Clinical distribution and molecular profiling on postoperative colorectal cancer patients with different traditional Chinese medicine syndromes

Background:Traditional Chinese medicine(TCM)syndrome,also named syndrome,are comprehensive and integral analyses of clinical information which helps to guide different individualized treatment prescriptions.Methods:Thirty healthy controls and 80 colorectal cancer(CRC)patients(including 33 Spleen Qi Deficiency syndrome,23 Dampness Heat syndrome,17 Blood Stasis syndrome and 7 other syndrome)were enrolled into this study.Human mRNAs were extracted from peripheral blood mononuclear cells.The gene expression for CRC patients with different TCM syndrome was determined by microarray and qRT-PCR.Results:Spleen Qi Deficiency,Dampness Heat and Blood Stasis were the most common syndromes in CRC patients.There is a significant difference was found in mRNA expression levels(especially for PIK3CA,STAT3,SOX9 and KDM5C)among Spleen Qi Deficiency,Dampness Heat and Blood Stasis syndrome groups.The higher mRNA levels of JNK1,TP53,MLH1,MSH6,PMS2,SOCS3,TCF7L2,FAM123B,PSAP,FBXW7,SALL4 and the lower expression of inflammatory cytokine IL-6 were found in Spleen Qi Deficiency group but not other syndrome types.The higher mRNA levels of KRAS,MUC16,EGFR,GRASP65,PIK3CA,MAPK7,CD24,STAT3,SLC11A1,Bcl-2,TXNDC17 and some inflammatory cytokines(IL-6,IL-23,TNF-a,CXCR4)were found in Dampness Heat group but not other syndrome types.Blood Stasis syndrome showed higher expression of SOX9,MLH1,MSH6,KDM5C,PCDH11X,PSAP and SALL4,and lower mRNA levels of PIK3CA,CD24,STAT3,CXCR4,TXNDC17 and TP53.The CRC patients with Dampness Heat syndrome might have a poor prognosis than other syndrome types.Conclusion:The identification of syndrome conditions had different impacts on CRC prognosis,and which might be related with different mRNA expression levels.Some oncogenes and pro-inflammatory cytokines were highly expressed in Dampness Heat group but not other syndrome types,suggesting that the CRC patients with Dampness Heat syndrome might have a poor prognosis.Our results prelimitarily uncovered the molecular basis of syndrome differences in CRC prognosis,a better understanding for TCM treatment of CRC.

Distribution patterns and industry planning of commonly used traditional Chinese medicinal plants in China

Medicinal plants are the primary material basis for disease prevention and treatment in traditional Chinese medicine(TCM).The conservation and sustainable utilization of these medicinal plants is critical for the development of the TCM industry.However,wild medicinal plant resources have sharply declined in recent decades.To ameliorate the shortage of medicinal plant resources,it is essential to explore the development potential of the TCM industry in different geographical regions.For this purpose,we examined the spatial distribution of commonly used medicinal plants in China,the number of Chinese medicinal material markets,and the number of TCM decoction piece enterprises.Specifically,multispecies superimposition analysis and Thiessen polygons were used to reveal the optimal range for planting bulk medicinal plants and the ideal regions for building Chinese medicinal material markets,respectively.Furthermore,we quantitatively analyzed mismatches between the spatial distribution of commonly used medicinal plant richness,Chinese medicinal material markets,and TCM decoction piece enterprises.We found that the areas suitable for growing commonly used medicinal plants in China were mainly distributed in Hengduan Mountain,Nanling Mountain,Wuling Mountain,and Daba Mountain areas.The Thiessen polygon network based on Chinese medicinal material market localities showed there are currently fewer markets in southwestern,northwestern,and northeastern China than in central and southern China.TCM decoction piece enterprises are concentrated in a few provinces,such as Hebei and Jiangxi.We found that the distribution of commonly used medicinal plants,Chinese medicinal material markets and TCM decoction piece enterprises are mismatched in Henan,Shaanxi,Hunan,Hubei,Zhejiang,Fujian,Chongqing,and Xizang.We recommend strengthening development of the TCM industry in Henan,Hunan,Zhejiang,Shaanxi,Hubei,Chongqing,Fujian,and Xizang;building more Chinese medicinal material markets in southwestern,northwestern,and northeastern China;and establishing medicinal plant nurseries in resource-rich provinces to better protect and domesticate local medicinal plants.

