| 摘要: |
| [目的] 分析老年代谢综合征（MetS）患者的中医证候和证素分布规律，为该病的中医药辨治提供循证依据。[方法] 回顾性纳入2018—2021年在中国中医科学院广安门医院老年病科住院的MetS患者1 990例，采用证素辨证方法，以年龄分层比较，并运用对应分析法和Logistic回归模型评估年龄与病位、病性证素的关联。[结果] 高频证型依次为气阴两虚（16.43%）、肝肾亏虚（11.41%）、痰瘀互结（8.04%）。证素发生以气虚（47.59%）、阴虚（26.83%）占比最高。分年龄层证素分布结果显示，随年龄增加，瘀血、痰邪及虚性证素（气虚、阴虚、阳虚）占比明显。对应分析结果显示，老年组与肾、脾、肝、湿邪、热邪等证素联系密切，其中60~74岁与湿邪、热邪等实性证素联系紧密，而≥75岁则气虚、阴虚、阳虚等虚性证素凸显。老年MetS患者具有“本虚兼实”的病机特点，且随着年龄增长，本虚的病机更显著。老年变量是阴虚和热邪的独立影响因素（P<0.05）。[结论] 老年MetS患者以“本虚兼实”为特征，阴虚、气虚、阳虚为疾病进展的关键环节，常兼痰瘀互结之象；病位多属肾、脾、肝等脏。临床治疗当以养阴、益气、补肾、健运肝脾为本，兼以化痰祛瘀为要。 |
| 关键词: 老龄化 代谢综合征 证候 证素 |
| DOI：10.11656/j.issn.1672-1519.2026.07.04 |
| 分类号:R589 |
| 基金项目:国家自然科学基金项目（82374428）；北京市中医药科技发展资金项目（BJZYZD-2025-16）；中国中医科学院科技创新工程（2022LYJSZX05）。 |
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| Distribution of traditional Chinese medicine syndromes and syndrome elements in older adults with metabolic syndrome： A retrospective single-center cross-sectional study |
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CHEN Chunmei, LIU Yuetong, LIU Pengfei, ZHANG Bingxuan, SONG Qingqiao
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Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
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| Abstract: |
| [Objective] To analyze the distribution of traditional Chinese medicine（TCM）syndromes and syndrome elements in elderly patients with metabolic syndrome（MetS），and to provide evidence-based support for TCM differentiation and treatment of this condition. [Methods] A retrospective cross-sectional study was conducted among 1 990 MetS patients who were admitted to the Department of Geriatrics，Guang’anmen Hospital，China Academy of Chinese Medical Sciences，between 2018 and 2021. Syndrome-element differentiation was applied，and patients were stratified by age for comparison. Correspondence analysis and Logistic regression models were used to evaluate the associations between age and syndrome elements related to disease location and nature. [Results] The most frequent TCM syndromes were qi-yin deficiency（16.43%），liver-kidney deficiency（11.41%），and phlegm-blood stasis interlocking（8.04%）. Among syndrome elements，qi deficiency（47.59%）and yin deficiency（26.83%）were the most prevalent. Age-stratified analyses showed that with increasing age，the proportions of blood stasis，phlegm retention，and deficiency elements（qi deficiency，yin deficiency，and yang deficiency）increased markedly. Correspondence analysis indicated that the elderly group was closely associated with syndrome elements involving the kidney，spleen，liver，dampness，and heat. Specifically，the 60~74 years old subgroup was more strongly associated with excess elements such as dampness and heat，whereas the ≥75 years old subgroup was characterized predominantly by deficiency elements，including qi，yin，and yang deficiency. Overall，elderly MetS patients exhibited a pathomechanism of“root deficiency with concomitant excess”with root deficiency becoming more prominent with advancing age. Logistic regression analysis further showed that advanced age was an independent influencing factor for yin deficiency and heat pathogen（P<0.05）. [Conclusion] Elderly patients with MetS are characterized by a TCM pathomechanism of“root deficiency with concomitant excess”in which yin deficiency，qi deficiency，and yang deficiency constitute key links in disease progression and are often accompanied by phlegm and blood stasis. The primary disease locations involve the kidney，spleen，and liver. Clinically， treatment should focus on nourishing yin，tonifying qi，reinforcing the kidney，and strengthening the liver and spleen，supplemented by therapies that resolve phlegm and dispel blood stasis. |
| Key words: aging metabolic syndrome syndrome syndrome element |
