北京中医药大学学报2026，Vol.49Issue(7)：968-978,11.DOI:10.3969/j.issn.1006-2157.2026.07.010
1 989例代谢综合征患者中医证候分布及合并症相关性分析
Distribution of traditional Chinese medicine syndromes in 1,989 patients with metabolic syndrome and correlation analysis of comorbidities
摘要
Abstract
Objective To investigate the distribution characteristics of traditional Chinese Medicine(TCM)syndromes among patients with metabolic syndrome(MetS),thereby providing evidence to support the standardization of TCM syndrome differentiation and optimization of clinical management strategies.Methods A retrospective cross-sectional study was conducted,and 1,989 patients with MetS hospitalized in the comprehensive ward of Guang'anmen Hospital,China Academy of Chinese Medical Sciences,from September 2018 to September 2021 were included.Collected data included general information(sex,age,blood pressure,triglycerides,high-density lipoprotein,and fasting blood glucose),TCM four diagnostic information(symptoms/signs,pulse manifestation,and tongue manifestation),and common comorbidities(hypertension,coronary heart disease,stroke,chronic kidney disease,fatty liver disease,and heart failure).General characteristics and clinical indicators were analyzed using descriptive statistics.Descriptive and factor analyses were performed on the four diagnostic data to obtain the loading coefficients of the diagnostic information,as well as the syndrome elements of disease nature and location.Cluster analysis was used to summarize the distribution characteristics of TCM syndrome types,and binary logistic regression was applied to analyze the correlation between common comorbidities and syndrome types.Results Among the 1,989 patients with MetS,males accounted for 48.47%(964/1,989),females for 51.53%(1,025/1,989),and patients aged≥60 years accounted for 73.60%(1,464/1,989).A total of 134 items of TCM four diagnostic information were extracted.The most frequent symptoms/signs were wiry pulse(58.77%;1,169/1,989),white tongue coating(50.63%;1,007/1,989),purplish-dark tongue(49.77%;990/1,989),and greasy tongue coating(49.02%;975/1,989).Factor analysis was conducted on 38 four diagnostic information with a frequency greater than 10%.Sixteen common factors were extracted,with a cumulative variance contribution rate of 58.97%.The syndrome elements of disease location primarily involved the kidney,liver,and spleen,extending to the heart and lungs;the syndrome elements of disease nature were predominantly qi deficiency,dampness,and yang deficiency.Cluster analysis identified four main syndrome types:liver depression and spleen deficiency with phlegm-qi stagnation(43.41%;863/1,988);heart-lung qi deficiency with kidney yang insufficiency(31.79%;632/1,988);lung-kidney yang deficiency with internal retention of phlegm-fluid(19.92%;396/1,988);and qi-yin deficiency with damp-turbidity obstruction the middle jiao(4.88%;97/1,988).Correlation analysis of comorbid diseases showed that hypertension was the most common comorbid disease,followed by coronary heart disease and heart failure.Among the different syndrome types,hypertension accounted for the highest proportion in heart-lung qi deficiency with kidney yang insufficiency,liver depression and spleen deficiency with phlegm-qi stagnation,and qi-yin deficiency with damp-turbidity obstruction the middle jiao,with proportions of 49.84%(315/632),41.37%(357/863),and 49.48%(48/97),respectively.In contrast,lung-kidney yang deficiency with internal retention of phlegm-fluid had the highest proportion of heart failure,at 60.86%(241/396).Conclusion The TCM pathogenesis of MetS is characterized by root deficiency and branch excess.The disease is primarily located in kidney,the liver,and spleen,involving the heart and lungs.Its syndrome distribution centers around liver stagnation and spleen deficiency with intermingled phlegm and qi,often accompanied by qi deficiency,yang deficiency,and internal damp-turbidity retention.Furthermore,different syndromes may have specific directional associations with certain comorbidities.关键词
代谢综合征/中医证候/证素/因子分析/聚类分析Key words
metabolic syndrome/traditional Chinese medicine patterns/syndrome elements/factor analysis/cluster analysis分类
医药卫生引用本文复制引用
张斯琦,刘玥彤,陈春妹,刘鹏飞,庞蒙蒙,张并璇,宋庆桥..1 989例代谢综合征患者中医证候分布及合并症相关性分析[J].北京中医药大学学报,2026,49(7):968-978,11.基金项目
国家自然科学基金面上项目(No.82374428) （No.82374428）
中央高水平中医医院临床研究和成果转化能力提升项目(No.HLCMHPP2023040) （No.HLCMHPP2023040）
中国中医科学院广安门医院临床医学研究中心建设专项经费项目(No.2022LYJSZX05) （No.2022LYJSZX05）
北京市中医药科技发展资金项目(No.BJZYZD-2025-16) National Natural Science Foundation of China(No.82374428) （No.BJZYZD-2025-16）