Visualization analysis of the international standard ISO/TC 249 for traditional Chinese medicine

Objective This study proposes to visually review the current situation and progress of standards sets by the International Organization for Standardization/Technical Committee on Traditional Chinese Medicine(ISO/TC 249). The review aims to explore the development strategies of the standards, which will exhibit the considerable impact on the economy, trade and exchanges, and cooperation in the area of traditional Chinese medicine(TCM).Methods ISO/TC 249 standards were searched on the ISO website, and their title, proposed time, current stage, scope, and classification were obtained for further summarization. Gephi was utilized to portray the co-occurrence network graph of the ISO/TC 249 standards subject.Results In ISO/TC 249, there were 116 standards, including 81 published standards and 35 developing standards by April 30, 2022. Two withdrawal standards were published after revision, which were not counted in the total standards. The number of published standards has been increasing since the first standard was published in 2014, whose title was “Sterile acupuncture needles for single use”. Among these standards, 17.24%(20/116) standards were in review, 56.03%(65/116) in publication, 3.45%(4/116) in approval, 5.17%(6/116) in enquiry,3.45%(4/116) in committee, and 14.66%(17/116) in preparation, respectively. With 116 standards, most of the research focused on the medicament, as its classification of the International Classification for Standards(ICS) showed the proportion reaching 49.54%. The network analysis data revealed that the top five most frequent words were “materials” “root” “requirements” “products” and “system”, after removing the noise data, such as prepositions,conjunctions, and pronouns. Additionally, the word “system” co-exists with the terms “computerized” “coding” “image” “tongue” and “analysis”;the word “requirement” co-exists with“manufacturing” “decoction” “process” and “materials”;whereas the word “devices” coexists with “pulse” “electric” “skin” and “measurement”.Conclusion With the increased diversification and complexity of problems, the development of standards is also oriented to multidisciplinary fields to cultivate the interdisciplinary talents, and especially the international standardization talents of compound TCM. Multi-angle analysis, formulation, and demonstration of standards, in line with industry needs in different disciplines, enhance the availability of standards and the ability to serve the industry.

JSON-ASR:A lightweight data storage and exchange format for automatic systematic reviews of TCM

Objectives:The aim of this study was to investigate and develop a data storage and exchange format for the process of automatic systematic reviews(ASR)of traditional Chinese medicine(TCM).Methods:A lightweight and commonly used data format,namely,JavaScript Object Notation(JSON),was introduced in this study.We designed a fully described data structure to collect TCM clinical trial information based on the JSON syntax.Results:A smart and powerful data format,JSON-ASR,was developed.JSON-ASR uses a plain-text data format in the form of key/value pairs and consists of six sections and more than 80 preset pairs.JSON-ASR adopts extensible structured arrays to support the situations of multi-groups and multi-outcomes.Conclusion:JSON-ASR has the characteristics of light weight,flexibility,and good scalability,which is suitable for the complex data of clinical evidence.

Wavy Distribution of Trace Elements in Phytolacca Samples from Different Areas

To study the distribution of 25 elements, i.e. Be, Cd, Ce, Cr, Cu, Dy, Er,Eu, Gd, Ge, Ho, La, Lu, Mo, Nd, Pb, Pr, Sm, Sr, Tb, Tl, Tm, Y, Yb and Zn in Phytolacca, atraditional Chinese medicinal herb, collected from nine areas of P. R. China. Methods Twenty-fiveelements in Phytolacca including essential elements, toxic elements and rare earth elements intraditional Chinese medicinal herbs from different areas were analyzed by ICP-MS. Results The 25elements in Phytolacca were determined by ICP-MS under optimized conditions. The detection limitswere 0.003 -0.71 ng·mL^(-1). The recoveries were 88% - 118% . The relative standard deviations ofthe measurements were 1.7% - 13.3%. Conclusion The determined concentrations of elements inPhytolacca acinosa Roxb vary from one area to another; however, the distribution tendency ofelements in all the samples is similar. The distribution tendency of rare earth elements inPhytolacca acinosa Roxb is consistent with that in nature.

