基于文献计量学分析探讨医疗机构提高中医非药物疗法占比和加强科学管理的理论路径研究

Study on theoretical path of increasing percentage of traditional Chinese medicine non-pharmacological therapies and strengthening scientific management in medical institutions based on bibliometric analysis

目的 梳理总结现阶段中医非药物疗法的研究热点与趋势,为医疗机构在提高中医非药物疗法占比和加强科学管理方面提供参考和建议。方法 检索中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(VIP)建库至2023年11月31日收录的中医非药物疗法研究文献,采用NoteExpress 3.5.0软件去重并管理文献,采用Excel 2022软件分析纳入文献发文时间、来源期刊情况,采用VOSviewer 1.6.20软件进行作者、关键词共现分析,采用CiteSpace6.1.R6软件进行研究机构共现分析及关键词聚类、时间线、突现分析。结果 共纳入4315篇文献,发文量总体呈上升趋势,在2010年达到顶峰,年发文量为287篇,之后维持在年发文量210篇的平稳状态。纳入文献中有3839篇文献来源于1162种期刊,其中33种期刊发文量≥20篇,占比28.2%,发文量最多的期刊是《中国误诊学杂志》。涉及作者11 574位,其中90位作者发文量≥5篇,共发文615篇(14.25%),聚类中作者数量≥5人共有3个,表明该聚类存在较为稳定且高产的研究团队。涉及2607个研究机构,总体上以大学、研究机构及其附属医院是主要的科研力量,以各科研院校及其附属医院为集群开展临床合作,跨机构和跨地区合作仍有待加强。通过关键词共现分析得出中医非药物疗法在疾病病种、治疗措施、系统评价和管理、研究群体等方面的研究热点和发展趋势。结论 基于对中医非药物疗法进行文献进行计量学及可视化分析,探索了该领域的研究热点与趋势,为医疗机构管理者提高中医非药物疗法占比、科学管理院内中医非药物疗法提供了三点理论路径:聚焦所在区域常见病、多发病、疑难危重症疾病,做好重点病种遴选;聚焦临床疗效,健全中医非药物疗法临床应用的质量管理体系;聚焦传承与创新,加强中医非药物疗法循证研究。

Objective To summarize the research hotspots and trends of non-pharmacological therapies in Chinese medicine at this stage,and to provide references and suggestions for medical institutions in increasing the proportion of Chinese medicine non-pharmacological therapies and strengthening scientific management.Methods The research literature on TCM non-pharmacological therapies included in the Chinese National Knowledge Infrastructure(CNKI),Wanfang database,and VIP Information network(VIP)was searched from the establishment of the database to October 31,2023,and NoteExpress 3.5.0 software was used to de-emphasize and manage the literature;and Excel 2022 software was used to analyze the time and source journals of the included literature;VOSviewer 1.6.20 software was used for author and keyword co-occurrence analysis;and CiteSpace 6.1.R6 software was used for researching institution co-occurrence analysis and keyword clustering,timeline,and emergence analysis.Results A total of 4,315 documents were included,and the number of publications showed an generally upward trend,reaching a peak in 2010 with 287 publications per year,and then maintained at a steady state of 210 publications per year.Among the included literature,there were 3,839 articles from 1,162 journals,of which 33 journals had articles over or equal to 20,accounting for 28.2%,and the journal with the most articles was the Chinese Journal of Misdiagnosis.The study involving 11,574 authors,of which 90 authors published articles over or equal to 5,ans published a total of 615 publications(14.25%),there were 3 clusters with authors over or equal to 5,indicating the existence of stable and productive research teams in the cluster.The study involving 2,607 research institutions,in general,universities,research institutes and their affiliated hospitals were the main research forces,and clinical cooperation was carried out in cluster between research institutes and their affiliated hospitals,and cross-institutional and cross-regional cooperation still needed to be strengthened.The research hotspots and development trends of TCM non-pharmacological therapies in the aspect of disease types,therapeutic measures,systematic evaluation and management,and research groups were derived from the keyword co-occurrence analysis.Conclusions Based on the econometrics and visualization analysis of the literature on TCM non-pharmacological therapies,we explored the research hotspots and trends in this field,and provided three theoretical paths for the managers of medical institutions to increase the proportion of TCM non-pharmacological therapies and scientifically manage TCM non-pharmacological therapies in the hospitals:focus on the common diseases,frequent diseases,and the difficult and critical diseases in their regions,and do a good job of selecting the key types of diseases,focus on the clinical efficacy,and improve the quality management system for the clinical application of TCM non-pharmacological therapies,focus on the clinical efficacy,and improve the quality management system for the clinical application of TCM non-pharmacological therapies.Focusing on clinical efficacy,the quality management system of clinical application of non-pharmacological therapies in Chinese medicine should be improved,focusing on inheritance and innovation,evidence-based research on non-pharmacological therapies in Chinese medicine should be enhanced.