studies showed that BSC was the most common type of constitution in the study population,involving 48 disease or morbid states.The diseases and median proportions of BSC with reported literature≥3 included coronary heart disease(28.8%),endometriosis(31.3%),neurocognitive impairment(26.4%),lumbar disc herniation(26.0%),ischemic stroke(25.0%),adenomyosis(34.7%),and endometrial polyps(25.0%).Fifty-eight studies found that BSC was a risk factor for disease occurrence,and these diseases reported more than 3 times included hypertension(median OR=2.956),type 2 diabetes(median OR=3.436),osteoporosis(median OR=5.171),sudden deafness(median OR=3.827)and endometriosis(median OR=5.412).One study indicated BSC as the protective factor of lateral growth tumor of large intestine(median OR=0.161).Conclusion BSC is closely related to circulatory system diseases,urogenital system diseases,and musculoskeletal system diseases.