ObjectiveThis study aimed to evaluate the impact of early rhythm control (ERC) on the occurrence of cardiocerebrovascular events in patients diagnosed with atrial fibrillation detected after stroke (AFDAS).MethodsA systematic search was conducted across nine databases from inception to October 15, 2023 to identify clinical trials comparing ERC with usual care interventions in AFDAS patients. The primary outcome assessed was recurrent stroke, with secondary outcomes including all-cause mortality, adverse events related to arrhythmias, and dementia.ResultsAnalysis of five studies, consisting of two randomized clinical trials (RCTs) involving 490 patients and three cohort studies involving 95,019 patients, revealed a reduced rate of recurrent stroke [odds ratio (OR) = 0.30, 95% confidence interval (CI) 0.11–0.80, P = 0.016 in RCTs; OR = 0.64, 95% CI 0.61–0.68, P < 0.00001 in cohort studies] and all-cause mortality (hazards ratio = 0.94, 95% CI 0.90–0.98, P = 0.005 in cohort studies) in the ERC group compared to the usual care group. In addition, ERC was associated with superior outcomes in terms of dementia.ConclusionsPatients with AFDAS who underwent ERC treatment exhibited a decreased risk of cardiocerebrovascular events compared to those receiving usual care. These results support the potential benefits of implementing an ERC strategy for this specific patient population.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, Identifier [CRD42023465994].

BackgroundThe angiography-derived index of microvascular resistance (A-IMR) is a novel tool for diagnosing coronary microvascular dysfunction (CMD) addressing limitation of unavailability. However, the clinical value of A-IMR remains controversial.MethodsA systematic review and meta-analysis was conducted. PubMed, EMBASE, Cochrane Library and Web of Science were searched for relevant studies. Studies that reported estimates of A-IMR's diagnostic accuracy (with thermodilution-based IMR as the reference test) and/or predictions of adverse cardiovascular events were selected. Pooled sensitivity, specificity, area under the summary receiver operating characteristic curve (sROC) were calculated to measure diagnostic performance; pooled hazard/risk ratio (HR/RR) and 95% confidence interval (95% CI) of major adverse cardiovascular events (MACE) or other independent adverse events were calculated to measure prognostic effect. This study was registered with PROSPERO (CRD42023451884).ResultsA total of 12 diagnostic studies pooling 1,642 vessels and 12 prognostic studies pooling 2,790 individuals were included. A-IMR yielded an area under sROC of 0.93 (95% CI: 0.91, 0.95), a pooled sensitivity of 0.85 (95% CI: 0.79, 0.89) and a pooled specificity of 0.89 (95% CI: 0.83, 0.93) for the diagnosis of CMD. CMD diagnosed using A-IMR was associated with higher risks of MACE (HR, 2.73, 95% CI: 2.16, 3.45), CV death (RR, 2.39, 95% CI: 1.49, 3.82) and heart failure hospitalization (HR, 2.30, 95% CI: 1.53, 3.45).ConclusionA-IMR demonstrated high diagnostic accuracy for CMD and showed a strong prognostic capability in predicting the risk of adverse CV outcomes.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023451884, PROSPERO (CRD42023451884).

Background The management of atrial fibrillation (AF) with oral anticoagulants (OAC) is generally recommended to reduce the risk of stroke. However, the decision to prescribe these medications for patients with AF and dementia remains controversial. Methods A systematic review and meta-analysis of retrospective cohort studies were conducted. The search encompassed PubMed, Cochrane Library, Web of Science, and Embase databases from inception until May 1st, 2023, with language limited to English. Eligible studies included comparisons between exposure to OAC vs. non-OAC in the AF population with dementia or cognitive impairment. Studies that compared the effects of direct oral anticoagulants (DOAC) and vitamin-K antagonists were also included. The primary outcome was all-cause mortality, and the secondary outcomes were ischemic stroke and major bleeding. This study was registered with PROSPERO (No. CRD42023420678). Results A total of five studies ( N = 21,962 patients) met the eligibility criteria and were included in this review. The follow-up duration ranged from 1 to 4 years. Meta-analysis demonstrated that OAC treatment was associated with a lower risk of all-cause mortality in AF patients with dementia with a hazard ratio (HR) of 0.79 and a 95% confidence interval (CI) ranging from 0.68 to 0.92, compared to non-OAC treatment. No statistical differences were observed in the risk of major bleeding (HR = 1.12, 95% CI: 0.88–1.42) or ischemic stroke (HR = 0.77, 95% CI: 0.58–1.00). Three studies reported comparisons between DOAC and warfarin; however, pooled analysis was not performed due to heterogeneity. Conclusion The use of OACs in individuals diagnosed with both AF and dementia holds the potential to reduce all-cause mortality rates, thereby improving the overall clinical prognosis within this specific population. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023420678 , PROSPERO identifier, CRD42023420678.

