目的：基于中医证素研究探讨代谢综合征的证候规律。方法：将912 例代谢综合征患者的病历资 料纳入研究。将病历资料中的中医证型拆分为病位证素与病性证素，探讨代谢综合征不同病位及兼杂病性的分 布规律以及合并症的情况，分析中医证素特征以及与性别、年龄的相关性。结果：912 例代谢综合征患者中， 糖尿病、高血压病、肥胖为常见合并症。12 种常见中医证型，出现频率从高到低依次为：湿浊瘀阻、气虚湿 热互结、脾虚湿瘀、气虚血瘀、阴虚血瘀、脾肾气虚、肝郁脾虚、脾肾阳虚、肝肾亏虚、水湿瘀阻、阴虚热 盛、肾虚血瘀。筛选出8 种常见中医证素，分别是气虚、湿、脾、瘀、阳虚、阴虚、肝、肾。病性证素按出现 频率从高到低依次为：气虚、湿、瘀、阴虚、阳虚；病位证素按出现频率从高到低依次为：脾、肾、肝。不同 性别的瘀、湿、肝、气虚证素百分比分别比较，差异均有统计学意义（P＜0.05）。性别与阴虚、气虚、瘀、肝 证素存在正相关关系（P＜0.05），与湿证素存在负相关关系（P＜0.05）。性别与阳虚、脾、肾不存在相关性。 老年患者（年龄≥65 岁） 与非老年患者（年龄＜65 岁） 的脾证素百分比比较，差异有统计学意义（P＜ 0.05）。年龄段与脾证素存在负相关关系（P＜0.05）。结论：代谢综合征为本虚标实之证，以气虚、阴虚、阳 虚为本，湿浊、瘀血为标。男性较女性更易出现湿浊证、少见肝郁证，女性较男性更易出现血瘀证，临证要注 重性别差异。非老年患者较老年患者更易出现脾虚证。
Abstract： Objective： To explore the syndrome rules of metabolic syndrome based on study of traditional Chinese medicine (TCM) syndrome elements. Methods： The medical records of 912 patients with metabolic syndrome were included in the study. Among the medical records， the TCM syndrome types were divided into disease location syndrome elements and disease-nature syndrome elements. The distribution patterns of different disease locations and concurrent diseases of metabolic syndrome，as well as the situation of complications were explored. The characteristics of TCM syndrome elements and their correlation with gender and age were analyzed. Results： Among 912 patients with metabolic syndrome， diabetes，hypertension and obesity are common complications. The frequency ranging from high to low of twelve common TCM syndrome types were： damp- turbidity stasis obstruction， accumulation of qi deficiency and damp- heat， spleen deficiency and dampness stasis， qi deficiency and blood stasis， yin deficiency and blood stasis， spleen and kidney qi deficiency， liver stagnation and spleen deficiency， spleen and kidney yang deficiency，liver and kidney deficiency，water- dampness stasis obstruction，yin deficiency and exuberant heat， and kidney deficiency and blood stasis. Eight common TCM syndrome elements were selected， namely qi deficiency， dampness， spleen， stasis， yang deficiency， yin deficiency， liver， and kidney. According to the frequency ranging from high to low， the disease- nature syndrome elements were qi deficiency，dampness，stasis，yin deficiency，and yang deficiency，and the disease- location syndrome elements were spleen， kidney， and liver. The percentages of syndrome elements including stasis，dampness，liver，and qi deficiency in different genders were compared，and the differences were statistically significant (P＜0.05). Gender had a positive correlation with yin deficiency， qi deficiency， stasis， and liver syndrome elements (P＜0.05)， and it had a negative correlation with dampness syndrome element (P＜0.05). There is no correlation between gender and yang deficiency， spleen，and kidney. There was a significant difference being found in the percentages of spleen syndrome element between elderly patients (aged≥65 years) and non- elderly patients (aged<65 years) (P＜0.05). There was a negative correlation between age group and spleen syndrome element (P＜0.05). Conclusion： Metabolic syndrome is a syndrome characterized by deficiency in the origin and excess in the superficiality， with qi deficiency，yin deficiency，and yang deficiency as the root causes，damp-turbidity and static blood as the symptoms. Men are more prone to appear damp- turbidity syndrome and less liver stagnation syndrome than women，and women are more prone to appear blood stasis syndrome. Gender differences should be emphasized in clinical practice. Non-elderly patients are more likely to develop spleen deficiency syndrome than the elderly patients.