主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

北京中医药大学学报 ›› 2016, Vol. 39 ›› Issue (4): 325-334.doi: 10.3969/j.issn.1006-2157.2016.04.012

• 临床研究 • 上一篇    下一篇

中医体质类型与代谢综合征相关性研究的系统评价和Meta分析*

罗辉1,2,王琦1#   

  1. 1 北京中医药大学中医体质与生殖医学研究中心 北京 100029;
    2 中国藏学研究中心藏医药研究所
  • 收稿日期:2015-12-26 出版日期:2016-04-30 发布日期:2016-04-30
  • 通讯作者: 王琦,男,教授,博士生导师
  • 作者简介:罗辉,男,在读博士生,助理研究员
  • 基金资助:
    *北京中医药大学中医体质健康医学协同创新中心资助项目(No.2013-XTCX),北京中医药大学自主选题在读研究生资助项目(No.2016-JYB-XS020)

Correlation between TCM constitution and metabolic syndrome: a systematic review and Meta-analysis*

LUO Hui1,2, WANG Qi1#   

  1. 1 Constitution and Reproductive Medicine Research Center , Beijing University of Chinese Medicine, Beijing 100029;
    2 Institute for Traditional Tibetan Medicine,China Tibetology Research Center
  • Received:2015-12-26 Online:2016-04-30 Published:2016-04-30

摘要: 目的 总结有关中医体质类型与代谢综合征相关性研究的现状,探讨代谢综合征患者的中医体质分布规律,为代谢综合征的中医药防治提供循证医学证据。方法 检索中国知网、重庆维普、万方数据、PubMed和Embase数据库,纳入所有评价中医体质类型与代谢综合征相关性的临床研究文献。采用R version 3.2.2软件进行横断面研究单个率的Meta分析,采用Review Manager 5.3软件进行有对照数据的Meta分析,并以率(rate)或比值比(odds ratio, OR)及其95%可信区间(confidence interval, CI)表达效应值。结果 共纳入13项横断面研究和2项病例对照研究,样本量总计10 318例,其中代谢综合征患者6 742例,对照组3 576例。痰湿质、气虚质和湿热质占代谢综合征患者的比例分别为30%(22%~40%)、19%(13%~28%)、14%(10%~20%)。病例对照研究的,Meta分析显示,痰湿质、气虚质和湿热质人群代谢综合征发病风险的OR值分别为5.87(1.94~17.79)、1.17(1.01~1.37)和1.96(1.65~2.33)。华北地区代谢综合征患者痰湿质、气虚质和湿热质的比例最高,华南地区居中,华东地区最低。男性和女性的痰湿质比例相当,女性气虚质的比例高于男性,男性湿热质的比例高于女性。2项病例对照研究具有较高的方法学质量;横断面研究的方法学质量总体偏低,存在较高的偏倚风险。结论 痰湿质、气虚质和湿热质是代谢综合征患者的主要体质类型,也是导致代谢综合征发病的危险因素,其中以痰湿质与代谢综合征的关系最为密切。建议今后研究遵循循证医学观察性研究的实施和报告规范,提高研究质量,以期进一步探讨体质与疾病的关联性,为辨体-辨证-辨病的临床诊疗模式提供有价值的参考。

关键词: 中医体质, 代谢综合征, 相关性, 系统评价, Meta分析

Abstract: Objective Based on the current studies of the correlation between TCM constitution and metabolic syndrome (MS), to study the distribution rule of TCM constitution of patients with MS, so as to provide proof of evidence-based medicine (EBM) for prevention and treatment of MS. Methods After searching China National Knowledge Infrastructure (CNKI), Chongqing VIP Chinese Science and Technology Periodical Database (VIP), Wanfang Data, PubMed, and Embase, all clinical literature linked to the correlation between constitution and MS were included. The meta-analysis of cross-sectional studies was conducted using R version 3.2.2 software, and the Meta-analysis of case-control studies was finished using Review Manager 5.3 software with rate or odds ratio (OR) and 95% confidence interval (CI) as effect size. Results 13 cross-sectional studies and 2 case-control studies were eligible, with 6 742 MS patients and 3 576 of control group. The constitution of phlegm-dampness, qi-deficiency and damp-heat accounted for 30% (22%~40%), 19% (13%~28%) and 14% (10%~20%) of MS patients respectively. The meta-analysis of case-control studies showed that OR of occurrance risk of MS in patients with constitution of phlegm-dampness, qi-deficiency, damp-heat were 5.87 (1.94~17.79), 1.17 (1.01~1.37) and 1.96 (1.65~2.33) respectively. Each of the three TCM constitutions mentioned above took up the highest proportion in MS patients of North China, the lowest proportion in East China, and the middle in South China. There was no gender difference on the rate of phlegm-dampness constitute, while the rate of qi-deficiency constitution in female was higher than male with damp-heat constitution reversely. The methodological quality of the two case-control studies was high, and that of the cross-sectional studies was low with higher bias risk. Conclusion The constitution of phlegm-dampness, qi-deficiency and damp-heat were the primary types in patients with MS, which were believed to be the risk factors of the incidence of MS,furthermore, the phlegm-dampness constitution was the closest with MS. We suggest that the clinical study should conduct and report in accordance with the consolidated standards to improve the study quality, so as to explore the correlation of constitutions and diseases, and to support the diagnosis and treatment model of “differentiation of constitution-pattern-disease”.

Key words: TCM constitution, metabolic syndrome, correlation, systematic review, Meta-analysis

中图分类号: 

  • R22