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临床研究将中医体质类型与疾病联系起来:1639 项观察性研究的文献综述。

Clinical research linking Traditional Chinese Medicine constitution types with diseases: a literature review of 1639 observational studies.

机构信息

Center for Studies in Constitution Research and Reproductive Sciences of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China.

Institute for Tibetan Medicine, China Tibetology Research Center, Beijing 100101, China.

出版信息

J Tradit Chin Med. 2020 Aug;40(4):690-702. doi: 10.19852/j.cnki.jtcm.2020.04.019.

Abstract

OBJECTIVE

To analyze clinical studies on correlations between Traditional Chinese Medicine (TCM) body constitution types and diseases published in the past 10 years, and to provide an evidence base to support the use of such correlations for health maintenance and disease prevention.

METHODS

We searched five databases for the period April 2009 to December 2019: China National Knowledge Infrastructure Database, Wanfang Database, China Science and Technology Journal Database, PubMed and Embase. Three types of observational studies on correlation between constitution types and diseases were included: cross-sectional, case-control and cohort studies. Descriptive statistical methods were employed for data analysis.

RESULTS

A total of 1639 clinical studies were identified: 1452 (88.59%) cross-sectional studies, 115 (7.02%) case-control studies and 72 (4.39%) cohort studies covering 30 regions of China and five other countries (Malaysia, South Korea, Singapore, Thailand and France). The collection of studies comprised 19 disease categories and 333 different diseases. The 10 most commonly studied diseases were hypertension, diabetes, stroke, coronary atherosclerotic heart disease (CAHD), sleep disorders, neoplasm of the breast, dysmenorrhea, fatty liver disease, chronic viral hepatitis B and dyslipidemia. We found high distributions for each biased constitution type in different patient populations as follows: Qi-deficiency constitution in stroke, diabetes, chronic obstructive pulmonary disease, acquired immunodeficiency syndrome and hypertension; Yang-deficiency constitution in female infertility, osteoporosis, irritable bowel syndrome, gonarthrosis and dysmenorrhea; Yin-deficiency constitution in hypertension, diabetes, constipation, female climacteric states and osteoporosis; phlegm- dampness constitution in hypertension, stroke, fatty liver disease, diabetes and metabolic syndrome; damp-heat constitution in acne, chronic gastritis, chronic viral hepatitis B, human papillomavirus infection and hyperuricemia; blood-stasis constitution in CAHD, endometriosis and stroke; Qi-stagnation constitution in hyperplasia and neoplasms of the breast, insomnia, depression and thyroid nodules; and inherited-special constitution in asthma and allergic rhinitis.

CONCLUSION

Eight biased TCM constitutions were closely related to specific diseases, and could be used to guide individualized prevention and treatment. More rigorously designed studies are recommended to further verify the constitution-disease relationship.

摘要

目的

分析近 10 年来中医体质类型与疾病相关性的临床研究,为体质相关性用于养生保健和疾病防治提供证据支持。

方法

检索中国知网、万方数据知识服务平台、维普中文科技期刊数据库、PubMed 和 Embase 数据库,时间截至 2019 年 12 月,纳入体质类型与疾病相关性的观察性研究,包括横断面研究、病例对照研究和队列研究。采用描述性统计方法进行数据分析。

结果

共纳入 1639 项临床研究,其中横断面研究 1452 项(88.59%)、病例对照研究 115 项(7.02%)、队列研究 72 项(4.39%),涉及中国 30 个地区和马来西亚、韩国、新加坡、泰国、法国等 5 个其他国家,涵盖 19 个疾病类别、333 种疾病。前 10 位高发疾病分别为高血压、糖尿病、脑卒中、冠心病、睡眠障碍、乳腺肿瘤、痛经、脂肪肝、慢性乙型病毒性肝炎和血脂异常。不同患者人群中各偏颇体质类型分布较高,如脑卒中、糖尿病、慢性阻塞性肺疾病、获得性免疫缺陷综合征和高血压患者以气虚质多见,女性不孕、骨质疏松、肠易激综合征、骨关节炎和痛经患者以阳虚质多见,高血压、糖尿病、便秘、女性更年期和骨质疏松患者以阴虚质多见,高血压、脑卒中、脂肪肝、糖尿病和代谢综合征患者以痰湿质多见,痤疮、慢性胃炎、慢性乙型病毒性肝炎、人乳头瘤病毒感染和高尿酸血症患者以湿热质多见,冠心病、子宫内膜异位症和脑卒中患者以血瘀质多见,乳腺增生和肿瘤、失眠、抑郁和甲状腺结节患者以气郁质多见,哮喘和过敏性鼻炎患者以特禀质多见。

结论

8 种偏颇体质与特定疾病密切相关,可用于指导个体化防治。建议开展更严谨的研究进一步验证体质-疾病相关性。

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