中医学报

目的:通过文献分析探讨老年肌少症的中医证候以及证素分布规律，为临床辨证论治提供理论依据。方法:检索中国知网、Pub Med以及万方数据库中有关肌少症中医证候的临床研究文献，筛选并提取文献中证素、基础证候及症状信息，应用Excel表建立数据库并进行频数分析，运用SPSS、Origin和Gephi软件进行因子、聚类及复杂网络分析。结果:最终纳入71篇文献，经标准化后获得中医证型51种，涉及病性证素14个，病位证素9个。证型分布以脾胃虚证、脾肾亏虚证为主;虚性病性证素主要为气虚、阴虚、阳虚、精亏、血虚，实性病性证素主要为湿、血瘀、热、痰;病位证素主要为脾、肾、胃、肝、经络。核心症状体征为倦怠乏力、肢体痿软、神疲、纳呆、肌肉萎缩、便溏、腰膝酸软、气短、舌淡、脉细。证素聚类为5类:脾胃气虚证、肝肾亏虚证、阴阳两虚证、湿热浸淫证、痰瘀互结证。结论:老年肌少症基本病机为脾胃亏虚，证候呈现虚实夹杂特征，以虚证为主，湿热、痰瘀为重要病理产物。

Objective: To explore the traditional Chinese medicine(TCM) syndromes and the distribution patterns of syndrome elements in elderly sarcopenia through literature analysis,providing a theoretical basis for clinical syndrome differentiation and treatment. Methods: Clinical research literature on TCM syndromes of sarcopenia was retrieved from CNKI,Pub Med,and Wanfang databases. Syndrome elements,basic syndromes and symptom information were screened and extracted from the literature. An Excel database was established and frequency analysis was performed,while factor analysis,cluster analysis,and complex network analysis were conducted using SPSS,Origin,and Gephi software. Results: A total of 71 studies were ultimately included. After standardization,51 types of TCM syndromes were identified,involving 14 pathogenic factors and 9 lesion locations. The distribution of syndromes was mainly characterized by SpleenStomach deficiency and Spleen-Kidney deficiency syndromes; deficiency-related pathogenic factors were primarily Qi deficiency,Yin deficiency,Yang deficiency,Essence deficiency,and blood deficiency,while excess-related syndrome elements were mainly Dampness,blood stasis,Heat,and Phlegm; lesion locations were mainly the Spleen,Kidney,Stomach,Liver,and meridians. Core symptoms and signs included fatigue,weakness of limbs,lassitude,poor appetite,muscle atrophy,loose stools,soreness of the waist and knees,shortness of breath,pale tongue,and thin pulse. Pathogenic factor clustering resulted in five categories: Spleen-Stomach Qi deficiency syndrome,Liver-Kidney deficiency syndrome,Yin-Yang deficiency syndrome,Damp-Heat infiltration syndrome,and Phlegm-stasis interlocking syndrome. Conclusion: The fundamental pathogenesis of sarcopenia in the elderly is Spleen-Stomach deficiency. The syndromes show a mixture of deficiency and excess in characteristics,mainly deficiency syndromes,while Damp-Heat and Phlegm-stasis are important pathological products.