Aims: The objective of this study was to assess the efficacy and potential mechanisms of Chinese herbal medicine (CHM) for treating coronary heart disease (CHD) patients with anxiety or depression.Methods: A systematic literature search was performed. Screening studies, extracting data, and assessing article quality were carried out independently by two researchers. The active ingredients of CHM for the treatment of CHD with anxiety or depression were analyzed by the network pharmacology, and the main potential mechanisms were summarized by the database of Web of Science.Results: A total of 32 studies were included. The results showed that compared with the blank control groups, CHM was more beneficial in treating anxiety or depression in patients with CHD [anxiety: OR = 3.22, 95% CI (1.94, 5.35), p < 0.00001, I2 = 0%; depression: OR = 3.27, 95% CI (1.67, 6.40), p = 0.0005, I2 = 0%], and the efficacy of CHM was not inferior to that of Western medicine (WM) [anxiety: OR = 1.58, 95%CI (0.39, 6.35), p = 0.52, I2 = 67%; depression: OR = 1.97, 95%CI (0.73, 5.28), p = 0.18, I2 = 33%,]. Additionally, CHM also showed a significant advantage in improving angina stability (AS) in CHD patients with anxiety or depression compared with blank groups [anxiety: SMD = 0.55, 95%CI (0.32, 0.79), p < 0.00001, I2 = 0%; depression: p = 0.004] and WM groups [anxiety: SMD = 1.14, 95%CI (0.80, 1.47), p < 0.00001, I2 = 0%; depression: SMD = 12.15, 95%CI (6.07, 18.23), p < 0.0001, I2 = 0%]. Angina frequency (AF) and electrocardiogram (ECG) analysis after using CHM demonstrated similar trends. Based on the network pharmacology, quercetin, kaempferol, luteolin, beta-sitosterol, puerarin, stigmasterol, isorhamnetin, baicalein, tanshinone IIa, and nobiletin were most closely and simultaneously related to the pathological targets of CHD, anxiety, and depression. The main underlying mechanisms might involve anti-damage/apoptosis, anti-inflammation, antioxidative stress, and maintaining neurotransmitter homeostasis.Conclusion: CHM exhibited an obvious efficacy in treating CHD patients with anxiety or depression, especially for improving the symptom of angina pectoris. The most active compounds of CHM could simultaneously act on the pathological targets of CHD, anxiety, and depression. Multiple effective components and multiple targets were the advantages of CHM compared with WM.

对中医风邪病因的客观化研究进行综述.风邪在中医病因理论中有着丰富的内涵,而随着现代科学技术的发展,认识到风邪可能存在相应的物质基础,外风与气象因素中的异常风速以及自然界的病原微生物、过敏源等密切相关,内风则与机体炎性因子具有内在一致性,也与免疫系统有重要联系.

Background: Intractable epilepsy (IE) is still a major concern in neurology, and existing therapies do not adequately control symptoms. Chinese Herbal Medicine (CHM) has been widely used as an adjunct to antiepileptic drugs (AEDs) for IE. However, because of the contradictory findings reported in previous studies, it is uncertain if the present evidence is robust enough to warrant its usage. The purpose of this meta-analysis was to systematically evaluate the efficacy of the combination of CHM and AEDs for IE.Methods: From inception to September 2021, Medline, Ovid, Embase, Cochrane Library, Chinese Biomedical Database, China National Knowledge Infrastructure, VIP Database, and Wanfang Database were searched. Only randomized controlled trials (RCTs) that assessed the efficacy of the combination of CHM and AEDs for IE were included. We defined monthly seizure frequency as the primary outcome. The secondary outcomes included the abnormal rate of electroencephalogram (EEG), seizure duration, quality of life (QoL), and adverse events (AEs).Results: Twenty studies with 1,830 patients were enrolled. Most trials had poor methodological quality. The meta-analysis showed that the combination of CHM and AEDs was more efficient than AEDs alone in reducing monthly seizure frequency [MD = -1.26%, 95% CI (-1.62, -0.91); p < 0.00001], the abnormal rate of EEG [RR = 0.66%, 95% CI (0.53, 0.82); p = 0.0002], and improving the QoL [MD = 6.96%, 95% CI (3.44, 10.49); p = 0.0001]. There was no significant difference in seizure duration between groups. Moreover, the combination of CHM and AEDs significantly reduced the AEs [RR = 0.45%, 95% CI (0.32, 0.64); p < 0.00001].Conclusion: The combination of CHM and AEDs could improve seizure control by reducing monthly seizure frequency and abnormal rate of EEG with a decreased risk of adverse events in patients with IE. However, these findings must be interpreted carefully due to the high or uncertain risk of bias in the included trials. To provide stronger evidence for the use of CHM combined with AEDs in IE, high-quality RCTs will be urgently warranted in the future.

