【目的】 探讨肺结节活检病理分型与中医体质、证型的相关性。【方法】 选取2023年3月至2025年2月期间华北石油管 理局总医院收治的 103例肺结节患者，根据活检结果分为良性组（炎性肉芽肿、错构瘤）41例和恶性组（腺癌、鳞癌）62例。 统计2组患者的中医体质、证型占比；采用多因素Logistic回归分析病理分型与中医体质、证型的相关性；采用Spearman相 关性检验分析不同病理亚型与中医体质、证型的相关性。【结果】（1）病理分型方面，恶性组腺癌、鳞癌占比分别为 85.48% （53/62）、14.52%（9/62），良性组炎性肉芽肿、错构瘤占比分别为 73.17%（30/41）、26.83%（11/41）。（2）中医体质方面，恶性 组患者以痰湿质、血瘀质为主，且均显著高于良性组（痰湿质 38.71% vs. 14.63%，χ2 =6.930，P＜0.01；血瘀质 33.87% vs.12.20%，χ2 =6.145，P＜0.05）；良性组气虚质、湿热质患者占比高于恶性组（气虚质 29.27% vs. 12.90%，χ2 =4.224，P＜ 0.05；湿热质 21.95% vs. 6.45%，χ2 =5.376，P＜0.05）。（3）中医证型方面，恶性组患者的气滞血瘀证、毒热壅结证占比显著高 于良性组（40.32% vs. 14.63%，χ2 =7.741，P＜0.01；30.65% vs. 4.88%，χ2 =10.095，P＜0.01），而良性组患者的痰湿蕴肺证占 比显著高于恶性组（43.90% vs. 14.52%，χ2 =11.109，P＜0.01）。（4）多因素 Logistic 回归分析结果显示：痰湿质（OR=2.365， 95%CI=1.358～4.118）、血瘀质（OR=1.375，95%CI=1.076～1.757）、气滞血瘀证（OR=2.361，95%CI=1.132～4.924）、毒热壅结 证（OR=1.629，95%CI=1.094～2.425）为恶性结节发生的危险因素（P＜0.05或P＜0.01）。（5）Spearman相关性分析结果显示：腺 癌、鳞癌、炎性肉芽肿分别与气滞血瘀证、毒热壅结证、痰湿蕴肺证显著相关（P＜0.05）。【结论】 肺结节良恶性及不同病理 亚型与中医体质、证型密切相关，痰湿质、血瘀质、气滞血瘀证、毒热壅结证是恶性结节发生的危险因素。

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.

R269.553

河北省中医药管理局科研项目（编号：2023349）