基于多中心大样本的子宫内膜异位症中医证候聚类分析及病机新探OA

Objective:In view of the current situation of vague TCM syndrome classification standards for endometriosis(EMS)and the lack of data-driven research,this study aims to reveal the distribution pattern of TCM syndromes in EMS through multi-center large sample data,combined with cluster analysis and expert consensus as well as TCM theory,and to construct a dynamic syndrome classification model.Furthermore,it aims to provide evidence-based support for precise TCM diagnosis and treatment by integrating the new pathogenesis theory of"disorder of Chong meridian-blood stasis and vessel obstruction".Methods:A cross-sectional study design was adopted,and 714 EMS patients from 7 tertiary hospitals across the country were included.A 69-item syndrome questionnaire was optimized through the Delphi method.based on frequency analysis(frequency≥15%),62 core symptoms were selected.K-means clustering algorithm(K=5 determined by the elbow method)was used for syndrome classification.Model stability was verified through Bootstrap resampling(1 000 times),and syndrome names and theoretical explanations were completed through expert consensus(consistency rate≥80%).Results:High-frequency symptoms included fatigue(56.16%),lumbar and knee weakness(51.40%),dysmenorrhea(50.00%),and cold pain in the lower abdomen(46.50%).Cluster analysis revealed five syndrome types:Cold aggregation and blood stasis syndrome(36.41%),qi Stagnation and blood stasis syndrome(22.69%),kidney deficiency and blood stasis syndrome(16.53%),qi deficiency and blood stasis syndrome(14.29%),and damp-heat and blood stasis syndrome(10.08%).Conclusion:This study constructed a dynamic TCM syndrome classification model for EMS,with five representative syndromes including cold aggregation and blood stasis syndrome.Combined with the new pathogenesis theory of"disorder of Chong meridian-blood stasis and vessel obstruction",it provides theoretical support for the standardized TCM diagnosis and accurate treatment of EMS.