Objectives: Wuling capsule has been used in treatment of insomnia disorder in China for decades, but the reported treatment efficacy of different studies was not consistent. This study intended to evaluate the efficacy and safety of Wuling capsule for insomnia disorder, so as to provide evidence for clinical application. Methods: Eight databases (MEDLINE, EMBASE, Ovid, Cochrane Library, Chinese National Knowledge Infrastructure, VIP information database, Chinese Biomedical Database and Wanfang) were searched from inception to September 14, 2021. Randomized controlled trials (RCTs) comparing Wuling capsule with controls in adults with insomnia disorder were eligible. The primary outcome was sleep quality assessed by Pittsburgh Sleep Quality Index (PSQI), and the secondary outcomes were severity of insomnia disorder measured by Sleep Dysfunction Rating Scale (SDRS) and adverse events. This study was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0. Results: Nineteen RCTs with a total of 1850 participants were included. In terms of sleep quality assessed by PSQI, Wuling capsule significantly lowered PSQI score (MD:-1.92, 95% CI: [-2.34,-1.50], P < 0.00001, I-2 = 95%) compared to controls, and the effect of Wuling capsule was significantly better than control no matter when Wuling capsule as monotherapy (MD:-1.71, 95% CI: [-2.33,-1.09], P < 0.00001, I-2 = 97%) or as adjunctive therapy (MD:-2.10, 95% CI: [-2.66,-1.55], P < 0.00001, I-2 = 90%). Wuling capsule was more effective for the treatment duration lasted 8 weeks (MD:-2.57, 95% CI: [-3.52,-1.62], P < 0.00001, I-2 = 93%) than 4 weeks (MD:-1.68, 95% CI: [-2.13,-1.22], P < 0.00001, I-2 = 95%). In terms of severity of insomnia disorder measured by SDRS, Wuling capsule significantly reduced SDRS score (MD:-4.21, 95% CI: [-4.95,-3.46], P < 0.00001, I-2 = 0%) compared to benzodiazepines. Wuling capsule significantly reduced adverse events compared to controls (RR: 0.47, 95% CI: [0.34, 0.65], P < 0.00001, I-2 = 43%). Conclusion: Wuling capsule can safely and effectively improve sleep quality in patients with insomnia disorder. However, these findings require careful recommendation due to the high heterogeneity and high risk of bias in the included trials. Clinical trials with higher quality designs are needed. (c) 2022 The Authors. Published by Elsevier B.V.

Graphical AbstractA systematic review and meta-analysis was performed to investigate the effect of sodium-glucose cotransporter 2 inhibitors for heart failure with preserved ejection fraction.

