Xia Shujie, Cai Jing, Chen Jianxin, Lin Xuejuan, Chen Shujiao, Gao Bizhen, Li Candong
Syndrome Research Base of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China.
Fujian Key Laboratory of TCM Health State, Fuzhou 350122, China.
Evid Based Complement Alternat Med. 2020 Jul 7;2020:7854325. doi: 10.1155/2020/7854325. eCollection 2020.
Traditional Chinese medicine (TCM) has the characteristics of multitarget and overall regulation, which has certain advantages in preventing and treating of metabolic syndrome (MS). The aim of the present study was to evaluate the similarities and differences of TCM syndrome distribution in different age groups to promote the optimization of treatment strategies.
This study was based on a real-world survey conducted in 3 hospitals in China. There are 1262 collected cases of MS meeting the inclusion criteria, which were divided into the young group, middle-aged group, and elderly group. Factor analysis (FA) was conducted for syndrome element extraction, and -means cluster analysis was processed for syndrome type classification. Frequency analysis and Chi-square test were used to compare the syndrome characteristics of each group.
Common factors extracted were assigned to 18 syndrome elements including 11 nature syndrome elements and 7 location syndrome elements. Phlegm and dampness are the most frequent syndrome elements in general. Compared with the middle-aged group and elderly group, the young group has more obvious nature syndrome elements in heat and Qi deficiency, and location syndrome elements in the stomach. As for the middle-aged group, the frequency of location syndrome in kidney syndrome was higher than that in other groups. When it comes to the elderly group, it is shown that the symptoms of Yin deficiency and blood deficiency increase with age and the old patients may have more location syndrome elements in the lung and gallbladder.
The TCM syndrome of MS is complex in that there may be the characteristics of deficiency and excess syndrome simultaneously. The main pathological factors of MS were phlegm and dampness. Besides, MS patients at different age periods may have their own syndrome distribution features. So, it is reasonable to adhere to the method of resolving phlegm and removing dampness and, at the same time, adopt the ways of clearing heat, promoting Qi, nourishing Yin, supplementing blood as well as regulating the liver, promoting the lung, transporting the spleen, nourishing the heart, and nourishing the kidney based on the syndrome feature of MS in different age stages.
中医具有多靶点和整体调节的特点，在防治代谢综合征（MS）方面具有一定优势。本研究旨在评估不同年龄组中医证候分布的异同，以促进治疗策略的优化。
本研究基于在中国3家医院进行的一项真实世界调查。共收集到1262例符合纳入标准的MS病例，分为青年组、中年组和老年组。采用因子分析（FA）提取证候要素，采用K均值聚类分析进行证型分类。采用频数分析和卡方检验比较各组的证候特征。
提取的共同因子被归为18个证候要素，包括11个性质证候要素和7个部位证候要素。一般来说，痰湿是最常见的证候要素。与中年组和老年组相比，青年组的热证和气虚证等性质证候要素以及胃的部位证候要素更为明显。中年组中，肾系证候的部位证候出现频率高于其他组。对于老年组，阴虚和血虚症状随年龄增加，老年患者在肺和胆的部位证候要素可能更多。
MS的中医证候较为复杂，可能同时存在虚实夹杂的特点。MS的主要病理因素为痰湿。此外，不同年龄段的MS患者可能有各自的证候分布特点。因此，在坚持化痰祛湿治法的同时，根据不同年龄阶段MS的证候特点，采用清热、行气、滋阴、补血以及疏肝、宣肺、运脾、养心、补肾等治法是合理的。
