基于现代文献的糖尿病足中医证候及证素分布研究

Research on TCM syndrome type and syndrome element distribution rules of diabetic foot based on modern literature

目的:通过对现代文献的研究探讨糖尿病足(DF)的中医证候、证候要素分布特征及组合规律。方法:检索中国知网、万方、维普及中国生物医学文献数据库建库以来至2023年12月收录的糖尿病足中医临床相关文献,提取符合纳排标准文献中的中医证候、证候要素信息,建立数据库,通过Excel软件对文献数据进行统计分析。结果:共纳入76篇文献,整理后规范证名得到57种中医证候,证候总频次为10035次,最常见的DF中医证候类型为瘀血阻络、气阴两虚、湿热毒盛、气血两虚、气阴两虚血瘀等;涉及8种病位证素,其中脉络、筋(肉)、肾、脾、肝为最常见的病位证素;涉及11种病性证素,其中实性证素共7个:瘀>热>湿>毒>寒>气滞>痰,总计占比为60.90%;虚性证素共4个:气虚>阴虚>血虚>阳虚,总计占比为39.10%;证素组合形式以两证素组合出现的频次最高,占总数的61.83%。结论:DF中医证候复杂,病位主要在脉络,与肾、脾、肝三脏有密切关联,病性为本虚标实,以气虚、阴虚为本,瘀热湿毒为标,证素组合形式复杂,多种证候要素常相兼致病。

Objective To explore the TCM syndrome type and syndrome element distribution and combination rules of diabetic foot(DF)through modern literature research.Methods Revelent modern literatures were searcheal from China National Knowledge Infrastructure(CNKI),Chinese Science and Technology Journal Database(VIP),China Online Journals(COJ),and China Biology Medicine(CBM)from their establishment to December 2023 were searched through computer.The clinical research literatures that meets the standards for emissions and discharges were extracted and the information of TCM syndrome type and syndrome element were established.The statistical analysis was performed using Excel software.Results A total of 76 articles were collected,including 10035 frequency of syndromes and 57 syndromes were obtained after normalization.The most common syndrome types of DF were blood stasis blocks collaterals,deficiency of both Qi and Yin,dampness-heat Toxicity,deficiency of both Qi and blood and Qi-Yin deficiency with blood Stasis.8 syndrome elements of disease location were extracted,the most common were vein,tendon(flesh),kidney,spleen and liver.11 pathogenic syndromes elements were extracted,of which 7 were solid syndromes:stasis>heat>dampness>poison>cold>Qi stagnation>phlegm,accounting for 60.90%.There were 4 deficiency syndrome elements:Qi deficiency>Yin deficiency>blood deficiency>Yang deficiency,accounting for 39.10%.The combination of two syndromes appeared most frequently,accounting for 61.83%of the total.Conclusion The syndrome of diabetic foot in TCM is complex,mainly in the meridians,and closely related to the kidney,spleen and liver.The disease is deficiency of the essence and excess of the substance,with Qi deficiency and Yin deficiency as the essence,and blood stasis and dampness as the substance.The combination of syndrome elements is complex,and a variety of syndrome elements often cause disease.