【目的】 研究病毒性急性肺损伤（VALI）患者的中医证候分布规律，为该病的临床规范化、精准辨证论治提供客观的参 考依据。【方法】 回顾性收集 2021年 7月至 2024年 8月期间在广州中医药大学东莞医院（东莞市中医院）呼吸与危重症医学科 住院诊治的222例VALI患者的一般资料及中医四诊信息，提取、整理后将数据录入Excel表，运用因子分析和聚类分析方法 对数据进行统计分析，归纳出VALI患者的中医证型分布规律。【结果】 对222例VALI患者的中医四诊信息进行频数分析，共 得到36个与VALI密切相关的症状或体征，其中出现频率排前10位的分别为喘息气促、咳嗽、黄脓痰、胸中烦闷、苔黄腻、 口渴欲饮、脉滑、舌红、胸痛、黄白痰。通过因子和聚类分析，最终得出4类中医证型，分别是痰热壅肺证（43.24%）、热毒 袭肺证（27.93%）、气阴两虚证（19.82%）、正虚喘脱证（9.01%）。【结论】 VALI患者的中医证候分布，实证方面以痰热壅肺证、 热毒袭肺证为主，虚证方面主要表现为气阴两虚证和正虚喘脱证。病位主要在肺脏，涉及脾、肾、心，病理因素主要为 “热”“毒”“痰”“虚”，尤以“热”“痰”为重。

Objective To investigate the distribution patterns of traditional Chinese medicine （TCM） syndromes in patients with viral acute lung injury （VALI），providing an objective reference for the clinical standardization and precise treatment based on syndrome differentiation. Methods A retrospective collection of general information and TCM four-examination information from 222 VALI patients hospitalized in the Department of Respiratory and Critical Care Medicine at Dongguan Hospital of Guangzhou University of Chinese Medicine （Dongguan Hospital of Traditional Chinese Medicine） between July 2021 and August 2024 was conducted. Data were extracted， organized，and entered into an Excel spreadsheet. Factor analysis and cluster analysis were employed for statistical analysis to summarize the distribution patterns of TCM syndromes in VALI patients. Results Frequency analysis of the TCM four-examination information from the 222 VALI patients identified 36 symptoms or signs closely related to VALI. The top 10 most frequent were wheezing and shortness of breath，cough，yellow purulent sputum，chest distress and oppression， yellow and greasy tongue coating， thirst with desire to drink， slippery pulse， red tongue，chest pain，and yellow-white sputum. Through factor analysis and cluster analysis，four TCM syndrome types were ultimately identified：phlegm-heat obstructing the lung syndrome （43.24%），heat-toxin attacking the lung syndrome （27.93%）， deficiency of both qi and yin syndrome （19.82%）， and healthy qi deficiency with panting-induced prostration syndrome（9.01%）. Conclusion The distribution of TCM syndromes in VALI patients is primarily characterized by excess syndromes such as phlegm-heat obstructing the lung syndrome and heat-toxin attacking the lung syndrome， while deficiency syndromes mainly manifest as deficiency of both qi and yin syndrome and critical qi deficiency with respiratory collapse syndrome. The disease location is mainly in the lung， involving the spleen， kidney， and heart. The key pathological factors are “heat”，“toxin”，“phlegm” and “deficiency”，with particular emphasis on “heat” and “phlegm”.

R259.631

国家自然科学基金资助项目（编号：82274381）；国家中医药传承创新科研专项基金资助项目（编号：2022QN24）