【目的】 探索岭南地区肺结节患者的症状分布和影响因素，为系统搭建肺结节患者的症状-证素-证候-体质辨治体系、 推动中医药深入参与肺癌的二级预防体系建设提供基础数据支撑。【方法】 采用横断面研究方法，对2023年8月至2024年1月在 广州中医药大学第一附属医院就诊的肺结节患者进行调查，收集患者的基本信息、临床特征和症状分布，并采用Likert 4级 评分法对症状严重程度进行分级，运用多因素线性回归的方法，构建3个回归模型，探索影响肺结节患者症状严重程度的因素。 【结果】（1）本研究共纳入274例患者，其中女性160例、男性114例，平均年龄（54.44 ± 12.00）岁，平均症状积分（3.97 ± 3.80）分， 纳入的肺结节患者的分布呈现出女性多于男性，中老年人比例较高，多发性肺结节更为常见。（2）纳入的274例患者中，发生 率超过30%的症状有疲乏（116例，42.34%）、咳嗽（105例，38.32%）、白痰（89例，32.48%）、烦躁苦恼（87例，31.75%）。（3）全 变量调整的多因素线性回归分析提示，男性较女性的总体症状程度更轻[β = -1.67，95%CI（-2.67，-0.68），P < 0.001]，症 状积分与年龄[β = 0.07，95%CI（0.03，0.10），P < 0.001]、二手烟接触史[β = 1.27，95%CI（0.26，2.27），P = 0.015]、其他 有害物质接触史[β = 1.96，95%CI（0.39，3.53），P = 0.015]、过敏史[β = 2.38，95%CI（1.22，3.54），P < 0.001]具有显著的正相 关性。【结论】 岭南地区肺结节患者的总体症状较轻，高发症状为疲乏、咳嗽、白痰、烦躁苦恼等；患者症状的严重程度与 性别、年龄、二手烟接触史、其他有害物质接触史、过敏史等因素相关。

Objective To explore the symptom prevalence in the patients with pulmonary nodules in Lingnan area and to investigate the influencing factors，thus to provide data support for the construction of differentiation and treatment system of symptoms-syndrome elements-syndromes-constitutions for patients with pulmonary nodules，and to promote the establishment of secondary prevention system of lung cancer with the in-depth participation of traditional Chinese medicine（TCM）. Methods A cross-sectional study was adopted to investigate patients with pulmonary nodules who admitted in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from August 2023 to January 2024. Data collection covered the basic information，clinical characteristics and symptoms of the patients. Likert four-level scale was used for the grading of the severity of the symptoms，multivariate linear regression was adopted to construct three regression models， and then the factors influencing the severity of symptoms of patients with pulmonary nodules were explored. Results（1）A total of 274 patients were enrolled in the analysis， including 160 females and 114 males， with a mean age of（54.44 ± 12.00）years old and the symptom scores averaging（3.97 ± 3.80）point. The included patients with pulmonary nodules were characterized by females outnumbering males，a higher proportion of middle-aged and elderly people，multiple pulmonary nodules being more common.（2）The analysis of the symptoms of the 274 patients showed that symptoms with an incidence over 30% were fatigue（116 cases，42.34%），cough（105 cases，38.32%），expectoration of white sputum（89 cases， 32.48%）， and irritability and distress（87 cases， 31.75%）.（3）Multivariate linear regression analysis after variable adjustment suggested that the overall symptomatic severity in the male was milder than that in the female [β = -1.67，95% CI（-2.67，-0.68），P < 0.001]，and symptom score was positively correlated with age [β = 0.07， 95%CI（0.03，0.10），P < 0.001]，history of exposure to secondhand smoke [β = 1.27，95%CI（0.26，2.27）， P = 0.015]，history of exposure to other hazardous substances [β = 1.96，95%CI（0.39，3.53），P = 0.015]，and history of allergy [β = 2.38，95%CI（1.22，3.54），P < 0.001] significantly. Conclusion The overall symptoms of patients with pulmonary nodules in Lingnan area are mild， and the high prevalence of symptoms are fatigue， cough， expectoration of white sputum， and irritability and distress. The symptom severity is correlated with gender，age，history of exposure to secondhand smoke，history of exposure to other hazardous substances，and history of allergy.

R273.342

国家科技部重点研发计划项目（编号：2022YFC3500203）；国家自然科学基金面上项目（编号：81973775）；广东省自然科学基 金面上项目（编号：2020A1515011176）；广东省基础与应用基础研究基金项目（编号：2022B1515230003）；广州市科技计划项目 （2023A03J0300、2023B01J1016）；广州地区中西医协同临床重大创新技术建设项目《多模态组学在高危肺结节（早期肺癌）诊断作用及中医 药干预》