肺结节活检病理分型与中医体质、证型的相关性分析OA

Objective To investigate the correlation between the pathological types of pulmonary nodules identified by biopsy and traditional Chinese medicine(TCM)constitution and syndrome types.Methods A total of 103 patients with pulmonary nodules admitted to the General Hospital of North China Petroleum Administration Bureau between March 2023 and February 2025 were selected.Based on biopsy results,they were divided into a benign group(inflammatory granuloma,hamartoma;n=41)and a malignant group(adenocarcinoma,squamous cell carcinoma;n=62).The distribution of TCM constitutions and syndrome types in both groups was analyzed.Multivariate Logistic regression was used to analyze the correlation between pathological types and TCM constitutions/syndrome types.Spearman correlation test was employed to analyze the correlation between different pathological subtypes and TCM constitutions/syndrome types.Results(1)Regarding pathological types,in the malignant group,adenocarcinoma and squamous cell carcinoma accounted for 85.48%(53/62)and 14.52%(9/62),respectively;in the benign group,inflammatory granuloma and hamartoma accounted for 73.17%(30/41)and 26.83%(11/41),respectively.(2)Regarding TCM constitutions,the malignant group was predominantly characterized by phlegm-damp constitution and blood stasis constitution,both being significantly higher than in the benign group(phlegm-damp constitution:38.71%vs.14.63%,χ2=6.930,P＜0.01;blood stasis constitution:33.87%vs.12.20%,χ2=6.145,P＜0.05).Conversely,compared to the malignant group,the benign group had a higher proportion of patients with qi deficiency constitution and damp-heat constitution(qi deficiency constitution:29.27%vs.12.90%,χ2=4.224,P＜0.05;damp-heat constitution:21.95%vs.6.45%,χ2=5.376,P＜0.05).(3)Regarding TCM syndrome types,the proportions of qi stagnation and blood stasis syndrome and toxin-heat accumulation syndrome in the malignant group were significantly higher than those in the benign group(40.32%vs.14.63%,χ2=7.741,P＜0.01;30.65%vs.4.88%,χ2=10.095,P＜0.01,respectively),while the proportion of phlegm-damp obstructing the lung syndrome in the benign group was significantly higher than that in the malignant group(43.90%vs.14.52%,χ2=11.109,P＜0.01).(4)Multivariate Logistic regression analysis showed that phlegm-damp syndrome(OR=2.365,95%CI=1.358-4.118),blood stasis constitution(OR=1.375,95%CI=1.076-1.757),qi stagnation and blood stasis syndrome(OR=2.361,95%CI=1.132-4.924),and toxin-heat accumulation syndrome(OR=1.629,95%CI=1.094-2.425)were risk factors for malignant nodules(P＜0.05 or P＜0.01).(5)Spearman correlation analysis indicated that adenocarcinoma,squamous cell carcinoma,and inflammatory granuloma were significantly correlated with qi stagnation and blood stasis syndrome,toxin-heat accumulation syndrome,and phlegm-damp obstructing the lung syndrome,respectively(P＜0.05).Conclusion The benign or malignant nature of pulmonary nodules and their different pathological subtypes are closely related to TCM constitutions and syndrome types.Phlegm-damp constitution,blood stasis constitution,qi stagnation and blood stasis syndrome,and toxin-heat accumulation syndrome are risk factors for malignant nodules.