【目的】探讨流行性感冒 （简称流感） 合并肺炎患者的中医证候特点，为中医药治疗流感合并肺炎提供参考。 【方法】回 顾性选取2016年1月至2023年12月于广东省中医院门诊或住院部接受治疗的流感合并肺炎患者，共189例。运用频数分析、 因子分析及聚类分析总结归纳出流感合并肺炎患者的中医证候分布规律。 【结果】（1） 临床特征方面：189例流感合并肺炎患 者中，感染甲型流感病毒162例，感染乙型流感病毒27例，同时感染甲型流感病毒和乙型流感病毒1例。其中，男性93例 （49.2%） ，女性96例 （50.8%） ；年龄分布为19～96岁，平均 （68.06 ± 19.08） 岁。 （2） 中医四诊信息方面：排前4位的临床症状 为咳嗽、发热、咳痰和疲倦；舌象方面，舌质以舌红、舌暗红、舌淡暗为主，舌苔以苔黄腻和苔白腻为主；脉象方面，以 脉滑、脉弦和脉数多见。 （3） 证候分布特征方面：因子分析结果显示，流感合并肺炎的病位以肺、脾为主，其病理因素以寒、 热、痰为主；聚类分析结果提炼出表寒里热证、痰浊内阻证和痰瘀阻肺证3种证型。 【结论】流感合并肺炎的中医证候以表寒 里热证、痰浊内阻证和痰瘀阻肺证为主，病位主要在肺和脾，寒、热、痰为其主要的病理因素，同时还要关注“瘀”这一 病理因素对流感合并肺炎患者的影响。

Objective To investigate the characteristics of traditional Chinese medicine （TCM） syndromes in patients with influenza complicated with pneumonia and to provide references for TCM treatment strategies. Methods A retrospective analysis was conducted on 189 cases of influenza complicated with pneumonia，which were treated in the outpatient or inpatient department of Guangdong Provincial Hospital of Chinese Medicine from January 2016 to December 2023. Frequency analysis，factor analysis，and cluster analysis were performed to summarize the distribution patterns of TCM syndromes in these patients. Results （1） Clinical characteristics： Among the 189 patients，162 were infected with influenza A virus，27 with influenza B virus，and 1 with co- infection of both viruses. There were 93 males （49.2%） and 96 females （50.8%） . The age of the patients ranged from 19 to 96 years，with a mean of （68.06 ± 19.08） years. （2） TCM four-examination findings：The top four clinical symptoms were cough，fever，expectoration，and fatigue. Regarding tongue manifestations，the predominant tongue colors were red，dark red，and pale with dark hue，while the primary tongue coatings were yellow greasy and white greasy. The most common pulse patterns were slippery，wiry，and rapid. （3） Syndrome distribution characteristics：Factor analysis revealed that the disease location was primarily lung and spleen，with cold，heat，and phlegm as the main pathological factors. Cluster analysis identified three distinct syndrome types： exterior cold with interior heat syndrome，phlegm-turbidity obstructing internally syndrome，and phlegm-stasis obstructing the lung syndrome. Conclusion The predominant TCM syndromes in influenza complicated with pneumonia are exterior cold with interior heat syndrome，phlegm-turbidity obstructing internally syndrome，and phlegm-stasis obstructing the lung syndrome. The disease primarily affects the lung and spleen，with cold，heat， and phlegm as the major pathological factors. Attention should also be paid to the influence of “stasis” as a pathological factor on these patients.

R259.117；R259.631

广东省重点领域研发计划项目 （编号：2022B1111020006）