基于现代文献探讨泌尿系结石中医辨证分型的临床应用现状

Exploring the application status of traditional chinese medicine syndrome differentiation of urolithiasis based on modern literature research

目的:系统评价现代文献中泌尿系结石经典中医辨证分型的临床应用现状,为建立科学实用的泌尿系结石现代中医辨证规范提供思路。方法:系统检索中国知网、万方数据知识服务平台及维普资讯数据库2001年1月1日—2021年12月31日收录的泌尿系结石中医辨证分型相关临床研究文献,提取文献信息,统计泌尿系结石各中医证候出现频次。结果:共纳入文献430篇,其中114篇注明中医诊断标准来源,涉及诊断标准19项,另有130篇自拟辨证分型,证型出现频次由高到低依次为湿热下注、气滞血瘀、肾气亏虚、肾阴亏虚、脾肾两虚、肾阳亏虚。结论:现代文献中泌尿系结石中医辨证诊断标准来源不一,不同中医诊断标准中对泌尿系结石辨证分型存在分歧,限制了临床应用及研究的规范性和统一性,急需建立符合泌尿系结石中医致病规律及临床疗效评价的辨证规范。

Objective To analyze clinical application status of traditional Chinese medicine(TCM)syndrome differentiation in the treatment of urolithiasis based on modern literature,providing insights for establishing a scientific and practical modern Chinese medicine syndrome differentiation standard for urolithiasis.Methods All relevant TCM clinical research literatures related to TCM syndrome differentiation of urolithiasis from January 1,2001 to December 31,2021 were searched in CNKI,Wanfang Data Knowledge Service Platform,and VIP databases to extract TCM syndrome elements,and to count the frequency of each TCM syndrome of urolithiasis.Results A total of 430 papers were included,114 of which indicated the source of TCM diagnostic criteria,involving 19 diagnostic criteria,and another 130 were self-designed to identify the syndromes.In descending order of frequency,these were damp-heat pouring downward syndrome,qi stagnation and blood stasis syndrome,kidney-qi deficiency syndrome,kidney-yin deficiency syndrome,spleen and kidney deficiency syndrome,and kidney-yang deficiency syndrome.Conclusion The sources of TCM diagnostic criteria for urolithiasis in modern literature are inconsistent,and there are discrepancies in the syndrome differentiation of urolithiasis among different TCM diagnostic criteria,which limits the standardization and uniformity of clinical application and research.It is urgent to establish a syndrome differentiation standard that conforms to the pathogenesis of urolithiasis in TCM and clinical efficacy evaluation.