[Distribution characteristics of traditional Chinese medicine syndromes in patients with hepatolenticular degeneration across all age groups].

Abstract

Objectives: To investigate the distribution of traditional Chinese medicine (TCM) syndrome patterns in hepatolenticular degeneration (Wilson disease, WD) and to characterize their variation across different age stages and clinical classifications.

Methods: A cross-sectional study was conducted on 2969 WD patients who visited the First Affiliated Hospital of Anhui University of Chinese Medicine between March 2020 and February 2025. Patients were divided into five age groups: childhood (3-<14 years), adolescence (14-<18 years), young adulthood (18-<45 years), middle age (45-<60 years), and old age (≥60 years). Meanwhile, the patients were divided into hepatic type, neurological type, other type and mixed type. Factor analysis was used to extract syndrome elements of disease location and disease nature, while cluster analysis summarized TCM syndrome patterns and analyzed their distribution across age stages and clinical classifications.

Results: The primary TCM syndrome elements of disease location in WD were the liver (65.88%),spleen (44.73%), and kidney (32.47%). The core disease nature syndrome elements were dampness (37.59%), heat pathogen (37.42%), and phlegm (32.70%), accompanied by yin deficiency (31.83%) and blood stasis (27.01%). Six TCM syndrome patterns were identified: internal retention of damp-heat (26.34%), syndrome of intermin-gled phlegm and blood stasis (24.59%), syndrome of stagnation of liver qi and spleen deficiency (20.04%), syndrome of yin deficiency of liver and kidney (16.30%), syndrome of deficiency of both qi and blood (6.87%), and syndrome of yang deficiency of spleen and kidney (5.86%). The distribution of TCM syndrome patterns showed clear age-related characteristics: childhood was predominantly characterized by internal retention of damp-heat (28.33%) and syndrome of yin deficiency of liver and kidney (19.70%); adolescence by internal retention of damp-heat (28.09%) and syndrome of stagnation of liver qi and spleen deficiency (23.41%); young adulthood by syndrome of intermin-gled phlegm and blood stasis (27.66%) and internal retention of damp-heat (26.39%); middle age mainly by syndrome of intermin-gled phlegm and blood stasis (30.33%); and old age by syndrome of yin deficiency of liver and kidney (35.71%) and syndrome of stagnation of liver qi and spleen deficiency (28.57%). Regarding clinical classification, the distribution of TCM syndrome patterns also differed: internal retention of damp-heat (35.48%) was most prevalent in the hepatic type, syndrome of intermin-gled phlegm and blood stasis (36.52%) predominated in the neurological type, while the mixed type exhibited a complex pattern with co-occurrence of syndrome of intermin-gled phlegm and blood stasis (27.97%), internal retention of damp-heat (24.09%), and syndrome of stagnation of liver qi and spleen deficiency (21.70%).

Conclusions: The distribution of TCM syndromes in WD exhibits significant age-stage characteristics and a correspondence with clinical classification. This study preliminarily establishes an age stage-syndrome pattern and clinical classification-syndrome pattern dual-dimensional differentiation reference framework for WD.