干眼中医证型分布规律及症状相关性研究
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摘要
目的总结干眼中医证型分布规律及眼部症状、全身症状之间的相关性。方法以中国知网、维普网、万方数据库、中国生物医学文献数据库中发表的文献为依据,借助SPSS20.0与SPSS Modeler14.1软件,频数分析观察干眼的不同类型、证型、证素、症状、舌象、脉象的分布规律,关联规则挖掘干眼的潜在症状组合规律。结果以相应的关键词检索得到文献3608篇,去除重复满足纳入与排除标准的有205篇,涉及中医证型38种、观察病例4756例,干眼类型3种、病例9233例,症状136个,舌象17种,脉象22种,证素22种,全身症状与眼部症状关联规则17条,眼部症状、全身症状与舌象、脉象关联规则7条。结论研究表明干眼的病因比较复杂,主要以水样液缺乏性干眼为主,证型、证素、病位、病性相互佐证,说明干眼症的病理本质在于"阴虚",为临床对于本病的诊治提供重要的指导作用。
OBJECTIVE To summarize the distribution pattern of syndromes and the correlation between ocular symptoms and constitutional symptoms in dry eye cases. METHODS Based on the literature of the CNKI, VIP, Wanfang data knowledge service platform, and the CBM, by means of SPSS20.0 and IBM SPSS Modeler14.1 software, using frequency analysis to observe the different types of dry eye syndrome, syndrome types, syndrome elements, symptoms, tongue manifestation, pulse distribution and association rules to explore the law of symptom combinations in dry eye. RESULTS A total of 3608 articles were retrieved by corresponding key words, and 205 articles of them met the inclusion criteria and while did not accord with exclusion criteria after the repetitive literature was removed. These studies involved 38 Chinese syndrome type, 4756 cases,3 types of dry eye, 9233 cases, 136 symptoms, 17 tongues, 22 pulses, 22 kinds of syndrome elements,17 association rules related to symptoms and ocular symptoms, 7 association rules related to general ocular symptoms, constitutional symptoms and tongues, pulses. CONCLUSIONS The results showed that the causes of dry eye syndrome were complex, most of them were aqueous tear deficie ncy, and the most common symptom was yin deficiency of liver and kidney. The main syndrome elements of location were liver and kidney, and the most common nature of syndrome was yin deficiency.
OBJECTIVE To summarize the distribution pattern of syndromes and the correlation between ocular symptoms and constitutional symptoms in dry eye cases. METHODS Based on the literature of the CNKI, VIP, Wanfang data knowledge service platform, and the CBM, by means of SPSS20.0 and IBM SPSS Modeler14.1 software, using frequency analysis to observe the different types of dry eye syndrome, syndrome types, syndrome elements, symptoms, tongue manifestation, pulse distribution and association rules to explore the law of symptom combinations in dry eye. RESULTS A total of 3608 articles were retrieved by corresponding key words, and 205 articles of them met the inclusion criteria and while did not accord with exclusion criteria after the repetitive literature was removed. These studies involved 38 Chinese syndrome type, 4756 cases,3 types of dry eye, 9233 cases, 136 symptoms, 17 tongues, 22 pulses, 22 kinds of syndrome elements,17 association rules related to symptoms and ocular symptoms, 7 association rules related to general ocular symptoms, constitutional symptoms and tongues, pulses. CONCLUSIONS The results showed that the causes of dry eye syndrome were complex, most of them were aqueous tear deficie ncy, and the most common symptom was yin deficiency of liver and kidney. The main syndrome elements of location were liver and kidney, and the most common nature of syndrome was yin deficiency.
引文
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[2]SCHEIN OD,MUNOZ B,TIELSCH JM,et al.Prevalence of dry eye among the elderly[J].Am J Ophthalmol,1997,124(6):723-728.
[3]MOSS SE,KLEIN R,KLEIN BE.Prevalence of and risk factors for dry eye syndrome[J].Arch Ophthalmol,2000,118(9):1264-1268.