Background: Lipid-lowering therapy is very important in secondary prevention of coronary heart disease (CHD). In many clinical trials, it has been found that Sodium Tanshinone IIA Sulfonate Injection (STS) have a lipid-lowering effect while reducing major cardiovascular events in patients with CHD. However, up to now, there is no system review on the effectiveness and safety of STS affecting blood lipids.Purpose: The aim of this review is to systematically assess the effects of STS on blood lipid levels in patients with CHD.Methods: Until Mar 2021, five databases (PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Database) were searched for randomized controlled trials (RCTs) about STS treating patients with CHD. Risk bias was assessed for included studies according to Cochrane handbook. The primary outcome was total cholesterol (TC). The secondary outcomes were triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and adverse events (AEs).Results: A total of 27 trials including 2,445 CHD patients met the eligibility criteria. Most trials had high risks in random sequence generation, allocation concealment, blinding of patients and personal, blinding of outcome assessment. Meta-analysis showed that STS significantly reduced plasma TC levels [MD = -1.34 mmol/l 95% CI (-1.59, -1.09), p < 0.00001, I-2 = 98%], TG levels [MD = -0.49 mmol/l 95% CI (-0.62, -0.35), p < 0.00001, I-2 = 97%], LDL-c levels [MD = -0.68 mmol/l (-0.80, -0.57), p < 0.00001, I-2 = 96%], increased HDL-c levels [MD = 0.26 mmol/l (0.15, 0.37), p < 0.00001, I-2 = 97%], without increasing the incidence of AEs [RR = 1.27 95% CI (0.72, 2.27), p = 0.94, I-2 = 0%] in patients with CHD.Conclusion: STS can safely and effectively reduce plasma TC, TG and LDL-c levels in patients with CHD, and improve plasma HDL-c levels. However, these findings require careful recommendation due to the low overall quality of RCTs at present. More multi-center, randomized, double-blind, placebo-controlled trials which are designed follow the CONSORT 2010 guideline are needed.

目的 应用超声探查帕金森病(Parkinson's disease,PD)患者和健康人群颈部迷走神经横截面积,探讨PD患者颈部迷走神经横截面积与临床特征的相关性.方法 30例PD患者为观察组,同期31例体检健康者为对照组.观察组采用统一PD评分量表Ⅲ(unified Parkinson's disease rating scale-Ⅲ,UPDRS-Ⅲ)评估运动症状.比较2组自主神经症状量表(the scales for outcomes in Parkinson's disease-autonomic,SCOPA-AUT)评分;2组均行颈部迷走神经超声探查,计算左、右侧迷走神经横截面积;Pearson相关法分析PD患者左、右侧颈部迷走神经横截面积与病程、UPDRS-Ⅲ、SCOPA-AUT评分的相关性.结果 观察组左、右侧颈部迷走神经横截面积[(0.72±0.25)、(0.82±0.31)11m12]均小于对照组[(0.99±0.13)、(1.18±0.21)mm2](P<0.05);观察组左、右侧颈部迷走神经横截面积比较差异无统计学意义(P>0.05),对照组左侧颈部迷走神经横截面积小于右侧(P<0.05).PD患者左、右侧颈部迷走神经横截面积与病程(r=-0.033,P = 0.863;r=0.097,P = 0.611)、UPDRS-Ⅲ(r=-0.145,P = 0.445;r=-0.359,P = 0.052)、SCOPA-AUT评分(r=-0.361,P=0.050;r=-0.296,P=0.113)均无相关性.结论 PD患者颈部迷走神经横截面积缩小,颈部迷走神经横截面积与病程、UPDRS-Ⅲ、SCOPA-AUT评分无相关性.

目的 探讨原发性帕金森病的关键中医证候.方法 招募的108例原发性帕金森病患者中85例完成经颅黑质超声检查,测量黑质强回声区面积(SN).应用帕金森病证候量表进行中医证候评分,将85例病例进行中医证候诊断,辨证为髓减证、阴虚证、肝风证、气虚证、内热证、肾虚证、脾虚证、阳亢证、痰浊证、血虚证、阳虚证、血瘀证、气滞证,并分为证候阳性组和证候阴性组.比较两组间黑质强回声区异常扩大(SN+)病例比例的差异,应用偏相关及Spearman相关分析中医证候与黑质强回声区面积的相关性. 结果 髓减证患者SN+占79.7％,高于非髓减证患者的36.4％ (P =0.002);肾虚证患者SN+占84.6％,高于非肾虚证患者的65.2％ (P =0.042).髓减证(r=0.276,P=0.011)、肾虚证(r=0.279,P=0.011)、痰浊证(r=0.277,P=0.011)证候积分与最大侧黑质强回声区面积(SNL)呈正相关;髓减证(r=0.297,P=0.006)、肾虚证(r=0.242,P=0.026)证候分布与SNL呈正相关. 结论 髓减证、肾虚证、痰浊证是PD的关键证候,一定程度上反映了原发性帕金森病颅内黑质区的神经病理改变.

