【目的】 探索侵袭性肺曲霉病（IPA）的中医证候特点和规律。【方法】 对广州中医药大学东莞医院 2019 年 8 月~ 2024 年 8 月诊治的 232例 IPA患者进行回顾性分析，提取患者的一般资料及中医症状信息等，制订 IPA的中医证候采集表，采用因 子分析及聚类分析，结合临床实际，探索 IPA 患者的中医证候分布规律。【结果】 232例 IPA 患者中，排除出现频率小于 5% 的中医证候因子后，共得到 42个中医证候因子，最常见的中医症状为咳嗽频作、喘息、干咳无痰或少痰、痰黏稠或脓痰、 胸满闷塞等，出现频率均在 65% 以上。 结合因子分析及聚类分析结果显示，IPA 的常见中医证型有痰热壅肺证（29.74%）、 痰湿蕴肺证（20.26%）、气阴两虚证（23.28%）、肺肾气虚证（15.09%）、虚火灼肺证（11.64%），病性为本虚标实、虚实夹杂， 病位主要在肺，与脾肾有关。【结论】 临床上IPA以痰热壅肺证最为常见，表现为本虚标实、虚实夹杂征象，在治疗上应以清 热化痰为主，随证兼用燥湿化痰、益气养阴、补肺益肾、滋阴降火之法。

Objective To explore the characteristics and distribution patterns of traditional Chinese medicine （TCM） syndromes in invasive pulmonary aspergillosis （IPA）. Methods A retrospective analysis was conducted on 232 IPA patients who were admitted at Dongguan Hospital of Guangzhou University of Chinese Medicine between August 2019 and August 2024. General clinical data and TCM symptom information were collected to establish a database of TCM syndrome for IPA. Factor analysis and cluster analysis were performed， and the results were interpreted by combining with clinical practice to investigate the distribution patterns of TCM syndromes. Results Among 232 IPA patients，42 TCM syndrome factors were identified after excluding the syndrome factors with the frequency below 5%. The common TCM symptoms of IPA were frequent cough， wheezing， dry cough without sputum or with scant sputum， thick or purulent sputum， and chest tightness and distress， all having the frequency above 65%. Integrated factor analysis and cluster analyse revealed five major TCM syndrome patterns： phlegm-heat congesting the lung syndrome （29.74%）， phlegm-damp accumulating in the lung syndrome （20.26%）， qi-yin deficiency syndrome （23.28%）， lung-kidney qi deficiency syndrome （15.09%）， and deficient-fire scorching the lung syndrome （11.64%）. The fundamental pathogenesis of IPA was characterized by deficiency in the origin and excess in the superficiality，and deficiency interweaved with excess. IPA primarily involved the lung，with secondary involvement of the spleen and kidney. Conclusion Phlegm-heat congesting the lung syndrome is the most common TCM syndrome pattern in IPA patients，reflecting a complexity of deficiency in the origin and excess in the superficiality， and deficiency interweaved with excess. Treatment of IPA should prioritize clearing heat and resolving phlegm，while adjunctive strategies such as drying dampness and resolving phlegm，tonifying qi and nourishing yin，supplementing lung and kidney，or nourishing yin to purge fire，should be tailored to specific syndrome manifestations.

R259.19

广东省自然科学基金面上项目（编号：2021A1515010146）；东莞市社会科技发展项目（编号：20231800900411）；广东省名中医 工作室建设项目（编号：粤中医办函[2018]5号）；全国第七批老中医药专家学术继承项目（编号：粤中医办函[2021]272号）