[4]MCCARTY C A,BANSAL AK,LIVINGSTON PM,et al.The epidemiology of dry eye in melbourne,australia.[J].Ophthalmology,1998,105(6):1114-1119.
[5]LAM H,BLEIDEN L,DE P C S,et al.Tear cytokine profiles in dysfunctional tear syndrome.[J].Am J Ophthalmol,2008,147(2):198-205+1.
[6]JOHNSON M E,MURPHY P J.Changes in the tear film and ocular surface from dry eye syndrome.[J].Prog Retin Eye Res,2004,23(4):449-474.
[7]GONG L,SUN X,CHAPIN WJ.Clinical curative effect of acupuncture therapy on xerophthalmia[J].Am J Chin Med,2010,38(4):651-659.
[8]SCHAUMBERG A D,BURING E J,SULLIVAN A D,et al.Hormone replacement therapy and dry eye syndrome[J].JAMA,2001,286(17):2114-2119.
[9]LIU Q,LIU J,REN C,et al.Proteomic analysis of tears following acupuncture treatment for menopausal dry eye disease by two-dimensional nano-liquid chromatography coupled with tandem mass spectrometry[J].Int J Nanomedicine,2017:1663-1671.
[10]MARGARITA CALONGE.The treatment of dry eye[J].Surv Ophthalmol,2001,45:227-239.
[11]朱文锋.证素辨证学[M].北京:人民卫生出版社,2008:5-10,189.
[12]赵艳青,李青松,项敏泓,等.糖尿病视网膜病变中医证候分布规律及症状相关性研究[J].中国中药杂志,2017,42(14):2796-2801.
[13]陈胜可.SPSS统计分析从入门到精通[M].北京:清华大学出版社,2010:6
[14]刘海涛,施家希,罗丹,等.中医药辨证治疗慢性乙型肝炎用药规律文献研究[J].中医杂志,2016,57(16):1421-1425.
[15]赵艳青,项敏泓,王雪菲,等.基于因子分析与关联规则挖掘干眼的用药规律[J].中华中医药杂志,2017,32(10):4708-4712.
[16]郭姣,朴胜华,石忠峰,等.高脂血症中医证候分布规律文献研究[J].广州中医药大学学报,2013,30(5):609-614+632.
[17]臧佩林,白锋.中医症状鉴别诊断[J].中医函授通讯,1983(3):6-8+11.
[18]朱文锋.常见症状中医鉴别诊疗学[M].北京:人民卫生出版社,2002:1-6.
[19]陆寿康.中医症状治疗学[M].北京:人民卫生出版社,2005:1-3.
[20]朱文锋.中医诊断学[M].北京:中国中医药出版社,2007:1-5.
[21]黎敬波,马力.中医临床常见症状术语规范[M].北京:中国医药科技出版社,2005:1-20.
[22]国家技术监督局,GB/T 16751.2-1997.中医临床诊疗术语证候部分[S].北京:中国标准出版社,1997.
[23]赵艳青.中医“五神”之“志”要素评定量表的研制及信效度考核[D].济南:山东中医药大学,2015,28.
[24]赵静,崔德芝,鞠建庆.基于数据挖掘的名老中医治疗高血压用药规律分析[J].国医论坛,2015,30(5):61-63.
[25]黄丽.结膜松弛症中医体质分析及其关联规则研究[D].上海中医药大学,2018,25.
[26]赵小静.中西医结合治疗干眼的现状与展望[J].国际眼科杂志,2013,13(2):299-301.
[27]刘畅,姚靖.干眼的论治思路探讨[J].中医药学报,2016,44(2):111-114.
[28]LI XQ,HE JC,HUANG PX,et al.Chinese medicine syndromes in congestive heart failure:a literature study and retrospective analysis of clinical cases[J].Chin J Integr Med,2016,22(10):738-744.
[29]FU XJ,SONG XX,WEI LB,et al.Study of the distribution patterns of the constituent herbs in classical chinese medicine prescriptions treating respiratory disease by data mining methods.[J].Chin J Integr Med,2013,19(8):621-628.