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Cluster analysis of traditional Chinese medicine syndrome types of ankylosing spondylitis and analysis of relationship with severity
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DOI   10.11656/j.issn.1673-9043.2026.04.04
Key Words   cluster analysis;factor analysis;ankylosing spondylitis;bone metabolism
Author NameAffiliation
SONG Yuanyuan Department of Rheumatology of Traditional Chinese Medicine, The 964th Hospital, Changchun 130062, China 
RUAN Zheng Department of Rheumatology of Traditional Chinese Medicine, The 964th Hospital, Changchun 130062, China 
SUN Haidong Department of Rheumatology of Traditional Chinese Medicine, The 964th Hospital, Changchun 130062, China 
SUN Wei Department of Rheumatology of Traditional Chinese Medicine, The 964th Hospital, Changchun 130062, China 
PAN Long Department of Rheumatology of Traditional Chinese Medicine, The 964th Hospital, Changchun 130062, China 
LIU Yunguo Department of Rheumatology of Traditional Chinese Medicine, The 964th Hospital, Changchun 130062, China 
Abstract
    [Objective] To explore the clustering characteristics of traditional Chinese medicine(TCM) syndromes in ankylosing spondylitis(AS),analyze their correlation with disease severity and bone metabolism indicators,and provide a scientific basis for TCM syndrome differentiation and treatment. [Methods] A total of 160 patients diagnosed with AS at the 946th hospital from April 2023 to April 2024 were selected. Cluster analysis was used to study the four diagnostic information of the 160 AS patients to obtain the classification and distribution patterns of major TCM syndromes of AS. General data and bone mineral metabolism indicators of the patients were collected. Clinical data of AS patients with different TCM syndromes were compared. Simple correspondence analysis was performed on the relationship between AS severity and TCM syndromes. Logistic regression was used to analyze the correlation between TCM syndromes and bone metabolism indicators. Multiple regression analysis was used to analyze the relationship between bone metabolism indicators and AS severity. [Results] Different positions of the cluster dendrogram yielded different syndrome classifications. Taking 5 as the cut-off point,four syndrome types were identified:blood stasis obstructing collaterals,liver and kidney deficiency,cold-dampness obstruction,and damp-heat obstructing collaterals. Among the 160 AS patients,there were 45 cases(28.12%) of blood stasis obstructing collaterals,21 cases(13.12%) of liver and kidney deficiency,22 cases(13.75%) of cold-dampness obstruction,and 72 cases(45.00%) of damp-heat obstructing collaterals. Significant differences were observed in the levels of type Ⅰ collagen carboxyl-terminal peptide(ICTP),type Ⅰ procollagen carboxyl-terminal peptide(PICP),and osteocalcin(BGP) among the four syndrome types(P<0.05). The blood stasis obstructing collaterals syndrome did not show a bias toward any particular grade of AS severity;liver and kidney deficiency syndrome was biased toward mild severity;damp-heat obstructing collaterals syndrome was biased toward moderate severity;and cold-dampness obstruction syndrome was biased toward severe severity. Multiple regression analysis showed that ICTP,PICP,and BGP levels in AS patients were positively correlated with AS severity(P<0.05). Regression analysis of the correlation between TCM syndromes and bone metabolism indicated that blood stasis obstructing collaterals and liver and kidney deficiency syndromes were positively correlated with ICTP and PICP but negatively correlated with BGP;cold-dampness obstruction and damp-heat obstructing collaterals syndromes were positively correlated with ICTP,PICP,and BGP(P<0.05). [Conclusion] Cluster analysis shows that the TCM syndromes of AS are mainly classified into blood stasis obstructing collaterals,liver and kidney deficiency,cold-dampness obstruction,and damp-heat obstructing collaterals,which are closely related to the severity of AS.

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