基于因子分析探讨急性胰腺炎早期诊断的敏感性指标及中医证型分布规律研究

目的通过因子分析探索急性胰腺炎早期诊断的血清生化指标及中医证型分布规律研究。方法选取陕西中医药大学附属医院消化科2021年1月—2021年5月确诊为急性胰腺炎的65例患者为研究组,65例体检正常者为对照组,建立首诊血清生化指标,对其进行因子分析法评价各指标的主成分,并进一步确定急性胰腺炎早期诊断的敏感指标。对研究组65例进行中医证型分布规律研究。结果急性胰腺炎血清生化指标经因子分析后,提取到5个成分,敏感性指标排序依次为中性粒细胞百分比、乳酸脱氢酶、白细胞、淀粉酶、脂肪酶、谷草转氨酶。急性胰腺炎中医证型按照从高到低依次为:肝郁气滞型,肝胆湿热型,腑实热结型,瘀毒互结型,内闭外脱型。结论利用因子分析可以揭示急性胰腺炎血清生化指标的潜在联系,为进一步探索急性胰腺炎早期诊断的敏感指标提供了依据;中性粒细胞百分比、乳酸脱氢酶、白细胞、淀粉酶、脂肪酶、谷草转氨酶可作为急性胰腺炎早期诊断的重要血清生化指标。急性胰腺炎中医证型分布以肝郁气滞型最为常见,是急性胰腺炎早期的常见证型。

Traditional Chinese Medicine Syndromes Distribution in Colorectal Cancer and its Association with Western Medicine Treatment and Clinical Laboratory Indicators

Objective:The objective of the study is to explore the traditional Chinese medicine (TCM) syndrome distribution in colorectal cancer (CRC) and its correlation with treatment methods and clinical laboratory indicators.Materials and Methods: Using the CRC cases report form of TCM,760 CRC patients with TCM four diagnosis information,western medicine treatment information and clinical laboratory indicators were collected,and TCM syndromes distribution in CRC were summarized.The correlation between TCM syndrome type and western medicine treatments,clinical laboratory indicators such as liver and kidney function,immune function,and tumor biomarkers was analyzed. Results:In 760 cases of CRC, Spleen deficiency syndrome (SDS, 25%),liver and kidney Yin deficiency syndrome (LKYDS, 13%), LKYDS-SDS,12%,spleen deficient Qi stagnation syndrome (SDQSS, 10%),and damp heat syndrome (DHS, 9%) were more common TCM syndrome types.LKYDS, SDS,LKYDS-SDS,and SDQSS were significantly distributed under different treatment methods (P < 0.001).There was no statistically significant difference in the distribution of immune fUnction and cytokine among the five TCM syndromes (P > 0.05),but there was statistically significant difference in the distribution of blood routine,liver and kidney function, and tumor biomarkers (P < 0.05). Conclusion: LKYDS,SDS,LKYDS-SDS, SDQSS,and DHS were the first five TCM syndromes in CRC.There were the significant correlations between the distribution of TCM syndrome and the clinical laboratory indicators,and the distribution of TCM syndromes was affected by surgery, radiotherapy,and chemotherapy.

Automatic Extraction of Tongue Coatings from Digital Images:A Traditional Chinese Medicine Diagnostic Tool

In traditional Chinese medicine, the coating on the tongue is considered to be a reflection of various pathologic factors. However, the conventional method to examine the tongue lacks an acceptable standard and does not provide the means for sharing information. This paper describes a segmentation method to extract tongue coatings. First, the tongue body was extracted from the original image using the watershed transform. Then, a threshold method was applied to the image to eliminate the light from the camera flash. Finally, a threshold method using the Otsu model in combination with a splitting-merging method was used in the red, green, and blue （RGB） space to extract the thin coating. The combination of the above two methods is applied in the hue, saturation, and value （HSV） space to extract the thick coating. The feasibility of this method is tested by experiments, and the accuracy of segmentation is 95.9%.

