全国172773例幽门螺杆菌感染患者中医证候分布的文献研究

Literature study on distribution of Traditional Chinese Medicine syndromes in 172773 patients with Helicobacter pylori infection

目的基于文献研究分析幽门螺杆菌(Helicobacter pylori,HP)感染者的中医证候分布情况,为中医或中西医结合治疗HP感染奠定基础。方法系统检索中国知网(CNKI)、万方数据库、维普数据库(VIP)自建库至2024年1月8日有关HP中医证候的临床研究文献,对其中医证候分布进行统计分析。结果共纳入1581篇文献,172773例HP感染者,分布于全国七大地区。中医证型主要是脾胃湿热证(36.67%)、脾胃虚弱证(23.51%)、肝胃不和证(17.91%)、寒热错杂证(5.32%)、脾胃气滞证(2.94%)。亚组分析显示,七大地区多以脾胃湿热证占比最高;5种不同HP感染相关性胃病中,除慢性萎缩性胃炎(脾胃虚弱证最多,29.14%)、消化性溃疡(脾胃虚弱证最多,37.93%)、胃食管反流病(肝胃不和证最多,46.59%)外,慢性非萎缩性胃炎、功能性消化不良均以脾胃湿热证为多(50.67%vs 26.12%)。中医证候分布情况敏感性分析表明,单证型研究、多证型研究与总体研究的证型分布差异无统计学意义,结果稳定。结论HP感染在总体、七大地区、5种HP感染相关性胃病中中医证候前3名均为脾胃湿热证、脾胃虚弱证、肝胃不和证,且占比达70%以上,未来应主要针对上述3种证型开展临床与基础研究,明确中医或中西医结合个体化治疗的适应证、根除方案及作用机制。

Objective To analyse the distribution of Traditional Chinese Medicine(TCM)syndromes in Helicobacter pylori(H.pylori)infected patients based on literature studies,and to provide a basis for clinical and scientific researches on the treatment of H.pylori infection with TCM or integrative medicine.Methods A systematic retrieval including CNKI,Wangfang and VIP was conducted up to Jan 8,2024 for clinical studies about TCM syndromes of H.pylori infected patients.WPS office and SPSS were used for statistical analysis.Results 1581 studies were included with 172773 H.pylori infected patients from 7 regions of China.The prime TCM syndromes were pattern of dampness and heat in the spleen and stomach(36.67%),pattern of spleen and stomach deficiency(23.51%),pattern of disharmony of liver and stomach(17.91%),pattern of cold and heat complex(5.32%),pattern of spleen and stomach disharmony(2.94%).Subgroup analyses demonstrated that the prime TCM syndromes were pattern of dampness and heat in the spleen and stomach,pattern of spleen and stomach deficiency and pattern of disharmony of liver and stomach in 7 regions and 5 H.pylori associated gastric diseases.Sensitivity analysis showed that the results of multi-TCM syndromes studies and full studies were basically consistent.Conclusion The prime TCM syndromes were pattern of dampness and heat in the spleen and stomach,pattern of spleen and stomach deficiency,pattern of disharmony of liver and stomach in full patients,7 regions and 5 H.pylori associated gastric diseases.Extensive clinical and basic researches should be conducted on the above patterns to explore individualized treatment for H.pylori infected patients.