Correlation between TCM constitution and polycystic ovary syndrome: a meta-analysis
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摘要:
目的 总结中医(TCM)体质类型和多囊卵巢综合征(PCOS)相关研究现状,探讨PCOS患者的中医体质分布规律,为PCOS的中医药防治提供循证医学证据。 方法 检索中国知网、维普、万方、PubMed、Cochrane、Embase数据库,纳入所有PCOS中医体质类型的临床研究文献。采用Stata 16.0进行meta分析,并分别以率和比值比及其95%可信区间表达效应值。 结果 共纳入20项研究,累计样本量4 928例。结果显示:痰湿质、阳虚质、气郁质和气虚质占PCOS患者的比例分别为15.8%、14.1%、12.5%和12.1%。按地区进行亚组分析显示华中痰湿质、阳虚质和特禀质比例最高,华北血瘀质和气虚质最高,华东气郁质和湿热质最高,华南和华西则分别以平和质和阴虚质为主。PCOS患者与一般人群体质类型比较显示,痰湿质(OR=1.871, 95% CI:1.109~3.156,P=0.019), 平和质(OR=0.313,95% CI:0.208~0.472,P < 0.001),其余体质类型差异无统计学意义。 结论 痰湿质、阳虚质、气郁质和气虚质是PCOS患者的主要体质类型;痰湿质为PCOS的危险因素,平和质为PCOS的保护因素。 Abstract:Objective To summarise the research status of traditional Chinese medicine (TCM) constitution types and polycystic ovary syndrome (PCOS), and to explore the distribution of TCM constitution of PCOS patients, so as to provide evidence-based medical evidence for TCM prevention and treatment of PCOS. Methods The databases of CNKI, CQVIP, Wanfang Data, PubMed, Cochrane and Embase were searched, and all clinical research documents of TCM constitution types of PCOS were retrieved. Meta-analysis was carried out with Stata 16.0, and the effect values were expressed in terms of rate, ratio and 95% confidence interval. Results Twenty studies were included with 4 928 individuals. The results showed that phlegm-dampness, yang deficiency, qi stagnation and qi deficiency accounted for 15.8%, 14.1%, 12.5% and 12.1% of PCOS patients, respectively. Subgroup analysis by region showed that the proportion of phlegm-dampness, yang deficiency and special was the highest in Central China, blood stasis constitutions and qi deficiency were the highest in North China, qi stagnation and damp-heat constitutions were the highest in East China, and balanced constitution and yin deficiency were the highest in South China and West China. The comparison of constitution types between PCOS patients and the general population showed that phlegm dampness (OR=1.871, 95% CI: 1.109-3.156, P=0.019) and peace (OR=0.313, 95% CI: 0.208-0.472, P < 0.001). There was no significant difference in other constitution types. Conclusion Phlegm-dampness, yang deficiency, qi stagnation and qi deficiency are the main constitution types of PCOS patients. Phlegm-dampness is a risk factor of PCOS, and balanced constitution is a protective factor of PCOS. -
表 1 纳入研究的基本特征及质量评分表
Table 1. Basic characteristics and quality evaluation table of the included studies
序号 纳入研究 时间 研究地区 研究类型 样本量(例) 年龄(岁) 质量评价(分) 1 陈俊杰[3]2011 2010年3月—2010年12月 四川 横断面 132 16~37 7 2 邹晴燕[4]2011 2009年9月—2010年9月 广西南宁 横断面 103 19~37 6 3 潘丽萍[5]2012 2011年1月—2012年1月 广东 横断面 256 18~43 7 4 李瑞丽等[6]2013 2011年6月—2012.10月 河南 横断面 980 18~40 8 5 赵铮[7]2013 2012年1月—2013年1月 广西壮族自治区 病例对照 90 不详 6 6 朱志琴等[8]2014 2011年6月—2012年12月 广东 病例对照 236 18~39 6 7 李欢欢[9]2014 2012年2月—2013年11月 河南 病例对照 88 18~40 6 8 郭丽等[10]2015 2013年10月—2014年7月 四川 病例对照 40 24~37 3 9 徐原哲[11]2015 2013年9月—2014年12月 山东 病例对照 108 18~38 5 10 柯欣[12]2015 2014年6月—2015年1月 四川 横断面 150 16~37 6 11 王昕等[13]2016 2014年11月—2015年6月 山东 病例对照 266 18~38 7 12 胥威风[14]2016 2015年4月—2016年2月 河南 病例对照 113 19~35 6 13 丁春丽等[15]2016 2013年1月—2015年2月 黑龙江 横断面 390 16~40 8 14 朱鸿秋等[16]2017 2015年4月—2016年2月 四川 病例对照 203 不详 5 15 张丽[17]2018 2015年1月—2018年1月 江苏 病例对照 200 18~38 6 16 吴思宁等[18]2018 2016年3月—2018年2月 广东 病例对照 60 23~36 6 17 文慧华[19]2018 2016年7月—2017年6月 广东 横断面 80 17~45 6 18 贾淑淋[20]2018 2016年5月—2018年2月 四川 病例对照 187 17~37 5 19 孙红涛[21]2019 2017年6月—2018年12月 宁夏 横断面 221 18~35 8 20 朱晨颖[22]2019 2016年1月—2018年12月 黑龙江 病例对照 1025 20~40 5 表 2 PCOS患者不同体质类型比率的meta分析结果
Table 2. Meta-analysis results of the ratio of PCOS patients with different constitution types
体质类型 纳入研究数量(项) 占总人数比例(%) 95% CI Q值 I2 (%) P值 痰湿质 20 15.8 12.8~18.7 204.57 90.7 < 0.001 阳虚质 20 14.1 10.8~17.4 346.89 94.5 < 0.001 气郁质 20 12.5 10.4~14.7 114.20 83.4 < 0.001 气虚质 20 12.1 8.5~15.7 388.03 95.1 < 0.001 湿热质 20 11.5 9.5~13.5 111.61 83.0 < 0.001 平和质 18 10.6 7.8~13.5 314.68 94.6 < 0.001 阴虚质 20 9.1 7.1~11.1 130.37 85.4 < 0.001 血瘀质 20 8.5 5.9~11.2 276.89 93.1 < 0.001 特禀质 15 3.6 2.0~5.2 150.53 90.7 < 0.001 表 3 PCOS患者与一般人群体质类型比较的meta分析
Table 3. Meta-analysis of comparison of physical types between PCOS patients and the general population
体质类型 OR值 95% CI I2(%) P值 痰湿质 1.871 1.109~3.156 0 0.019 阳虚质 0.827 0.530~1.290 0 0.402 气郁质 1.471 0.935~2.313 29.3 0.095 气虚质 0.953 0.595~1.527 0 0.843 湿热质 1.434 0.925~2.224 0 0.107 平和质 0.313 0.208~0.472 0 < 0.001 阴虚质 1.293 0.764~2.185 0 0.338 血瘀质 1.444 0.750~2.781 0 0.272 特禀质 1.614 0.654~3.981 0 0.299 -
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