基于批数据过采样的中医临床记录四诊描述抽取方法

中医临床记录四诊描述抽取对中医临床辨证论治的提质增效具有重要的应用价值,然而该任务尚有待探索,类别分布不均衡是该任务面临的关键挑战之一。该文围绕中医临床记录四诊描述抽取任务展开研究,首先构建了中医临床四诊描述抽取语料库;然后基于无标注的中医临床记录微调通用预训练语言模型实现该模型的领域适应;最后利用小规模标注数据,采用批数据过采样算法,完成中医临床记录四诊描述抽取模型的训练。实验结果表明,该文提出的抽取方法的总体性能均优于对比方法,并且与对比方法的最优结果相比,该文方法将少见类别的抽取性能F1值平均提升了2.13%。

2019~2023年某中医院6种多重耐药菌临床分布与耐药性分析

目的了解本院6种多重耐药菌的分布及耐药情况。方法对北京中医药大学东方医院2019年1月至2023年12月分离的菌株进行分析,统计6种临床常见耐药菌的检出情况。结果耐碳青霉烯类大肠埃希菌(CRECO)、耐甲氧西林金黄色葡萄球菌(MRSA)检出率呈逐步上升趋势;耐碳青霉烯类肺炎克雷伯菌(CRKPN)、耐碳青霉烯类铜绿假单胞菌(CRPA)呈波浪形下降趋势;耐碳青霉烯类鲍曼不动杆菌(CRAB)起伏波动较大;万古霉素耐药肠球菌(VRE)总体检出率较低,变化趋势不大。6种多重耐药菌主要分布于脑病内科、脑病外科、呼吸热病科、急诊科、重症监护、肿瘤科等科室。标本来源中CRKPN、CRPA、CRAB、MRSA均以痰标本为首,CRECO、VRE均以尿标本为首。性别方面,CRKPN、CRPA、CRAB、MRSA男性多于女性,CRECO和VRE则反之;6种耐药菌年龄分布均以60岁以上老年患者为主;季节分布上,CRKPN、CRPA、VRE以冬季占比最高,CRAB以夏季占比最高,CRECO、MRSA则是以秋季占比最高。CRECO、CRKPN、CRAB对多种抗菌药物耐药率均较高。结论应加强对多重耐药菌的监控,延缓细菌耐药发生。

桥本甲状腺炎并发甲状腺毒症人群临床症状及证型分布规律研究

背景中国传统医学对桥本甲状腺炎并发甲状腺毒症的发生、发展和诊疗已经有了系统的认识,但是目前关于本病人群中医临床症状和证型分布情况研究甚少,国家行业标准中亦缺乏关于本病的证型分布及证候诊断标准的描述。目的运用因子分析联合聚类分析探讨桥本甲状腺炎并发甲状腺毒症人群临床症状及证型分布规律,为临床辨证提供依据,促进桥本甲状腺炎并发甲状腺毒症证候标准化研究。方法收集2020年12月—2021年12月就诊于北京中医药大学东直门医院东城院区、通州院区、北京中医药大学孙思邈医院甲状腺病科门诊符合诊断标准的171例桥本甲状腺炎并发甲状腺毒症患者,使用《桥本甲状腺炎并发甲状腺毒症中医四诊信息采集表》对症状/体征、舌、脉等四诊信息进行采集,基于因子分析和聚类分析研究桥本甲状腺炎并发甲状腺毒症的症状及证型分布规律。结果171例桥本甲状腺炎并发甲状腺毒症患者中男17例、女154例,平均年龄(39.98±13.30)岁,其中20~60岁患者占87.72%。症状分布方面出现频率较高的症状有神疲乏力、心慌心悸、烦躁或急躁易怒,体征有颈前肿大、手指震颤,频率较高的舌象有舌红、舌瘦薄和舌有齿痕,苔质为苔白和苔薄,脉象是脉弦、脉数。收集调查表的82个四诊条目因子分析,提取出25个公因子,累计方差贡献率为70.562%,筛选出具有意义的症状62项。利用因子分析得到的25个公因子结果作为变量对其进行R型系统聚类分析,共得到5类证候分型,分别是:肝郁痰凝证、阴虚火旺证、脾肾阳虚证、肝郁气滞证、气阴两虚证。结论桥本甲状腺炎并发甲状腺毒症的基本中医证候可分为肝郁痰凝证、阴虚火旺证、脾肾阳虚证、肝郁气滞证、气阴两虚证。