As a noninvasive technique, transcranial sonography (TCS) of substantia nigra (SN) has gradually showed its effectiveness not only in diagnosis but also in understanding clinical features of Parkinson's Disease (PD). This study aimed to further evaluate TCS for clinical diagnosis of PD, and to explore the association between sonographic manifestations and visual hallucinations (VH). A total of 226 subjects including 141 PD patients and 85 controls were recruited. All participants received TCS. A series of rating scales to evaluate motor and non-motor symptoms were performed in PD patients. Results showed that 172 subjects were successfully assessed by TCS. The area of SN was greater in PD patients than that in controls (P < 0.001). As receiver-operating characteristic (ROC) curve analysis showed, the best cutoff value for the larger SN echogenicity size was 23.5 mm2 (sensitivity 70.3%, specificity 77.0%). Patients with VH had larger SN area (P = 0.019), as well as higher Non-Motor Symptoms Scale (NMSS) scores (P = 0.018). Moreover, binary logistic regression analysis indicated that SN hyperechogenicity (odds ratio = 4.227, P = 0.012) and NMSS scores (odds ratio = 0.027, P = 0.042) could be the independent predictors for VH. In conclusion, TCS can be used as an auxiliary diagnostic tool for Parkinson's disease. Increased SN echogenicity is correlated with VH in Parkinson's disease, possibly because the brain stem is involved in the mechanism in the onset of VH. Further studies are needed to confirm these findings.

目的 研究帕金森病睡眠障碍患者的中医证候特征. 方法 将156例帕金森病患者采用帕金森病睡眠障碍量表分为睡眠障碍组(105例)和非睡眠障碍组(51例),并采用课题组制定的帕金森病证候要素量表进行证候要素辨别,包括肾虚、脾虚、气虚、血虚、阴虚、阳虚、髓减、血瘀、阳亢、内热、痰浊、气滞和肝风13个中医证候要素.比较两组患者各证候要素积分和所占比例的差异及复合证候要素分布情况,用Logistic回归法分析各证候要素对帕金森病睡眠障碍发病的危险度.结果 睡眠障碍组阴虚占85.7％,髓减占87.6％,非睡眠障碍组分别为70.6％、66.7％,差异有统计学意义(P =0.031,P=0.004);睡眠障碍组肾虚证候要素积分为(10.62±3.46)分,非睡眠障碍组为(9.04±3.43)分,差异有统计学意义(P=0.012).睡眠障碍组阴虚+阳亢、肾虚+髓减、阴虚+髓减比例分别为63.8％、81.9％、77.1％,显著高于非睡眠障碍组的45.1％、58.8％、47.1％,差异具有统计学意义(P =0.038、P=0.003、P＜0.001).阴虚(P =0.027、OR=2.500)、髓减(P=0.003、OR=3.538)证候要素对帕金森病睡眠障碍发病具有危险性;阴虚+阳亢(P=0.028、OR =2.146)、肾虚+髓减(P =0.002、OR =3.168)、阴虚+髓减(P＜0.001、OR=3.797)对帕金森病睡眠障碍发病具有危险性.结论 帕金森病睡眠障碍的主要证候要素为阴虚、髓减,常以阴虚阳亢、肾虚髓减的复合证候形式出现,其对帕金森病睡眠障碍的发病具有危险性.

目的 探讨帕金森病合并功能性便秘的中医证候特征.方法 296例帕金森病患者依据功能性便秘诊断标准分为便秘组123例和非便秘组173例.应用帕金森病证候量表(PD-PES-13)对两组受试者进行中医证候评分.比较两组中医证候积分和各证候分布频率,并用Logistic回归法分析中医证候对帕金森病合并功能性便秘发病的危险度.结果 便秘组肾虚、气虚、阴虚、髓减、阳亢、内热、肝风的积分显著高于非便秘组(P＜0.05),肾虚、阴虚、阳亢、内热、肝风的分布频率显著高于非便秘组(P＜0.05).中医证候对帕金森病便秘危险度的分析显示,帕金森病合并功能性便秘的发生与阴虚(r=1.006,P=0.001)、阳亢(r=0.748,P=0.003)、内热(r=0.747,P=0.003)、肝风(r=0.733,P=0.008)、肾虚(r=0.516,P=0.031)具有正相关性. 结论 帕金森病合并功能性便秘患者的中医证候以阴虚、阳亢、内热、肾虚、肝风、气虚、髓减为主.

