王益德 李争 李风森

摘要 目的：系統评价稳定期慢性阻塞性肺疾病中医体质的分布状况，为慢性阻塞性肺疾病的中医药防治提供循证依据。方法：从中国期刊全文数据库、中国学术期刊数据库、中文科技期刊数据库、Pubmed等4个中英文数据库，2名研究者独立进行相关文献的检索、筛选及信息提取工作。运用Stata13.0软件对纳入的研究合并效应量进行荟萃分析，采用亚组分析、敏感性分析探求较大异质性的可能来源，最后应用Begg、Egger方法检测发表偏倚。结果：最终纳入17项横断面研究，共计5 077例患者。方法学质量评价中高质量和低质量研究各2项，中等质量研究13项。稳定期COPD患者中医体质类型的比例和95%置信区间从高到低排列前5位依次为气虚质28%（95%CI为24%～32%）、阳虚质21%（95%CI为17%～25%）、痰湿质14%（95%CI为11%～18%）、阴虚质10%（95%CI为7%～13%）、湿热质8%（95%CI为6%～10%）。此外稳定期慢阻肺中医体质分布在性别、地区等方面具有差异。Begg、Egger检测发现并未存在明显发表偏倚。结论：气虚质、阳虚质、痰湿质、阴虚质是稳定期慢阻肺的主要偏颇体质类型，且部分中医体质在性别、地区等方面存在差异。建议今后相关研究应遵循横断面研究的循证医学规范，以提高研究质量。

关键词 慢性阻塞性肺疾病;稳定期;中医体质;性别;Meta分析;循证医学

Relationship Between the Stable COPD and the Traditional Chinese Medicine Syndromes：A Meta-Analysis

WANG Yide1，LI Zheng2，LI Fengsen2

（1 The Fourth Clinical Medical College of Xinjiang Medical University，Urumqi 830011，China; 2 Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region，Urumqi 830000，China）

Abstract Objective：To systematically evaluate the distribution of traditional Chinese Medicine （TCM） constitutions in stable chronic obstructive pulmonary disease （COPD），and to provide evidence-based evidence for the prevention and treatment of COPD by TCM.Methods：A total of 4 Chinese and English databases，including CNKI，WAN FANG，VIP，and Pubmed，were searched by computer using a comprehensive retrieval strategy.A total of 2 researchers independently searched，screened，and extracted the literature on the correlation between TCM constitution and chronic obstructive pulmonary disease worldwide.Stata13.0 software was used to conduct a meta-analysis on the combined effect sizes of included studies，and subgroup analysis and sensitivity analysis were used to explore possible sources of greater heterogeneity.Finally，Begg，Egger methods were used to detect publication bias.Results：After strict inclusion and exclusion criteria，17 cross-sectional studies were included，with a total of 5，077 patients.AHRG evaluation criteria were used to evaluate the methodological quality of the included studies，including two high quality and two low-quality studies，and 13 medium quality studies.The proportion and 95% confidence interval of TCM constitution types in stable COPD patients were qi-deficiency 28%[95%CI（24%，32%）]，yang-deficiency 21%[95%CI（17%，25%）]，phlegm-dampness 14%[95%CI（11%，18%）]，yin-deficiency 10%[95%CI（7%，13%）]，and damp-heat constitution 8%[95%CI（6%，10%）].Besides，there are differences in the distribution of TCM constitutions of COPD by gender and region.The findings of Begg′s，Egger′s showed no significant publication bias.Conclusion：Qi-deficiency，yang-deficiency，phlegm-dampness，and yin-deficiency are the main types of biased constitutions in COPD at a stable period，and some TCM constitutions are different in gender and region.To improve the quality of literature，it is suggested that the related research should follow the EBM standard of a cross-sectional study.

Keywords Chronic obstructive pulmonary disease; Stability; Traditional Chinese medicine （TCM） constitution; Gender; Meta-analysis; Evidence-based medicine

中图分类号：R228;R256.14;R563;R563.3文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.23.021

慢性阻塞性肺疾病（Chronic Obstructive Pulmonary Disease，COPD）作为一种呼吸系统常见病，以持续性进行性气流受限为重要特征。随着全球老龄化和相关危险因素暴露等原因，发病率和病死率逐年上升，预计到2030年成为世界第3大死因[1]。……