1327例突发性聋的中医证型分布特点

【目的】通过大样本分析探讨突发性聋的证型分布规律,为突发性聋的中医辨证提供参考。【方法】对广州中医药大学第一附属医院收治的1 327例突发性聋住院患者的临床资料进行回顾性分析,统计各证型分布比例,并分析不同证型患者的性别、年龄、伴随症状、听力曲线类型及耳聋程度等有无差异,总结其证型分布规律及临床特点。【结果】(1)按中医辨证分型标准,1 327例突发性聋患者的证型分布频次由高到低依次为气血亏虚证(75.4%)、痰火郁结证(13.8%)、气滞血瘀证(5.3%)、肝火上扰证(2.8%)、风热侵袭证(1.5%)、肾精亏损证(1.3%)。(2)气血亏虚证女性占比多于男性(P<0.05),而痰火郁结证及其他证型则男性占比多于女性(P<0.05)。(3)痰火郁结证伴眩晕比例较高(P<0.05),而其他伴随症状及年龄、听力曲线类型、耳聋程度等方面,不同证型间比较差异均无统计学意义(P>0.05)。【结论】突发性聋以气血亏虚证最为常见,其次为痰火郁结证,其他证型相对少见,性别及是否伴眩晕对于辨证可能有一定参考意义。

非小细胞肺癌胸腔镜下肺切除术后咳嗽中医证型分布及其影响因素

目的:评估非小细胞肺癌胸腔镜下肺切除术后咳嗽患者的咳嗽程度,探讨非小细胞肺癌胸腔镜下肺切除术后咳嗽中医证型分布特点及其影响因素。方法:对315例非小细胞肺癌胸腔镜下肺切除术后咳嗽患者进行问卷调查,收集患者基本信息、手术资料、中医四诊信息,并评估患者术后咳嗽程度。根据咳嗽中医辨证标准进行证型判定,分析肺癌术后咳嗽中医证型分布规律并探究其影响因素。结果:315例患者术后咳嗽中医证型出现频率由高到低依次为:风盛挛急证(39.68%)>气阴两虚证(30.16%)>肺气亏虚证(14.29%)>肺阴亏虚证(12.06%)>痰湿蕴肺证(2.54%)>痰热郁肺证(1.27%)。315名患者中文版莱斯特咳嗽量表(LCQ-MC)生理维度得分(4.68±1.21)分,心理维度得分(5.10±1.12)分,社会维度得分(5.78±1.02)分,总分(15.79±3.30)分;咳嗽数字分级法评估量表(NRS)得分(3.30±2.05)分。4种主要中医证型分布与年龄、手术侧、术中出血量、是否进行系统淋巴结清扫、病理类型、病理分期的相关性无统计学意义(P>0.05)。4种主要中医证型分布与性别、吸烟史、手术时长、手术范围相关,差异有统计学意义(P<0.05)。结论:非小细胞肺癌胸腔镜下肺切除术后咳嗽中医证型以风盛挛急证为主,其次是气阴两虚证、肺气亏虚证、肺阴亏虚证,痰湿蕴肺证和痰热郁肺证出现较少。证型与性别、吸烟史、手术时长、手术范围有关。术后咳嗽患者多为轻中度咳嗽。

300例射血分数保留心力衰竭患者的中医证候分布规律

目的基于射血分数保留心力衰竭(heart failure with preserved ejection fraction,HFpEF)基本证候要素的病证结合诊断标准分析HFpEF的证候特征及分布规律。方法纳入300例符合标准的HFpEF患者,收集证候诊断所需信息及相关临床资料,统计单个证素、证素组合的频数分布,并采用两步聚类法探讨主要证型的划分。结果(1)300例HFpEF患者单个证素的出现频率依次为:气虚(97.0%)、血瘀(92.7%)、水饮(79.7%)、痰浊(55.0%)、阴虚(44.7%)、阳虚(36.3%)。(2)同时具有4证素和5证素的患者最多,分别占39.0%和30.3%。(3)患者以虚实夹杂证(94.0%)为主,纯虚证(3.0%)和纯实证(3.0%)较少。(4)300例患者共出现15种证素组合,通过两步聚类可分为8类,每类患者均有气虚、血瘀。结论HFpEF的病机关键为气虚、血瘀、水饮,气虚是始动因素,气虚血瘀为基本证候,可分为气虚血瘀、气阴两虚血瘀、阳气亏虚血瘀和阴阳两虚血瘀4种证型。

