54例肺隐球菌病患者中医证型与临床指标的相关性分析OA

Objective To investigate the correlation between traditional Chinese medicine(TCM)syndrome types and clinical characteristics in patients with pulmonary cryptococcosis(PC).Methods A retrospective study was conducted.Data were collected from 54 patients initially diagnosed with PC at the First Affiliated Hospital of Guangzhou University of Chinese Medicine between January 2019 and August 2025,including general demographics,TCM four-examination information,laboratory findings,and chest high-resolution computed tomography(HRCT)results.A database was established,and TCM syndrome types were determined.SPSS 26.0 was used to analyze the correlation between TCM syndrome types and clinical characteristics.Results(1)Among the 54 PC patients,29 were male(53.70%)and 25 were female(46.30%),with a mean age of(51.70±14.48)years.Various underlying diseases were present,most commonly hypertension,chronic liver disease,rheumatic immune diseases,and diabetes mellitus.(2)The distribution of TCM syndrome types in descending order was:wind-heat invading the lung syndrome(35.19%)＞phlegm-heat obstructing the lung syndrome(22.22%)=spleen-kidney yang deficiency syndrome(22.22%)＞phlegm-dampness accumulating in the lung syndrome(20.37%).(3)Age:Patients in the spleen-kidney yang deficiency group were significantly older than those in the phlegm-heat obstructing the lung group,the difference being statistically significant(P＜0.01).Body mass index(BMI):Patients in the spleen-kidney yang deficiency group had significantly lower BMI compared to those in the phlegm-dampness accumulating in the lung group and wind-heat invading the lung group,the difference being statistically significant(P＜0.05 or P＜0.01).No significant differences were observed among the different TCM syndrome types regarding sex,height,or body weight(P＞0.05).(4)Laboratory findings:Hemoglobin(Hb)levels in the wind-heat invading the lung group were significantly lower than those in the phlegm-heat obstructing the lung group and phlegm-dampness accumulating in the lung group,the difference being statistically significant(P＜0.05).Total bilirubin(TBIL)levels in the spleen-kidney yang deficiency group were significantly higher than those in the wind-heat invading the lung group,the difference being statistically significant(P＜0.05).No significant differences were found among TCM syndrome types in white blood cell count(WBC),lymphocyte count(LYM),neutrophil count(NE),neutrophil-to-lymphocyte ratio(NLR)platelet count(PLT),activated partial thromboplastin time(APTT),alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transferase(GGT),total protein(TP),albumin(ALB),serum creatinine(CREA),or blood urea nitrogen(BUN)(P＞0.05).(5)Imaging findings:The proportion of mixed-type lesions on chest HRCT was significantly higher in the phlegm-heat obstructing the lung group than in the phlegm-dampness accumulating in the lung group,the difference being statistically significant(P＜0.05).No significant differences were observed among TCM syndrome types in the number or location of lesions(P＞0.05).Conclusion The pathogenesis of pulmonary cryptococcosis is primarily characterized by healthy qi deficiency,with"heat"and"phlegm-dampness"being the main pathological factors.Spleen-kidney yang deficiency serves as both an underlying cause and a determinant of disease progression.When applying TCM differentiation and treatment for pulmonary cryptococcosis,clinicians should adhere to the pathogenesis,adopt a dynamic syndrome differentiation approach,and prescribe accordingly.Furthermore,objective modern medical indicators are correlated with TCM syndrome types of pulmonary cryptococcosis and may serve as useful references in clinical syndrome differentiation to improve diagnostic accuracy.