[目的]探讨帕金森病(PD)排便障碍的中医证候特征,为中医治疗PD排便障碍提供辨证论治依据.[方法]将纳入的102例PD患者,依据排便障碍诊断标准分为PD排便障碍组(44例)和非排便障碍组(58例).应用PD证候量表(PD-PES-13)对两组受试者进行中医证候评分.分析PD排便障碍的中医证候特征及其与中医证候的相关性.[结果]证候积分方面,两组均以髓减积分数值为最高,排便障碍组(9.44±5.98)分,非排便障碍组(9.18±5.60)分.经卡方检验,PD排便障碍患者脾虚比例高于非排便障碍患者(P<0.01).PD排便障碍患者中,髓减证与HOEHN&YAHR(H&Y)分级呈正相关(P<0.05);髓减证、肝风证与统一帕金森病评定量表(UPDRS)积分具有相关性(P<0.05或P<0.01).[结论]PD可能以髓减证突出.脾虚对伴发排便障碍的PD患者可能存在影响.PD排便障碍患者H&Y分级越高髓减证越重.随着UPDRS积分升高,PD排便障碍患者髓减证和肝风证逐渐加重.

[目的]系统评价中西医结合治疗帕金森病非运动症状的临床疗效与安全性.[方法]全面检索相关中英文数据库,搜集自建库至2018年7月所有中药联合西医基础治疗与西医基础治疗(和中药安慰剂)的临床随机对照试验,根据纳入标准、排除标准,选择符合标准的相关文献并提取资料,依据Cochrane Handbook对纳入的文献进行质量评价,并采用RevMan5.3软件进行Meta分析.[结果]最终纳入24篇RCT,共计1836例患者,分别采用主要指标及次要指标进行评价.结果显示:NMSS量表[MD=-6.19,95％CI=(-7.68,-4.69),Chi2=0.83,DF=3,n=302];NMS-Quest量表[MD=-2.17,95％CI=(-2.67,-1.68),n=601]UPDRS I量表,未进行Meta分析[Chi2=75.91,DF=10,n=882],UPDRS II量表[MD=-2.71,95％CI=(-3.34,-2.08),n=1164];PDQ-39量表[MD=-7.81,95％CI=(-9.97,-5.64),n=407].[结论]中西医结合治疗帕金森病非运动症状有效,且优于单纯西医基础治疗.

Objective To study the characteristics of traditional Chinese medicine ( TCM ) syndrome elements of depression in Parkinson's disease (dPD). Methods All PD patients(254 cases) were divided into depression(HAMD≥8, 135 cases)and non-depression(HAMD<8, 119 cases) groups according to the scores of Hamilton depression rating scale( HAMD) . TCM syndrome elements of two groups were diagnosed by the pattern element scale of PD( PD-PES-13) . The differences in the integral and ratio of TCM syndrome factors in the 2 groups were compared, and the risk degree of TCM syndrome factors on the incidence of dPD was calculated by Logistic regression. Results Compared with the non-depression group, the ratio of yin deficiency syndrome, internal heat syndrome and qi stagnation syndrome in the de-pression group were significantly higher than those in the non depression group ( P<0.05) . The score of yin deficiency syndrome, internal heat syndrome, qi stagnation syndrome and medullary reduction were significantly higher than those of non depression group (P<0.05). The risk degree of TCM syndrome ele-ments to dPD shows that the occurrence of dPD was positively correlated with yin deficiency syndrome ( r=0.518, P=0. 043 ) , internal heat syndrome ( r=0. 712, P=0. 007 ) and qi stagnation syndrome (r=0.716, P=0.014), OR value was 1.679, 2.038 and 2.016 respectively. Conclusions The major TCM syndrome elements of dPD are yin deficiency, internal heat, qi stagnation and medullary reduction , and the first three could increase the risk of dPD.

目的 调查医学高校非直属教学医院学生学校归属感现状,以北京中医药大学为例,通过与直属教学医院学生学校归属感进行比较统计分析,并提出相关建议.方法 通过对北京中医药大学在读2014—2016级专业学位研究生整群抽样,采用问卷调查、调研采访等形式展开,运用SPSS 20.0软件进行统计分析.结果 非直属教学医院学生学校归属感(61.08±10.66)比直属教学医院学生学校归属感(67.99±10.40)低(P<0.05).结论 非直属教学医院学生学校归属感较低,与学校、教学医院、自身密切相关,学校、教学医院可以通过政策保障、条件保障等增强非直属教学医院学生学校归属感,非直属教学医院的学生亦需要通过自身努力获得更高的学校归属感.