1034例甲型流行性感冒患者中医证候特点的回顾性分析

目的:明确2023年春季望京地区甲型流行性感冒患者中医证候特点。方法:回顾性分析2023年2—3月中国中医科学院望京医院感染科1034例甲型流感患者临床资料,对其一般情况、中医四诊信息等进行频数统计分析。通过因子分析提炼甲型流感的中医证候要素;运用聚类方法总结甲型流感主要中医证型及分布规律。结果:1034例患者男539例,女495例,男女之比为1.09∶1;患者平均年龄(32.62±12.95)岁,14~44岁患者878例(84.91%),≥45岁患者156例(15.09%),2组在性别上差异无统计学意义(P=0.355)。排名前5位的临床症状为发热、咳嗽、咽痛、全身肌肉酸痛、头痛;舌象以舌质红、苔薄黄、苔薄白腻为主;脉象以脉浮数、脉数为主;14~44岁组发热程度高于≥45岁组,差异有统计学意义(P=0.018)。通过因子分析明确病性涉及热、外风、湿、痰等病理因素,病位在卫表和肺,与脾和少阳有关;聚类分析提炼出3类证候分别为风热犯卫证(40.62%)、热毒袭肺证(35.98%)、表寒里热证(23.40%)。结论:2023年春季望京地区甲型流行性感冒中医证候以风热犯卫为主,病性总体以实为主,病位在卫表和肺,本研究结论可为今后流感中医诊治方案的优化提供理论依据。

老年衰弱患者中医证型及血瘀证分布规律研究

目的分析老年衰弱患者的中医证型和血瘀证的分布情况。方法收集2019年1月—2022年12月在中国中医科学院西苑医院老年病科门诊及住院的年龄≥60岁的西医诊断标准符合老年衰弱患者500例,根据患者中医证型和血瘀证量表评分进行分析。结果500例老年衰弱患者中医辨证证型比重大小依次是气虚两虚型29%、脾肾阳虚型26.8%、肝肾阴虚型25.8%、脾虚痰湿型18.4%。低年龄层的衰弱患者以气血两虚型和脾虚痰湿型较为多见,高年龄层的衰弱患者以脾肾阳虚型和肝肾阴虚型较为多见。老年衰弱患者中有87.4%伴有血瘀证。结论老年衰弱的病机特征是以虚为本、虚瘀并现。血瘀是老年衰弱发生发展过程中的重要病理因素。随着年龄增长,老年衰弱病机演变是由气血两虚逐渐向脾肾阳虚和肝肾阴虚进展,终致阴阳两虚。

中医药认可程度在年龄分布和临床疗效方面的对比分析

目的探究中医药认可程度在年龄分布和临床疗效方面的对比。方法选取2023年7月15日—2023年9月15日在本院采用中医技术保守治疗的18~80岁患者作为研究对象,总计200例。采取问卷调查,根据问卷结果,将患者分为“完全认可”“基本认可”“不认可”3个组,比较三组患者性别、年龄分布情况、职业、受教育程度以及疾病转归的关系。结果三组患者年龄、职业、受教育程度及疾病转归,差异有统计学意义(P<0.05)。结论中医药认可程度与年龄、受教育程度以及疾病是否痊愈有关。

