冠心病痰瘀互结证文献系统评价

目的]采用文献系统评价方法评价冠心病痰瘀互结证辨证依据的规律。方法]制定合格检索策略,全面收集冠心病痰瘀互结证相关文献,从中西医病名、病因病机、证候名称、临床症状、舌象、脉象进行归类分析,运用聚类分析和因子分析降维处理,提练冠心病痰瘀互结证的核心辨证依据。结果]共检索文献1 540篇,相关专著136本,最后共有合格研究文献89篇,专著67本。综合文献系统评价、聚类分析和因子分析结果,得出冠心病痰瘀互结证辨证依据:胸闷胸痛,倦怠乏力,心悸,气短,脘痞满,恶心欲呕,面色晦暗,唇甲青紫,口黏,肢体困重,有痰,舌质暗,舌有瘀斑、斑点,苔腻,白腻苔,脉弦,脉滑。结论]本研究结果中冠心病痰瘀互结证舌象、脉象与相关文献一致,临床症状覆盖了文献相关诊断标准的内容,提示冠心病痰瘀互结证候较复杂,兼证较多,可兼气滞、气虚、阳虚、气阴两虚,也可寒化和热化,但这一结果还需临床实践的进一步证实。

Literature system evaluation of phlegm and blood stasis syndrome of coronary heart disease

Objective] To evaluate the inner rule of phlegm and blood stasis syndrome of coronary heart disease (CHD) by using the literature system evaluation method.Methods] Formulated the qualified retrieval strategy and collect comprehensive literature of phlegm and blood stasis syndrome of CHD. Proceed classification analysis via the name of Chinese and Western medicine of disease,etiology and pathogenesis name of syndrome,clinical symptoms,tongue and pulse condition, etc. Using cluster analysis and factor analysis dimension to dimension reduction and refine the core clue of phlegm and blood stasis syndrome of CHD.Results] The 1 540 references and 136 relevant monographs were found and 89 literature and 67 relevant monographs were finally qualified. Synthesize the result of literature system evaluation,the cluster analysis and factor analysis,we found that the features of phlegm and blood stasis syndrome of CHD were in list,chest tightness,and pain,tired and fatigue,palpitations,shortness of breath,distention and fullness,nausea,dark complexion blue lip and fingernail,sticky mouth,heavy body trapped,phlegmy,dark tongue,tongue ecchymosis,moss greasy,white greasy moss,wiry pulse,smooth pulse.Conclusion] The results reveal the consistency of phlegm and blood stasis syndrome of CHD in tongue,pulse condition and literature. Clinical symptoms cover the contents of relevant diagnostic standard of literature and include a lot of complicated accompanied symptoms such as qi stagnation,qi deficiency,yang deficiency,qi and yin deficiency,cold conversion,hot conversion,etc. But the results also need to be further confirmed in clinical practice.