【目的】 探讨强直性脊柱炎患者不同中医证候类型的分布规律及相关影响因素。【方法】 回顾性分析安徽中医药大学 附属太和中医院风湿科2022年6月至2024年3月期间收治的强直性脊柱炎患者116例，通过收集患者的临床资料以及社会人 口学特征，经Excel软件进行数据归纳整理后，总结强直性脊柱炎患者的中医证候分布规律，并探讨不同中医证型患者的首 发症状差异及可能的影响因素。【结果】（1）性别方面，116例患者中，男性80例（68.96%），女性36例（占31.04%）；饮食习 惯方面，存在过食辛辣肥甘厚腻之物的患者有55例（占47.41%），存在过食生冷之品的患者有24例（占20.69%）；既往有吸烟 史的患者 25 例（占 21.55%），有饮酒史的患者 14 例（占 12.07%）；年龄方面，116 例患者的平均发病年龄为（30.06 ± 12.68）岁，其中以 21~30岁年龄组占比最高，为 40.52%（47/116）。（2）证型分布方面，最常见的中医证候类型为肾虚湿热证， 占 84.48%（98/116）；肾虚督寒证患者较少，仅占 15.52%（18/116）。（3）首发症状方面，以中轴关节疼痛为主者有 85 例（占 73.28%），其中肾虚湿热证 76 例（占 89.41%），肾虚督寒证 9 例（占 10.59%）；以中轴加外周关节疼痛为主者有 23 例（占 19.83%），其中肾虚湿热证 15例（占 65.22%），肾虚督寒证 8例（占 34.78%）；不同证型的首发症状比较，差异均有统计学意 义（P＜0.05或 P＜0.01）。（4）影响因素方面，不同中医证型患者的年龄、性别、饮酒史、吸烟史、过食生冷之品比较，差异 均无统计学意义（P＞0.05）；而不同中医证型患者过食辛辣肥甘厚腻之品和运动情况比较，差异均有统计学意义（P＜0.05）。 【结论】 强直性脊柱炎好发于青壮年人群中，中医证型以肾虚湿热证患者占比最多，且不同中医证型患者的首发症状有所不 同，这可能与患者的饮食习惯及运动情况等有关。

Objective To investigate the distribution patterns of different traditional Chinese medicine （TCM） syndromes and their related influencing factors in patients with ankylosing spondylitis （AS）. Methods A retrospective analysis was conducted on 116 AS patients admitted to the Rheumatology Department of Taihe Traditional Chinese Medicine Hospital Affiliated to Anhui University of Chinese Medicine between June 2022 and March 2024. Clinical data and socio-demographic information were collected and organized using Excel software. The distribution patterns of TCM syndromes in AS patients were summarized， and differences in initial symptoms as well as potential influencing factors across different TCM syndrome types were explored. Results （1） Regarding gender distribution，among the 116 patients，80 were male （68.96%） and 36 were female （31.04%）. In terms of dietary habits，55 patients （47.41%） reported excessive consumption of spicy，fatty，sweet，and greasy foods，while 24 patients （20.69%） reported excessive consumption of raw and cold foods. Twenty-five patients （21.55%） had a history of smoking，and 14 patients （12.07%） had a history of alcohol consumption. The mean age of onset was （30.06 ± 12.68） years，with the highest proportion（40.52%，47/116） in the 21-30 years age group.（2） Regarding syndrome distribution，the most common TCM syndrome type was kidney deficiency with damp-heat syndrome， accounting for 84.48% （98/116），while kidney deficiency with governor vessel cold syndrome was less common， accounting for only 15.52% （18/116）.（3） Regarding initial symptoms，85 patients （73.28%） primarily presented with axial joint pain，of which there were 76 cases （89.41%） of kidney deficiency with damp-heat syndrome and 9 cases （10.59%） of kidney deficiency with governor vessel cold syndrome； 23 patients （19.83%） primarily presented with both axial and peripheral joint pain，of which there were 15 cases （65.22%） of kidney deficiency with damp-heat syndrome and 8 cases （34.78%） of kidney deficiency with governor vessel cold syndrome. Statistically significant differences were observed in the initial symptoms across different syndrome types （P＜0.05 or P＜0.01）.（4） Regarding influencing factors，no statistically significant differences were found in age，gender， history of alcohol consumption，smoking history，or excessive consumption of raw and cold foods among patients with different TCM syndrome types （P＞0.05）. However，statistically significant differences were observed in the consumption of spicy， fatty， sweet， and greasy foods and exercise habits among patients with different TCM syndrome types （P＜0.05）. Conclusion AS predominantly affects young and middle-aged adults， with kidney deficiency with damp-heat syndrome being the most common TCM syndrome type. The initial symptoms vary among patients with different TCM syndrome types，which may be related to dietary habits and exercise habits.

R259.932

安徽省科学技术厅临床医学研究转化专项基金项目（编号：202304295107020116）；安徽中医药大学科研基金资助项目（编号： 2021LCTH39，2023LCTH46）