基于文献数据挖掘探讨糖尿病大血管病变患者的中医证候及核心病机OA

Objective To investigate the distribution of traditional Chinese medicine(TCM)syndromes and to explore the core pathogenesis in patients with diabetic macrovascular complications based on literature data mining.Methods Clinical research literature on TCM syndrome differentiation for diabetic macrovascular complications was retrieved from databases including CNKI,VIP,Wanfang,CBM,PubMed,Web of Science,and Cochrane Library.The time span for literature search was from the inception of each database to October 2023.Following standardization of syndrome terminology,syndrome elements were extracted.Descriptive analysis was performed on the TCM syndrome types and syndrome elements of diabetic macrovascular complications.Gephi software was used to construct a syndrome-disease association network,and Origin software was employed to generate a heatmap of syndrome element distribution.Results A total of 123 articles was included.On the whole,diabetic macrovascular complications were usually differentiated as qi and yin deficiency syndrome(16.36%),qi and yin deficiency with blood stasis syndrome(11.40%),phlegm-stasis obstructing collaterals syndrome(9.95%)and qi deficiency with blord stasis syndrome(8.63%);the predominant syndrome elements were qi deficiency,yin deficiency,and blood stasis.The disorders of the collaterals appeared throughout the disease course.Separately,diabetic lower extremity vascular disease showed a strong correlation with damp-heat internal accumulation syndrome,with damp turbidity(7.14%)and heat syndrome(8.01%)as its pathological features.Diabetic coronary heart disease was primarily associated with blood stasis obstructing heart vessels syndrome,with a prominent pathological feature of phlegm turbidity(12.10%)and the disease location in the heart(5.92%).Diabetic cerebral infarction demonstrated the strongest correlation with wind-phlegm obstructing the collaterals syndrome,with prominent pathological features of phlegm turbidity(15.31%)and wind pathogen(10.40%).Conclusion The core pathogenesis of diabetic macrovascular complications is characterized by deficiency in the origin and excess in the superficiality,showing as stasis,stagnation,and vessel damage.The dynamic evolution of the pathogenesis of diabetic macrovascular complications adheres to the pattern of deficiency-stasis-toxin-vessel damage.And the pathogenesis of diabetic macrovascular complications of lower extremity vascular disease,coronary heart disease,and cerebral infarction is separately characterized by damp-heat-toxin accumulation,phlegm-stasis-toxin blending,and wind-phlegm-toxin stirring.The results will provide a theoretical basis for establishing a precise TCM syndrome differentiation and treatment system for diabetic macrovascular complications.