基于现代文献的溃疡性结肠炎证候及证素分布特点研究

目的开展溃疡性结肠炎(ulcerative colitis,UC)的现代文献研究,探讨中医证候及证素的分布规律及特点。方法通过中国知网(CNKI)、万方、维普(VIP)及中国生物医学数据库(CBM)四大数据库在线检索UC相关文献,筛选具有辨证信息的临床研究类文献,提取证候及证素信息建立数据库,分析UC证候及证素分布特点。结果(1)纳入104篇文献,共12792例患者,来源于26个不同的省或直辖市,男性稍多于女性。(2)UC疾病总体证候分布以大肠湿热证占比最高,为23.32%;病位证素以脾占比最高,为46.08%,其次为大肠20.25%;病性证素以湿占比最高,为26.18%,其次为火(热)(23.13%)、气虚(22.99%)。(3)活动期UC中大肠湿热证的占比优势更为明显,为36.09%;病位证素仍以脾(39.87%)和大肠(36.00%)为主;病性证素则以湿(30.16%)、火(热)(28.20%)和气虚(19.23%)为主要类型。(4)缓解期UC证候分布相对均匀,占比前六的证候频率在10%~15%之间,依次为脾胃虚弱证、脾虚湿热证、脾肾阳虚证、脾虚湿阻证、大肠湿热证和肝郁脾虚证;脾在其病位证素中占据绝对优势,为60.19%;其次为肾(12.23%)和大肠(10.08%);病性证素则以气虚(34.35%)、湿(24.55%)和火(热)(16.35%)为主要类型。结论UC疾病总体呈现虚实夹杂的病理特点,不同疾病分期证候及证素表现具有一定的差异,活动期以实证为主,尤以大肠湿热证最为突出;缓解期以虚证为主;脾虚和湿贯穿在疾病的始终,是UC最主要的病理因素。

Study on the distribution characteristics of syndrome and syndrome elements in ulcerative colitis based on modern literature

Objective To carry out modern literature research on ulcerative colitis(UC)and to discuss the distribution characteristics of TCM syndrome and syndrome elements in UC.Methods The UC related literature were searched online from 4 database,including China National Knowledge Infrastructure(CNKI),Wanfang,VIP and Chinese biology medicine(CBM).The clinical research literature with syndrome differentiation information was screened,the information on syndrome and syndrome elements were extracted to establish a database,and the distribution characteristics of syndrome and syndrome elements in UC were analyzed.Results(1)104 references were included,with a total of 12,792 patients from 26 different provinces or municipalities,with slightly more males than females.(2)The syndrome of dampness-heat in large intestine accounted for the largest proportion in overall syndrome distribution of UC disease(23.32%).In syndrome element of disease location,spleen accounted for the largest proportion(46.08%),followed by large intestine(20.25%).In syndrome element of disease nature,dampness accounted for the highest proportion(26.18%),followed by fire or heat(23.13%),and qi deficiency(22.99%).(3)In the active stage of UC,the proportion of syndrome of dampness-heat in large intestine was more obvious,accounting for 36.09%.Spleen(39.87%)and large intestine(36.00%)still were the main syndrome element of disease location.The main types of syndrome element of disease nature were dampness(30.16%),fire or heat(28.20%)and qi deficiency(19.23%).(4)In the remission stage,the syndrome distribution of UC is relatively homogeneous,with the frequency of the first six syndromes ranging from 10%to 15%,successively including the syndrome of spleen-stomach weakness,syndrome of spleen-stomach dampness-heat,syndrome of spleen-kidney yang deficiency,syndrome of dampness obstruction due to spleen deficiency,syndrome of dampness-heat in large intestine,and syndrome of liver depression and spleen deficiency.In syndrome element of disease location,the spleen was the abusolute advantage,accounting for 60.19%,followed by the kidney,accounting for 12.23%,and the large intestine,accounting for 10.08%.The main types of disease syndromes of disease nature were qi deficiency(34.35%),dampness(24.55%)and fire(16.35%).Conclusion UC were characterized by a mixture of deficiency and excess,and there were certain differences in syndromes and syndrome elements in different disease stages.The active period was characterized with excessive syndrome,the most is syndrome of dampness-heat in large intestine.The remission period was dominated by deficiency syndrome.Spleen deficiency and dampness were the main pathological factors of UC throughout the disease.