The development of traditional Chinese medicine (TCM) has been listed as a national development strategy with vigorous improvement of TCM service capacity in primary care institutions as the important elements, however, there are few studies on the disease spectrum of TCM in community health service institutions.

To analysis the TCM disease spectrum in outpatient clinics of contracted residents by family doctors in Shenzhen community health service centers (abbreviated as CHSC) and understand the capability of TCM in Shenzhen health centers, thus providing a theoretical basis for promoting the development of TCM in primary care in China.

From May to June 2022, the records of outpatient consultations with treatment cost of 10 Shenzhen CHSCs from 2021-01-01 to 2021-06-30 were extracted by the unified information platform of the Health Commission of Shenzhen Municipality (Hangchuang Community Health Service Center Business System) . The 385 138 records with purpose of TCM treatment, matching diagnosis and treatment costs, first diagnosis can be coded in Classification and Codes of Diseases and ZHENG of Traditional Chinese Medicine (TCD) were collected. The disease spectrum was analyzed based on the classification of disease in TCD, mainly involving department categories, specialty system classifications, and TCM disease terms.

A total of 385 138 records of TCM diagnosis and treatment were selected in this study, including 170 077 (44.16%) male cases and 215 061 (55.84%) female cases, with an average age of (36.7±9.4) years. All of the 7 TCD categories of disease spectrum were involved, including internal medicine accounting for 56.98% (219 445 cases) , pediatrics accounting for 20.56% (79 201 cases) , otolaryngology accounting for 12.45% (47 965 cases) , gynecology accounting for 7.95% (30 620 cases) , surgery accounting for 1.51% (5 797 cases) , orthopedics accounting for 0.37% (1 407 cases) and ophthalmology accounting for 0.18% (703 cases) . Apart from the specialty system classifications of tumor diseases, cancer diseases in each category, classifications of middle canthal disease, black eye disease, pupillary disease, traumatic eye disease in Ophthalmology, the disease spectrum involves all specialty system classifications in 7 categories. The cumulative diagnosis and treatment volume of several disease spectrums accounted for 90.00% of the total diagnosis and treatment in each category. The top 5 system diseases in the spectrum included respiratory system diseases accounting for 54.19% (208 701 cases) , musculoskeletal system diseases accounting for 19.05% (73 369 cases) , gynecological system diseases accounting for 7.95% (30 620 cases) , cardiovascular and cerebrovascular system diseases accounting for 7.15% (27 539 cases) , and the digestive system diseases accounting for 4.98% (19 162 cases) . Patients aged <15 years and 15-24 years mainly suffered from diseases related to the respiratory and digestive systems, and the incidence of diseases such as paralysis, dizziness, headache, insomnia, fatigue were increased with the increase of age; cold ranked the first for patients aged below 45 years, the paralysis of muscle and joint pain ranked the first for patients aged above 45 years.

The TCM diseases spectrum in Shenzhen CHSCs is wide, but the categories are relatively concentrated and single, mainly involving internal medicine, concentrating on respiratory system diseases, musculoskeletal system diseases, gynecological system diseases, cardiovascular and cerebrovascular system diseases, and digestive system diseases. It is necessary to strengthen and expand the TCM diagnosis and treatment capabilities in CHSCs to better meet diverse health needs of the residents.

中医药发展已被列为国家发展战略，大力提升基层医疗卫生机构的中医药服务能力是其中的重要内容之一，但目前鲜有针对社区卫生服务机构中医药诊疗疾病谱的研究。

分析深圳市社区健康服务中心（简称社康中心）家庭医生签约居民门诊就诊的中医诊疗疾病谱，以了解深圳市社康中心的中医药诊疗能力，为推动我国基层中医药事业发展提供理论依据。

于2022年5—6月，从深圳市卫生健康委员会统一信息平台"杭创社区健康服务中心业务系统"中提取2021-01-01至2021-06-30家庭医生签约居民在深圳市10个区社康中心门诊就诊且产生诊疗费用的记录，选取以中医诊疗为就诊目的、产生相匹配诊疗费用、第一诊断为《中医病证分类与代码》（TCD）编码诊断的诊疗记录纳入研究（n=385 138）。基于TCD中的病名分类对疾病谱进行分析，主要涉及科别类目、专科系统分类目、中医疾病名称。

纳入的385 138条诊疗记录中，男170 077人次（44.16%），平均年龄（37.5±8.2）岁；女215 061人次（55.84%），平均年龄（36.7±9.4）岁。疾病谱涵盖TCD所有7个科别类目，依次为：内科219 445条（56.98%）、儿科79 201条（20.56%）、耳鼻喉科47 965条（12.45%）、妇科30 620条（7.95%）、外科5 797条（1.51%）、骨伤科1 407条（0.37%）、眼科703条（0.18%）。除各科别类目中瘤病类、癌病类，眼科中眦病类、黑睛病类、瞳神病类、外伤眼病类外，疾病谱涵盖7个科别类目下的所有专科系统分类目。各科别类目下，数个疾病谱累计诊疗量占据该科别类目≥90.00%总诊疗量。疾病谱排名前5位系统疾病分别为呼吸系统疾病208 701条（54.19%）、肌肉骨骼系统疾病73 369条（19.05%）、妇科系统疾病30 620条（7.95%）、心脑血管系统疾病27 539条（7.15%）、消化系统疾病19 162条（4.98%）。<15岁和15~24岁患者以与呼吸道、消化道有关的疾病为主，随着年龄的增长，痹病、眩晕病、头痛病、不寐病、乏力等患者逐渐增多；45岁前以感冒病为首位疾病，45岁后以肌肉关节疼痛的痹病为首位疾病。

深圳市社康中心的中医诊疗疾病谱较广，但病种集中、单一，以内科疾病为主，疾病谱主要集中在呼吸系统、肌肉骨骼系统、妇科系统、心脑血管系统、消化系统五大类系统疾病，需要进一步提升和拓展社康中心中医诊疗能力，以更好满足居民多样化的健康需求。