【目的】 基于隐结构结合因子分析探讨超重/肥胖患者常见证候类型的分布规律，为超重/肥胖的临床辨证施治提供参 考。【方法】 基于问卷调查对超重/肥胖患者的症状、舌象、脉象进行统计分析，采用描述统计构建隐结构模型，通过综合聚 类分析得出超重/肥胖的常见中医证型，并构建中医诊断量表。【结果】（1）该研究有效问卷386份，根据描述统计结果发现， 超重/肥胖患者的中医证型分布频次从多到少依次为：脾虚湿困证、肝郁脾虚证、湿热蕴脾证、脾肾阳虚证、痰瘀互结证和 肝阴不足证。（2）聚类分析结果筛选出脾虚湿困证、肝郁脾虚证、湿热蕴脾证、脾肾阳虚证4种常见证候类型。（3）隐结构模型 结果显示5种常见证型为脾虚湿困证、肝郁脾虚证、湿热蕴脾证、脾肾阳虚证和痰瘀互结证。（4）根据常见中医证型的确定标 准，最终得到超重/肥胖5个常见证型，构建了中医诊断量表。【结论】 依据以上数据分析结果，确定了超重/肥胖患者的5种 常见证型，即脾虚湿困证、肝郁脾虚证、湿热蕴脾证、脾肾阳虚证和痰瘀互结证，并构建了中医诊断量表。该研究为进一 步建立超重/肥胖的中医证候诊断标准提供了思路。

Objective To explore the distribution patterns of common syndrome types in overweight/obese patients using latent structure analysis combined with factor analysis，providing a reference for syndrome differentiation and treatment in clinical practice. Methods A questionnaire-based survey was conducted to statistically analyze symptoms， tongue manifestations， and pulse characteristics in overweight/obese patients. Descriptive statistics were employed to construct a latent structure model，and comprehensive cluster analysis was performed to identify common traditional Chinese medicine （TCM） syndrome types in overweight/obesity patients，thereby establishing a TCM diagnostic scale. Results （1） A total of 386 valid questionnaires were included in this study. Descriptive statistics revealed the frequency distribution of TCM syndrome types in overweight/obese patients， ranked from highest to lowest as follows： spleen deficiency leading to damp encumbrance syndrome， liver depression with spleen deficiency syndrome， damp-heat accumulation in spleen syndrome， spleen-kidney yang deficiency syndrome， phlegm blended with stasis syndrome， and liver yin deficiency syndrome. （2） Cluster analysis identified four common syndromes：spleen deficiency leading to damp encumbrance syndrome，liver depression with spleen deficiency syndrome， damp-heat accumulation in spleen syndrome， and spleen-kidney yang deficiency syndrome.（3） The latent structure model demonstrated five common syndromes： spleen deficiency leading to damp encumbrance syndrome， liver depression with spleen deficiency syndrome， damp-heat accumulation in spleen syndrome， spleen-kidney yang deficiency syndrome， and phlegm blended with stasis syndrome. （4） Based on the established criteria for common TCM syndromes， five typical syndromes were ultimately identified in overweight/obesity patients， and a TCM diagnostic scale was constructed. Conclusion According to the above data analysis， five common TCM syndromes have been identified in overweight/obese patients：spleen deficiency with dampness retention syndrome，liver depression with spleen deficiency syndrome， damp-heat accumulation in spleen syndrome， spleen-kidney yang deficiency syndrome， and phlegm blended with stasis syndrome. A TCM diagnostic scale was developed accordingly， providing a foundation for further establishing diagnostic criteria for TCM syndromes of overweight/obesity.

R259.892

杭州市科技发展计划项目（编号：202204B17）；浙江省科学技术厅“尖兵、领雁”重大项目（编号：2022C03138）