基于临床文献分析冠状动脉粥样硬化性心脏病中医证型及证素分布规律OA

Objective:Through clinical literature retrieval,to analyze the distribution patterns of TCM syndrome pat-terns and syndrome elements in coronary heart disease(CHD)over the past 10 years.Methods:Literature inclusion criteria were established.Clinical literature on TCM syndrome patterns and syndrome elements of CHD from 2014 to 2024 was re-trieved from the China National Knowledge Infrastructure(CNKI)Journal Full-text Database,Wanfang Data Knowledge Service Platform,VIP Chinese Sci-tech Journals Database,and Chinese Medical Journal Network.A literature database for TCM syndrome patterns and syndrome elements of CHD was constructed.Frequency and percentage statistics were per-formed using Excel,and the distribution patterns of TCM syndrome patterns and syndrome elements across different year in-tervals were analyzed.Results:A total of 114 syndrome patterns and 25 categories of syndrome elements were summarized.After classifying the literature by year intervals,syndrome patterns with a frequency greater than 5%included heart blood stasis pattern,qi and yin deficiency pattern,phlegm turbidity internal obstruction pattern,qi deficiency and blood stasis pat-tern,qi stagnation and blood stasis pattern,cold congealing heart vessel pattern,heart and kidney yin deficiency pattern,phlegm obstructing heart vessel pattern,and phlegm and blood stasis mutual binding pattern.Pathogenic nature syndrome el-ements comprised blood stasis,qi deficiency,phlegm,yin deficiency,yang deficiency,qi stagnation,and cold.Pathogenic lo-cation syndrome elements included heart,channels and collaterals,and kidney.Four combination forms of syndrome ele-ments were identified:(1)Two syndrome elements(69.64%),dominated by two pathogenic nature syndrome elements(37.73%)and one pathogenic nature syndrome element plus one pathogenic location syndrome element(31.33%).The most frequent combinations were qi deficiency+yin deficiency(11.64%)and heart+blood stasis(11.35%),followed by qi defi-ciency+blood stasis(8.92%)and qi stagnation+blood stasis(8.15%).(2)Single syndrome element:single pathogenic na-ture syndrome elements had a frequency of 15.42%,while single pathogenic location syndrome elements accounted for only 0.19%.(3)Three syndrome elements:primarily concentrated in one pathogenic nature syndrome element plus two pathogenic location syndrome elements(10.86%),with heart+kidney+yin deficiency showing the highest frequency(5.43%).(4)Four syndrome element combinations were rare,including only four pathogenic nature syndrome elements(0.10%)and two patho-genic nature syndrome elements plus two pathogenic location syndrome elements(0.39%).Conclusion:Secondary analysis from a literature perspective further clarifies that the pathogenesis characteristics of CHD present a complex pattern of defi-ciency as the root and excess as the manifestation,with deficiency and excess intermingled.The study reveals that in recent years,deficiency patterns have dominated the pathogenesis of CHD,with qi and yin deficiency comprising the largest pro-portion.This provides more precise diagnostic and therapeutic strategies for clinical practice,leading to a deeper and more detailed understanding of TCM pathogenesis in CHD.It offers a theoretical basis for syndrome differentiation and treatment,thereby enriching the foundation for individualized CHD management.