摘要
目的探讨和归纳非酒精性脂肪性肝病(NAFLD)的证型及证素分布规律。方法检索知网、万方、维普数据库自建库至2020年7月关于NAFLD辨证的相关文献资料,由两名研究者依据纳、排标准分别独立进行文献筛选、证型收集总结,证名规范化、证型再分解、证素提取,建立Excel 2010数据库,导入SPSS 25.0统计软件进行数据频数分布统计。结果收集到符合条件文献45篇,报道病例总数8703例,经规范化后得到证型14种,证型拆解后获得病性证素10个,病位证素4个。证型分布以肝郁脾虚证(26.47%)、湿热蕴结证(22.16%)最为常见,其次是痰湿内阻证、痰瘀互结证、肝郁气滞证。病性证素以湿(23.75%)、气滞(19.82%)、气虚(17.12%)、痰(15.43%)、热(12.13%)最常见,其次是瘀、阴虚、阳虚,而火、寒则较少见,组合分布以气滞、气虚相兼(26.63%),湿、热相兼(22.30%),痰、湿相兼(16.17%),痰、瘀相兼(12.19%)致病最多见。病位证素以肝、脾多见,占构成比的90.95%,组合分布以肝、脾同病为主,占54.01%。证素组合有一、二、三、四证素组合方式,以二证素组合为多,占76.03%。结论肝郁脾虚是NAFLD基本病机,肝、脾、湿、气滞、气虚、痰、热为常见证素,湿、痰、热是本病发生发展的重要因素。
Objective To investigate the distribution of traditional Chinese medicine(TCM)syndrome types and syndrome elements of nonalcoholic fatty liver disease(NAFLD).Methods Related databases(CNKI,Wanfang Dota,and VIP)were searched for articles on the syndrome differentiation of NAFLD published up to July 2020.Two investigators independently performed literature screening and collection and summarization of syndrome types based on the inclusion and exclusion criteria,and an Excel 2010 database was established after the standardization of syndrome names,re-decomposition of syndrome types,and extraction of syndrome elements.The data were imported into SPSS 25.0 statistical software for the analysis of frequency distribution.Results A total of 45 qualified articles were collected,with a total of 8703 cases reported.A total of 14 syndrome types were obtained after standardization,and 10 syndrome elements reflecting the nature of disease and 4 syndrome elements of disease location were obtained after the syndrome types were disassembled.Stagnation of liver Qi and spleen deficiency syndrome(26.47%)and damp-heat accumulation syndrome(22.16%)were the most common syndrome types,followed by stagnation of phlegm dampness,intermingled phlegm and blood stasis,and stagnation of liver Qi and Qi stagnation.Dampness(23.75%),Qi stagnation(19.82%),Qi deficiency(17.12%),phlegm(15.43%),and heat(12.13%)were the most common syndrome elements reflecting the nature of disease,followed by stasis,Yin deficiency,and Yang deficiency,while fire and cold were relatively uncommon.Qi stagnation and Qi deficiency(26.63%),dampness and heat(22.30%),phlegm and dampness(16.17%),and phlegm and stasis(12.19%)were the most common combinations of syndrome elements.The liver and the spleen were the most common syndrome elements of disease location,accounting for 90.95%of the constituent ratio,and the combination of the liver and the spleen with the same disease accounted for 54.01%.The combination of one,two,three,or four syndrome elements was observed,and the combination of two syndrome elements accounted for 76.03%.Conclusion Stagnation of liver Qi and spleen deficiency are the basic pathogeneses of NAFLD,and liver,spleen,dampness,Qi stagnation,Qi deficiency,phlegm,and heat are common syndrome elements.Dampness,phlegm,and heat are important factors for the development and progression of this disease.
作者
高改娅
李莎
薛敬东
白艳艳
惠友谊
GAO Gaiya;LI Sha;XUE Jingdong;BAI Yanyan;HUI Youyi(The First Clinical Medical College of Shaanxi University of Chinese Medicine,Xianyang,Shaanxi 712046,China;Department of Hepatology,Shaanxi Provincial Hospital of Traditional Chinese Medicine,Xi’an 710000,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2021年第1期89-93,共5页
Journal of Clinical Hepatology
基金
陕西省中医药管理局——长安医学张氏肝病流派传承工作室(2018)。
关键词
非酒精性脂肪性肝病
证候
中医学
Non-alcoholic Fatty Liver Disease
Symptom Complex
TCM Science
