目的 系统挖掘冠状动脉微血管疾病（Coronary microvascular disease，CMVD）中医常见症状、证候要素、 临床辨证分型及用药规律，为量化CMVD 临床辨证标准、规范中医临床证候诊断及疗效评价、指导临床用药 提供参考依据。方法 分别检索中国知网（CNKI）、万方数据库（Wanfang）、维普中文期刊（VIP）、中国生物医 学文献服务系统（SinoMed）自建库至2023 年5 月16 日有关中医药治疗CMVD 的相关文献。提取纳入文献相关 信息建立数据库并对症状、证素、证型、中药进行频数统计，分别采用Latern 5.0 与Rstudio 软件构建隐结构 模型进行综合聚类与关联规则分析，探讨中医药治疗CMVD 的症状特点、证素分布、常见证型及用药规律。 结果 共纳入107 篇文献，涉及证型36 个，证素17 个，症状121 个，中药143 种，推测出CMVD 的主要证 候要素为血瘀，其次为气虚、气滞、痰浊、阴虚和阳虚；主要证型为气虚血瘀证，其次为心血瘀阻证、气滞血 瘀证、痰瘀互结证、气阴两虚证等；用药以川芎、丹参、当归、黄芪为主；按功效分类主要为活血化瘀药、补 虚药、理气药。结论 CMVD 病位在心，与肝、肾相关，属本虚标实之证，血瘀贯穿本病发展的始终；治疗以 活血化瘀、通络止痛为主，并结合辨证选用补中益气、疏肝理气、祛痰散结等治法。

Abstract： Objective To systematically explore the traditional Chinese medicine （TCM） common symptoms， syndrome elements， clinical syndrome differentiation， and medication rules of coronary microvascular disease （CMVD），and to provide a reference for quantitative criteria of clinical differentiation of CMVD，specification of the diagnosis and efficacy evaluation of TCM clinical syndrome， and guidance of clinical medication. Methods The databases including CNKI， Wanfang， VIP， and SinoMed were searched for research papers on the treatment of CMVD by TCM published from database inception to May 16，2023. Relevant information of the included literature was extracted and the database was established. Then， the frequency statistics of symptoms， syndrome elements， syndrome types and Chinese medicinals were carried out. Latent structural models were constructed using Latern 5.0 and Rstudio softwares respectively for comprehensive clustering and association rule analysis， so as to explore the symptom characteristics， syndrome elements distribution， common syndromes and medication rules for TCM treatment of CMVD. Results A total of 107 literature were included， involving 36 syndromes， 17 syndrome elements， 121 symptoms and 143 Chinese medicinals. It was speculated that the main syndrome element of CMVD was blood stasis， followed by qi deficiency， qi stagnation， phlegm turbidity， yin deficiency and yang deficiency. The main type of syndrome was qi deficiency and blood stasis， followed by heart blood stasis obstruction， qi stagnation and blood stasis， phlegm blended with stasis， qi-yin deficiency， etc.. The main medicinals were Chuanxiong Rhizoma， Salviae Miltiorrhizae Radix et Rhizoma， Angelica Sinensis Radix and Astragali Radix. The medicinals used in the treatment of CMVD were classified as blood-activating and stasis-resolving drugs，deficiencytonifying drugs，qi-regulating drugs in terms of their efficacy. Conclusion The location of CMVD is in heart，and related to liver and kidney. The syndrome of CMVD is deficiency in origin and excess in superficiality. Blood stasis runs through the development of the disease. The treatment is mainly to activate blood circulation and remove stasis， activate meridians and relieve pain，which should be supplemented with the therapies of tonifying and invigorating qi， soothing the liver and regulating qi， dispelling phlegm and dissipating masses according to the patients’ syndromes.

R285.6

国家重点研发计划重点专项课题（2019YFC1710000，2019YFC1710003）；国家自然科学基金项目（82074226）；国家中医药管理局中医药 循证能力建设项目（2019XZZX-XXG003）。