肺部结节患者中医临床证候特点研究

Characteristics of clinical syndromes of traditional Chinese medicine in patients with lung nodules

目的研究肺部结节患者中医临床证候分布特点,为中医辨治肺部结节提供参考依据。方法回顾性分析2021年10月—2022年12月在广州中医药大学东莞医院呼吸科门诊及住院部治疗的318例经胸部CT检查确诊为肺部结节的患者的一般资料、临床症状以及四诊信息,运用聚类分析、因子分析方法对数据进行分析,归纳出肺部结节患者的中医证型特点和分布规律。结果肺部结节患者症状及体征通过聚类分析和因子分析后得到4个中医证型,分别为痰热郁肺证(36.47%)、肺脾气虚证(24.52%)、肺阴亏虚证(23.00%)、气滞痰凝证(16.03%)。病位在肺,可涉及脾肝。病性本虚标实,虚实夹杂。结论肺部结节中医证候虚证以肺脾气虚证、肺阴亏虚证为主,实证以痰热郁肺证、气滞痰凝证为主。其病理因素为痰热、气滞、痰凝,正气亏虚是肺部结节变化发展的主要病机。

Objective It is to study the distribution characteristics of clinical symptoms of traditional Chinese medicine(TCM)in patients with lung nodules,and to provide some references for the TCM differentiation and treatment of lung nodules.Methods The general data,clinical symptoms,and four-diagnosis information of 318 patients diagnosed with lung nodules by chest CT examination who were treated in the outpatient and inpatient departments of the Department of Respiratory Medicine of Dongguan Hospital of Guangzhou University of Chinese Medicine from October 2021 to December 2022 were retrospectively analyzed,and the data was analyzed by cluster analysis and factor analysis,to summarize the characteristics and distribution of Chinese medicine syndrome in patients with lung nodules.Results After cluster analysis and factor analysis of symptoms and signs of patients with lung nodules,4 TCM syndromes were obtained,namely phlegm-heat constraining the lung(36.47%),lung-spleen qi deficiency(24.52%),lung Yin deficiency(23.00%),and Qi stagnation and phlegm coagulation(16.03%).The disease located in the lung and may involved the spleen and liver.The nature of the disease was deficiency in origin and excess in superficiality,with complication of deficiency and excessiveness.Conclusion The deficiency syndromes of TCM syndromes of lung nodules were mainly lung-spleen qi deficiency and lung Yin deficiency,while the excessiveness syndromes were mainly phlegm-heat constraining the lung,and Qi stagnation and phlegm condensation.The main pathological factors of pulmonary nodules are phlegm-heat,Qi stagnation and phlegm coagulation,and the deficiency of healthy energy is the main pathogenesis of this disease.