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[4367例成人流感患者中医证候分布特征的Meta分析]

[Distribution characteristics of traditional Chinese medicine syndromes in 4 367 adult influenza patients: a Meta-analysis].

作者信息

Lei Siyuan, Li Xuanlin, Feng Zhenzhen, Chun Liu, Li Jiansheng

机构信息

Co-construction Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment and Chinese Medicine Development of Henan Province, Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou 450046, Henan, China.

Department of Respiratory, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450046, Henan, China. Corresponding author: Li Jiansheng, Email:

出版信息

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2023 Jan;35(1):23-27. doi: 10.3760/cma.j.cn121430-20220114-00063.

DOI:10.3760/cma.j.cn121430-20220114-00063
PMID:36880233
Abstract

OBJECTIVE

To systematically evaluate the distribution characteristics of traditional Chinese medicine (TCM) syndromes in adult influenza patients and to provide a basis for the TCM syndrome differentiation of influenza.

METHODS

The CNKI, CBM, Wanfang, VIP, PubMed, Embase, Cochrane Library databases were searched to collect cross-sectional studies on the distribution pattern of TCM syndromes in adult patients with influenza. The risk of bias assessment tool for cross-sectional studies developed by the Joanna Briggs Institute (JBI) evidence-based health care center was used to evaluate the literature quality, and the Stata 15.1 software was used to conduct a Meta-analysis of the pooled effect sizes of the included studies.

RESULTS

A total of 11 studies with 4 367 influenza patients were included. Quality assessment results of JBI showed that the risk bias was higher in the sample size calculation, and the description of sampling modalities and response rate was unclear. There were 17 influenza syndromes after specification, and a single group rate Meta-analysis was performed of the syndromes with ≥ 50 incident cases showed that there were 9 syndromes with an incidence ≥ 10% and statistical significance, the top 5 syndromes were syndrome of wind and heat invading the defense [n = 1 583, RATE = 34.3%, 95% confidence interval (95%CI) was 22.2%-46.3%], syndrome of exterior cold and interior heat (n = 1 122, RATE = 36.1%, 95%CI was 21.2%-51.1%), syndrome of wind-cold fettering the exterior (n = 860, RATE = 19.4%, 95%CI was 10.7%-28.0%), syndrome of heat and toxin in the lung (n = 217, RATE = 17.1%, 95%CI was 9.1%-25.0%), and syndrome of disease involving both defense phase and qi phase (n = 184, RATE = 38.8%, 95%CI was 14.2%-63.5%). The results of the subgroup analysis in different geographical regions showed that the frequency of distribution of syndrome of wind and heat invading the defense and heat and toxin in the lung was higher in the South (RATE: 36.5%, 18.6%) than in the North (RATE: 30.9%, 15.4%), and the frequency of distribution of syndrome of wind-cold fettering the exterior and exterior cold and interior heat in the North (RATE: 23.8%, 40.1%) was higher than that in the South (RATE: 15.7%, 32.3%).

CONCLUSIONS

There are 9 common TCM syndromes of influenza, including wind and heat invading the defense syndrome, exterior cold and interior heat syndrome, wind-cold fettering the exterior syndrome, heat and toxin in the lung syndrome, disease involving both defense phase and qi phase syndrome, wind and heat complicated by dampnessinvading the surface syndrome, wind and cold complicated by dampnessinvading the surface syndrome, defense phase syndrome and dampness and heatinvading the surface syndrome, which can provide a reference for the TCM syndrome differentiation and treatment of influenza.

摘要

目的

系统评价成人流感患者中医证候分布特征,为流感的中医辨证提供依据。

方法

检索中国知网、中国生物医学文献数据库、万方数据知识服务平台、维普资讯网、PubMed、Embase、Cochrane图书馆数据库,收集关于成人流感患者中医证候分布规律的横断面研究。采用乔安娜布里格斯研究所(JBI)循证卫生保健中心制定的横断面研究偏倚风险评估工具评价文献质量,并用Stata 15.1软件对纳入研究的合并效应量进行Meta分析。

结果

共纳入11项研究,涉及4367例流感患者。JBI质量评估结果显示,样本量计算方面的偏倚风险较高,抽样方式及应答率描述不清。规范后有17种流感证候,对≥50例发病例数的证候进行单组率Meta分析,结果显示发病率≥10%且有统计学意义的证候有9种,前5位依次为风热犯卫证(n = 1583,RATE = 34.3%,95%置信区间(95%CI)为22.2% - 46.3%)、表寒里热证(n = 1122,RATE = 36.1%,95%CI为21.2% - 51.1%)、风寒束表证(n = 860,RATE = 19.4%,95%CI为10.7% - 28.0%)、热毒袭肺证(n = 217,RATE = 17.1%,95%CI为9.1% - 25.0%)、卫气同病证(n = 184,RATE = 38.8%,95%CI为14.2% - 63.5%)。不同地理区域亚组分析结果显示,风热犯卫证和热毒袭肺证在南方的分布频率(RATE:36.5%,18.6%)高于北方(RATE:30.9%,15.4%),风寒束表证和表寒里热证在北方的分布频率(RATE:23.8%,40.1%)高于南方(RATE:15.7%,32.3%)。

结论

流感常见中医证候有9种,包括风热犯卫证、表寒里热证、风寒束表证、热毒袭肺证、卫气同病证、风热夹湿袭表证、风寒夹湿袭表证、卫分证、湿热袭表证,可为流感的中医辨证论治提供参考。

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