摘要
【目的】探讨亚厘米肺结节(≤1 cm)手术患者中医证型与临床病理的关系。【方法】采用回顾性研究方法,选取2021年1月至2021年12月在广州中医药大学第一附属医院接受手术治疗的100例亚厘米肺结节患者作为研究对象,所有患者在院期间均接受胸部CT检查和手术治疗,术中将肺结节组织送病理检查,通过对患者术前临床中医证型和病理结果进行分析,总结两者之间的关联性。【结果】(1)100例行手术治疗的亚厘米肺结节中,前驱腺体病变40例,良性结节16例,恶性结节44例,所占比例较多者为微浸润腺癌、原位腺癌、非典型腺瘤样增生。(2)中医证型方面,无法归类型41例,阳虚气郁型28例,气郁痰瘀型12例,肝郁化火型16例,肺肝气郁型4例,肺脾气虚型7例,多种证型9例,其中以无法归类型占多数。中医症状方面,常见的临床中医症状有焦虑、胸闷、口干、口苦、畏寒喜暖等。(3)临床资料在良恶性组间的对比分析发现,患者年龄、结节密度、结节数目的差异有统计学意义(P<0.05),结节大小、性别、体质量指数(BMI)正常与否、结节所在部位的差异无统计学意义(P>0.05)。(4)良恶性组间的中医证型分布比较,差异有统计学意义(P<0.05),其中,良性组的无法归类型、阳虚气郁型占比高于恶性组,气郁痰瘀型、肝郁化火型占比低于恶性组;对可归类型与不可归类型进行比较发现,两者在良恶性组间的分布差异无统计学意义(P>0.05)。【结论】本研究100例亚厘米肺结节手术患者,病理以前驱腺体病变及恶性结节居多;多数患者无明显症状体征;中医证型方面,属于气郁痰瘀型、肝郁化火型者恶性可能性较大,无法归类型、阳虚气郁型、肺脾气虚型、肺肝气郁型者偏良性及前驱腺体病变可能性大;不排除可归类型较无法归类型恶性可能性大,还需进一步验证。
Objective To investigate the correlation of traditional Chinese medicine(TCM)syndrome types with clinical pathology in patients undergoing sub-centimeter pulmonary nodules(≤1 cm)surgery.Methods A retrospective study was conducted in 100 patients with sub-centimeter lung nodules who underwent surgery in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2021 to December 2021.All of the patients underwent chest CT examination and surgery during the hospitalization,and the lung nodule tissues were sampled during the surgery for the pathological examination.The pathological findings and the preoperative TCM syndromes were analyzed to explore their correlation.Results(1)Among the 100 patients undergoing subcentimeter pulmonary nodule surgery,40 cases of the sub-centimeter pulmonary nodules were differentiated as precursor glandular lesions,16 cases as benign nodules and 44 cases as malignant nodules,with a higher proportion of minimally invasive adenocarcinoma(MIA),adenocarcinoma in situ(AIS)and atypical adenomatous hyperplasia(AAH).(2)In terms of TCM syndrome types,41 cases of the patients were differentiated as nonclassified syndrome type,28 cases as yang deficiency and qi stagnation type,12 cases as qi stagnation and phlegm-stasis type,16 cases as stagnated liver qi transforming into fire type,4 cases as lung and liver qi stagnation type,7 cases as lung and spleen qi deficiency type,and 9 cases as complex syndrome type,of which non-classified syndrome type accounted for the majority.In terms of TCM symptoms,the common symptoms were anxiety,chest distress,dry mouth,bitter mouth,aversion to cold and preference of warmth.(3)Comparative analysis of clinical data between the benign group and malignant group showed that there were statistically significant differences in age,nodule density and nodule count between the two groups(P<0.05),while there were no statistically significant differences in nodule size,gender,body mass index(BMI)being normal or not,and nodule location(P>0.05).(
作者
向科旭
汪真辉
瞿颖
王蓓茹
沈春辉
刘艳中
吴志钰
王继勇
XIANG Ke-Xu;WANG Zhen-Hui;QU Ying;WANG Bei-Ru;SHEN Chun-Hui;LIU Yan-Zhong;WU Zhi-Yu;WANG Ji-Yong(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Dept.of Respiratory and Critical Care Medicine,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120 Guangdong,China;Dept.of Cardiothoracic and Vascular Surgery,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2022年第8期1732-1738,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
关键词
亚厘米肺结节
中医证型
临床病理
良恶性
手术治疗
sub-centimeter pulmonary nodules
traditional Chinese medicine(TCM)syndrome type
clinical pathology
benign and malignant
surgical treatment
