1.上海中医药大学附属龙华医院脾胃病科(上海 200032)
2.杭州市富阳区大源社区卫生服务中心医疗康复科(浙江 杭州 311413)
3.上海中医药大学附属龙华医院临床研究中心(上海 200032)
边杨清,女,硕士研究生,住院医师,主要从事消化科临床研究工作
柳涛,副主任医师,硕士研究生导师;E-mail:lh2488@126.com
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边杨清, 郑昱, 郑培永, 等. 中医体质类型与结直肠息肉相关性的Meta分析[J]. 上海中医药杂志, 2021,55(2):24-32.
Yangqing BIAN, Yu ZHENG, Peiyong ZHENG, et al. Meta-analysis of correlation between TCM constitution and colorectal polyps[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(2):24-32.
边杨清, 郑昱, 郑培永, 等. 中医体质类型与结直肠息肉相关性的Meta分析[J]. 上海中医药杂志, 2021,55(2):24-32. DOI: 10.16305/j.1007-1334.2021.1912017.
Yangqing BIAN, Yu ZHENG, Peiyong ZHENG, et al. Meta-analysis of correlation between TCM constitution and colorectal polyps[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(2):24-32. DOI: 10.16305/j.1007-1334.2021.1912017.
目的,2,探讨结直肠息肉与患者中医体质分布的相关性,为防治结直肠息肉提供循证医学依据。,方法,2,检索中国知网、维普数据库、万方数据库、中国生物医学文献数据库、PubMed 、EMBASE 、Cochrane Library等数据库从建库开始至2018年收录的关于中医体质类型与结直肠息肉相关性的临床研究文献,并根据纳入标准与排除标准人工筛选出最终符合条件的文献,提取有效数据,采用美国卫生保健质量和研究机构(AHRQ)的横断面研究质量评价量表评价文献的质量,并采用R软件及Review Manager 5.3软件对相关文献数据进行Meta分析。,结果,2,①最终纳入的16篇文献均为横断面研究,其中结直肠息肉病例样本量为2 341例。②7项研究中结直肠非腺瘤性息肉患者人群中湿热质、气虚质、阳虚质及痰湿质占总人数的比例较高、均大于10%;13项研究中结直肠非腺瘤性息肉患者人群中痰湿质、湿热质、阳虚质及气虚质占总人数的比例较高、均大于10%。③共有4项研究对腺瘤性息肉与非腺瘤性息肉患者的体质类型进行了比较,涉及研究对象共678例;对这4项研究的数据进行合并分析,湿热质、痰湿质、阳虚质及阴虚质患者发生腺瘤性息肉风险的优势比(,OR,)值相对较高,其中痰湿质与阳虚质发生腺瘤性息肉的风险明显高于非腺瘤性息肉(,P,<,0.05)。④共有3项研究对进展期腺瘤息肉与非进展期腺瘤息肉患者的体质类型进行了比较,涉及研究对象共345例;对这3项研究的数据进行合并分析,湿热质、痰湿质、阳虚质、气虚质、阴虚质、特禀质及平和质患者发生进展期腺瘤息肉风险的,OR,值较高,其中痰湿质与气虚质发生进展期腺瘤息肉的风险明显高于非腺瘤性息肉(,P,<,0.05)。⑤采用AHRQ量表评估纳入的16项研究的方法学质量,发现本研究中纳入的文献总体质量较低,存在相对较高的偏倚风险。,结论,2,湿热质、痰湿质、阳虚质和气虚质是结直肠息肉(包括腺瘤性息肉)患者的主要体质类型,其中阳虚质、痰湿质是结直肠腺瘤性息肉发病的主要危险因素,而痰湿质、气虚质是进展期腺瘤息肉发病的主要危险因素。
Objective,2,To explore the correlation between colorectal polyps and patient’s TCM constitution types for the purpose of providing evidence-based medical basis for prevention and treatment of colorectal polyps.,Methods,2,The clinical research literature on the correlation between TCM constitution types and colorectal polyps were retrieved from China National Knowledge Infrastructure (CNKI), Chongqing VIP fulltext periodical database (VIP), Wanfang data, China Biomedical Literature Database, PubMed, EMBASE, Cochrane Library from the beginning of database establishment to 2018. Based on the inclusion and exclusion criteria, the literatures that finally met the inclusion criteria were manually screened out, and the valid data were extracted. The American Health Care Quality and Research Institute (AHRQ) Cross-Sectional (Prevalence) Study Quality Checklist was applied to evaluate the quality of the literatures, and the relevant literatures were meta-analyzed by R software and Review Manager 5.3 software.,Results,2,①Finally 16 articles included were all cross-sectional studies, of which the sample size of colorectal polyps reached 2,341. ②Among patients with colorectal non-adenomatous polyps included in 7 studies, the number of patients with damp-heat constitution, qi-deficiency constitution, yang-deficiency constitution and phlegm-dampness constitution accounted for a higher proportion of the total number, all exceeding 10%. Among patients with colorectal non-adenomatous polyps included in 13 studies, the number of patients with phlegm-damp constitution, damp-heat constitution, yang-deficiency constitution and qi-deficiency constitution accounted for a higher proportion of the total number, all exceeding 10%. ③There were 4 studies that compared the constitution types of patients with and without adenomatous polyps, involving 678 cases. After data integration and analysis, it was found that the odds ratio (OR) value of adenomatous polyp risk was relatively higher in patients with damp-heat constitution, phlegm-dampness constitution, yang-deficiency constitution and yin-deficiency constitution respectively, and the adenomatous polyp risk was significantly higher than the non-adenomatous polyp risk in patients with phlegm-dampness constitution and yang-deficiency constitution. ④A total of 3 studies compared the constitution types of patients with progressive adenomatous polyps and of those with non-progressive adenomatous polyps, involving 345 cases. After data integration and analysis, it was found that the OR values of the risk of progressive adenoma polyp risk was relatively higher in patients with damp-heat constitution, phlegm-dampness constitution, yang-deficiency constitution, qi-deficiency constitution, yin-deficiency constitution, allergic constitution and mild constitution, and the progressive adenoma polyp risk was significantly higher than the non-progressive adenoma polyp in patients with phlegm-dampness constitution and qi-deficiency constitution. ⑤AHRQ Cross-Sectional (Prevalence) Study Quality Checklist was used to evaluate the methodological quality of the 16 studies included. It was found that the overall quality of literatures included was relatively low and there was a relatively high risk of bias.,Conclusion,2,Damp-heat constitution, phlegm-dampness constitution, yang-deficiency constitution and qi-deficiency constitution are the main constitution types of patients with colorectal polyps (including adenomatous polyps), of which yang-deficiency constitution and phlegm-dampness constitution are the primary risk factors for the onset of colorectal adenomatous polyps, while phlegm-dampness constitution and qi-deficiency constitution are the primary risk factors for the onset of progressive adenomatous polyps.
中医体质结直肠息肉大肠息肉相关性危险因素循证依据系统评价Meta分析
TCM constitutioncolorectal polypscolonic polypscorrelationrisk factorevidence-based basissystematic reviewmeta-analysis
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