世界中医药

作者	单位
刘蕊洁1，杨先照2，张嘉鑫2，曹旭2，叶永安2	1 首都医科大学附属北京同仁医院传统医学科，北京，100730； 2 北京中医药大学东直门医院脾胃病科，北京，100700

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中文摘要:

目的：通过单组率合并Meta分析的方法，探讨乙肝肝硬化的中医证候分布特点。方法：计算机检索国家知识基础设施数据库（CNKI）、中国生物医学文献数据库（CBM）、中国学术期刊数据库（CSPD）及中文科技期刊数据库（CCD）、PubMed、EMBASE、Web of knowledge及Cochrane library数据库，检索时间自1963年1月1日至2020年6月30日。由2位研究者根据纳入、排除标准独立筛选文献，提取相应研究信息并交叉核对，以美国卫生保健质量和研究机构（AHRQ）横断面研究量表进行质量评价，采用Stata16.0软件进行中医证候单组率的Meta分析。结果：共纳入35篇文献，其中中文文献33篇，英文文献2篇，涉及乙肝肝硬化患者4 805例、主要证候11种，其中8种证候可进行Meta分析：肝气郁结证分布频率为0.22（95%CI为0.18~0.26，P<0.01），水湿内阻证分布频率为0.19（95%CI为0.14~0.24，P<0.01），湿热蕴结证分布频率为0.22（95%CI为0.19~0.25，P<0.01），肝肾阴虚证分布频率为0.19（95%CI为0.19~0.24，P<0.01），瘀血阻络证分布频率为0.16（95%CI为0.12~0.21，P<0.01），脾肾阳虚证分布频率为0.11（95%CI为0.09~0.14，P<0.01），肝郁脾虚证分布频率为0.32（95%CI为0.14~0.50，P<0.01），脾虚湿盛证分布频率为0.16（95%CI为0.13~0.19，P<0.01）；亚组分析显示，湿热蕴结证、肝肾阴虚证、肝郁气滞证及水湿内阻证在南方、北方不同地域分布比较，差异有统计学意义（P<0.01）。结论：乙肝肝硬化中医证候以肝郁脾虚证、肝气郁结证、湿热蕴结证比例最高，不同地域对乙肝肝硬化的中医证候分布有一定影响。

English Summary:

To explore the distribution characteristics of traditional Chinese medicine(TCM) syndromes in hepatitis B cirrhosis by a single arm Meta-analysis.Methods:China National Knowledge Infrastructure(CNKI),Chinese Biomedical Literature Database(CBM),China Science Periodical Database(CSPD),Chinese Citation Database(CCD),PubMed,EMBASE,Web of knowledge and Cochrane library were searched by computer from January 1,1963 to June 30,2020.Two researchers independently screened the literature according to inclusion and exclusion criteria,and extracted and cross-checked relevant research information.Agency for Healthcare Research and Quality(AHRQ) scale was used for quality assessment of included cross-sectional studies.The single arm Meta-analysis of TCM syndromes in hepatitis B cirrhosis was performed by Stata 16.0.Results:A total of 35 articles were included,33 in Chinese and 2 in English,involving 4,805 hepatitis B cirrhosis patients and 11 main TCM syndromes.Specifically,8 of the 11 syndromes could be subjected to Meta-analysis for distribution frequency,which were as follows:The syndrome of liver qi depression was 0.22 （95%CI 0.18 to 0.26,P<0.01),the syndrome of water-dampness internal obstruction was 0.19 (95%CI 0.14 to 0.24,P<0.01),the syndrome of dampness-heat accumulation was 0.22 (95%CI 0.19 to 0.25,P<0.01),the syndrome of liver-kidney yin deficiency was 0.19 (95%CI 0.19 to 0.24,P<0.01),the syndrome of static blood obstructing collaterals was 0.16 (95%CI 0.12 to 0.21,P<0.01),the syndrome of spleen-kidney yang deficiency was 0.11 (95%CI 0.09 to 0.14,P<0.01),the syndrome of liver depression and spleen deficiency was 0.32 (95%CI 0.14 to 0.50,P<0.01),and the syndrome of spleen deficiency and exuberant dampness was 0.16 (95%CI 0.13 to 0.19,P<0.01).Subgroup analysis demonstrated that there were statistically significant differences in the distribution of the syndromes of dampness-heat accumulation,liver-kidney yin deficiency,liver qi depression and water-dampness internal obstruction between southern and northern regions.Conclusion:The highest proportion of TCM syndromes in hepatitis B cirrhosis were liver depression and spleen deficiency,liver qi depression and dampness-heat accumulation,which showed the characteristics of the syndrome distribution to a certain degree.Additionally,the distribution of the four syndromes was different in different regions.

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