To investigate the distribution of traditional Chinese medicine (TCM) syndrome patterns in hepatolenticular degeneration (Wilson disease, WD) and to characterize their variation across different age stages and clinical classifications. A cross-sectional study was conducted on 2969 WD patients who visited the First Affiliated Hospital of Anhui University of Chinese Medicine between March 2020 and February 2025. Patients were divided into five age groups: childhood (3-<14 years), adolescence (14-<18 years), young adulthood (18-<45 years), middle age (45-<60 years), and old age (≥60 years). Meanwhile, the patients were divided into hepatic type, neurological type, other type and mixed type. Factor analysis was used to extract syndrome elements of disease location and disease nature, while cluster analysis summarized TCM syndrome patterns and analyzed their distribution across age stages and clinical classifications. The primary TCM syndrome elements of disease location in WD were the liver (65.88%),spleen (44.73%), and kidney (32.47%). The core disease nature syndrome elements were dampness (37.59%), heat pathogen (37.42%), and phlegm (32.70%), accompanied by yin deficiency (31.83%) and blood stasis (27.01%). Six TCM syndrome patterns were identified: internal retention of damp-heat (26.34%), syndrome of intermin-gled phlegm and blood stasis (24.59%), syndrome of stagnation of liver qi and spleen deficiency (20.04%), syndrome of yin deficiency of liver and kidney (16.30%), syndrome of deficiency of both qi and blood (6.87%), and syndrome of yang deficiency of spleen and kidney (5.86%). The distribution of TCM syndrome patterns showed clear age-related characteristics: childhood was predominantly characterized by internal retention of damp-heat (28.33%) and syndrome of yin deficiency of liver and kidney (19.70%); adolescence by internal retention of damp-heat (28.09%) and syndrome of stagnation of liver qi and spleen deficiency (23.41%); young adulthood by syndrome of intermin-gled phlegm and blood stasis (27.66%) and internal retention of damp-heat (26.39%); middle age mainly by syndrome of intermin-gled phlegm and blood stasis (30.33%); and old age by syndrome of yin deficiency of liver and kidney (35.71%) and syndrome of stagnation of liver qi and spleen deficiency (28.57%). Regarding clinical classification, the distribution of TCM syndrome patterns also differed: internal retention of damp-heat (35.48%) was most prevalent in the hepatic type, syndrome of intermin-gled phlegm and blood stasis (36.52%) predominated in the neurological type, while the mixed type exhibited a complex pattern with co-occurrence of syndrome of intermin-gled phlegm and blood stasis (27.97%), internal retention of damp-heat (24.09%), and syndrome of stagnation of liver qi and spleen deficiency (21.70%). The distribution of TCM syndromes in WD exhibits significant age-stage characteristics and a correspondence with clinical classification. This study preliminarily establishes an age stage-syndrome pattern and clinical classification-syndrome pattern dual-dimensional differentiation reference framework for WD. 目的: 探讨肝豆状核变性（又称“威尔逊病”，WD）中医证候分布规律及其在不同年龄分期及临床分型中的分布特征。方法: 采用横断面研究方法，收集2020年3月至2025年2月就诊于安徽中医药大学第一附属医院的2969例WD患者的临床资料，按入院年龄分为儿童期（3~<14岁）、青少年期（14~<18岁）、青年期（18~<45岁）、中年期（45~<60岁）和老年期（≥60岁）五组。同时，根据指南将患者分为肝型、脑型、其他型和混合型。运用因子分析法提取病位和病性证素，通过聚类分析法归纳中医证型，进而分析各年龄分期及临床分型的中医证候分布特征。结果: WD中医病位证素以肝（65.88%）、脾（44.73%）、肾（32.47%）为主;病性证素以湿（37.59%）、热（37.42%）、痰（32.70%）为主，阴虚（31.83%）和血瘀（27.01%）亦较为常见。共归纳出六种中医证型:湿热内蕴证（26.34%）、痰瘀互结证（24.59%）、肝郁脾虚证（20.04%）、肝肾阴虚证（16.30%）、气血两虚证（6.87%）、脾肾阳虚证（5.86%）。中医证型分布呈现明显的年龄阶段性差异:儿童期以湿热内蕴证（28.33%）、肝肾阴虚证（19.70%）为主;青少年期以湿热内蕴证（28.09%）、肝郁脾虚证（23.41%）为主;青年期以痰瘀互结证（27.66%）、湿热内蕴证（26.39%）为主;中年期以痰瘀互结证（30.33%）为主;老年期以肝肾阴虚证（35.71%）、肝郁脾虚证（28.57%）为主。不同临床分型的WD患者呈现中医证型分布差异:肝型WD以湿热内蕴证（35.48%）为主，脑型WD以痰瘀互结证（36.52%）为主，混合型WD则痰瘀互结证（27.97%）、湿热内蕴证（24.09%）及肝郁脾虚证（21.70%）并见。结论: WD中医证候分布具有明显的年龄阶段性特征以及临床分型-中医证型对应规律，有助于构建WD“年龄分期-证型”及“临床分型-证型”辨证参考体系。.
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