高血压与中医体质相关性的荟萃分析＊

目的 通过Meta分析研究高血压与中医体质的相关性,为高血压防治提供依据。方法 通过检索国内文献库,纳入符合要求的高血压与中医体质相关性文献,提取原始文献资料并评价研究的质量;以RevMan 5.3软件进行异质性检验和Meta分析,并通过亚组分析探索异质性来源,以漏斗图评估发表偏倚。结果 共有10篇文献符合纳入标准,涉及高血压病人4 401例,对照组7 934例,全部为横断面研究。痰湿质（OR = 2.24,95%CI：1.77 - 2.83,P < 0.001）、阴虚质（OR = 1.28,95%CI：1.13 - 1.45,P < 0.001）、气虚质（OR = 1.21,95%CI：1.06 - 1.37,P = 0.005）、血瘀质（OR = 1.24,95%CI：1.06 - 1.46,P = 0.007）是高血压人群更易出现的体质类型;而平和质是对照组更易出现的体质类型（OR = 0.56,95%CI：0.51 - 0.61,P < 0.001）;阳虚质、气郁质、湿热质、特禀质在高血压人群和非高血压人群的分布无明显统计学差异。亚组分析显示是否明确纳入既往诊断的高血压和研究质量是异质性主要来源;目测漏斗图未发现明显发表性偏倚。结论 痰湿质、阴虚质、气虚质、血瘀质是高血压易感体质,平和质是保护体质,但由于纳入研究质量不佳,且存在设计缺陷,无法说明中医体质与高血压发生的因果关系,结论需谨慎对待。

Meta-analysis of Correlation between Hypertension and TCM Constitution

Objective Meta-analysis was conducted to study the correlation between hypertension and TCM constitution, to provide evidence for prevention and treatment of hypertension.Methods By searching the domestic literature database, the relevant literatures of hypertension and TCM constitution were included, the data were extracted and the quality of the included research was evaluated; the heterogeneity test and meta-analysis were performed by RevMan 5.3 software. Moreover, the heterogeneity sources were explored by subgroup analysis, and the publication bias was evaluated by funnel plot.Results A total of 10 articles met the inclusion criteria, involving 4401 patients with hypertension and 7934 patients in the control group. Phlegm-dampness, moderate constitution, yang-deficiency and dampness-heat all showed obvious heterogeneity. Phlegm-dampness (OR = 2.24, 95%CI: 1.77 - 2.83, P < 0.001), yin-deficiency (OR = 1.28, 95%CI: 1.13 - 1.45, P < 0.001), Qi-deficiency (OR = 1.21, 95%CI: 1.06 - 1.37, P = 0.005) and blood stasis (OR = 1.24, 95%CI: 1.06 - 1.46, P = 0.007) were the most common constitutional types in hypertension, while moderate constitution was the most common type in the control group (OR = 0.56, 95%CI: 0.51 - 0.61, P < 0.001). There was no statistically significant difference in the distribution of yang deficiency, qi stagnation, damp heat and special constitution in hypertensive patients and non-hypertensive patients. Subgroup analyses showed whether the inclusion of previously diagnosed hypertension and study quality was a major source of heterogeneity; no apparent publication bias was observed in the visual funnel plot.Conclusion Phlegm-dampness, yin deficiency, qi-deficiency and blood-staining are high-pressure susceptibility, and moderate constitution is the protection constitution. However, due to the poor quality of the included studies and design flaws, it is impossible to explain the causal relationship between constitution and high blood pressure. The conclusion needs to be treated with caution.