1601例盆腔炎性疾病及其后遗症患者中医证型分布特征

目的探究盆腔炎性疾病(pelvic inflammatory disease,PID)和盆腔炎性疾病后遗症(sequelae of pelvic inflammatory disease,SPID)患者中医证型分布特征。方法以成都中医药大学附属医院为牵头单位,通过横断面调查,对全国17个省、自治区、直辖市的22家医院的1601例PID和SPID患者(其中PID患者874例,SPID患者727例)的中医证候特征进行分析。结果PID以湿热蕴结证(占40.96%)、湿热瘀结证(占30.32%)、瘀热内结证(占10.64%)、热毒炽盛证(占7.89%)为常见证型;盆腔炎性疾病反复发作急性期以湿热瘀结证(占22.39%)、气滞血瘀夹湿热证(占22.39%)为常见证型;SPID非急性加重期以湿热瘀结证(占38.52%)为常见证型;其中慢性盆腔疼痛、盆腔炎性疾病反复发作、不孕症以湿热瘀结证为常见证型。PID患者湿热蕴结证、湿热瘀结证在所有地区的分布频率均较高,瘀热内结证、热毒炽盛证在西南地区分布较多;SPID患者的证型中,西南、华中、华南地区以湿热瘀结证、气滞血瘀证较多见,气虚血瘀证在华中、西北地区分布频率较高,肾虚血瘀证在华东、华北地区分布频率较高,寒湿凝滞证在西北、东北地区分布较多;中医证型与地区分布的差异有统计学意义(P<0.05)。结论PID和SPID中医证型分布具有一定规律性,地区分布存在一定差异性,可为临床因地制宜地辨证治疗PID提供一定的参考依据。

类风湿关节炎中医证型及证素分布特征的文献研究概述

目的:整理和归纳类风湿关节炎(RA)的中医证候及证候要素(证素)分布特征,了解其文献研究概况。方法:检索国家知识基础设施数据库、中文科技期刊数据库、中国生物医学文献数据库、中国学术期刊数据库、PubMed等电子数据库自2000年1月至2023年9月收录的RA中医证候研究文献,由2位研究者根据纳排标准独立完成文献筛选、文献信息整理,对年发文量、发文单位省份、资助基金、纳入患者信息、证候类型分布、证候要素分布及证素组合分布进行统计描述。结果:共纳入文献66篇,发文最多的单位所在省份为云南省(8篇),基金资助来源主要为国家级课题和省级课题。纳入文献包含病例总数32365例,病例数最多的5种证型为风寒湿阻证(19.39%)、湿热痹阻证(16.36%)、寒湿痹阻证(10.64%)、痰瘀痹阻证(9.00%)、肝肾不足证(7.62%)。提取证素后获得RA病位证素3个,分别为肾、肝、脾;病性证素10个,其中频数最高的4种证素为湿19284(30.16%)、寒13663(21.37%)、热9397(14.70%)、风8945(13.99%)。证素组合形式以二证素和三证素组合形式居多,分别占62.91%和35.97%。结论:寒、热、湿、风为RA的重要病理因素,其病位集中于肾、脾、肝三脏,占比较大的证型及证候要素一定程度上解释了本病的病因病机。

南宁地区人群中医偏颇体质类型分布特点研究

目的研究南宁地区人群中医偏颇体质类型(单一及兼夹组合体质)分布的特点。方法选取2019~2023年在我院的体检人群2633例进行体质分类,通过偏颇体质的单一类型、2种和3种兼夹组合体质与平和质体质比较,在性别、年龄、职业、血压、血脂、疾病发病率等方面进行横断面回顾性研究,分析南宁地区人群偏颇体质类型分布规律。结果平和质体质139例(5.28%),偏颇体质2494例(94.72%)。在偏颇体质中,单一类型体质中血瘀质最高(4.02%),2种兼夹组合体质中痰湿质-血瘀质最高(10.33%)、3种兼夹组合体质中湿热质-阴虚质-痰湿质最高(13.74%)。在性别分布上,男性的湿热质-阴虚质-痰湿质、痰湿质、阴虚质均显著高于女性(P<0.05),女性的血瘀质-阳虚质、痰湿质-阳虚质、痰湿质-血瘀质、阳虚质-阴虚质-湿热质、阳虚质-阴虚质-血瘀质均显著高于男性(P<0.05)。各偏颇体质类型与平和质体质比较,在青年组、中老年组以及不同职业人群中的分布,差异均有统计学意义(均P<0.05);在高血压病的发病率比较,差异具有统计学意义(P<0.05);在血脂异常的发病率比较,差异无统计学意义(P>0.05)。交互性方差分析显示,各偏颇体质类型的总胆固醇、甘油三酯和体重指数(BMI)之间呈正相关关系(P<0.05)。结论在南宁地区人群中,中医偏颇体质占比高于平和质,其分布与年龄、性别、职业、血压、血脂、疾病发病率有着密切关系。