【目的】 探讨肺结节患者临床症状及中医证候分布特征，并分析肺结节各证型的关联性。【方法】 选取 2024 年 3 月至 2025年3月在驻马店市中医院诊治的384例肺结节患者为研究对象，分析肺结节患者的临床症状和中医证候分布情况（包括 寒热辨证和病性辨证），并采用Apriori算法分析肺结节各证型的关联性。【结果】（1）高危因素方面，384例肺结节患者中，以 1 个高危因素的患者最多，共 144 例（占 37.50%），其次为无明显高危因素的患者，有 117 例（占 30.47%）。（2）结节表现方面 （包括结节数目、结节大小、结节性质、结节稳定性和新发结节等），以多发、＜10 mm、纯磨玻璃、结节稳定以及无新发结 节的患者占绝大多数。（3）临床症状方面，常见的10个症状中，以疲乏的发生率最高，为44.01%，其次是咳嗽（40.10%）、白 痰（34.38%）、烦躁苦恼（33.59%）等。（4）中医证候方面，寒热辨证的中医证候以寒热错杂证的占比最高，为63.54%；病性辨 证的中医证候以气虚证的占比最高，为 88.02%，其次是气郁证（83.07%）和痰证（70.83%）。结节大小为 10～30 mm 的寒证、 湿证占比高于结节大小＜10 mm（P＜0.05），新发结节寒热错杂证、气逆证的占比高于无新发结节（P＜0.05或P＜0.01）。（5）关 联性方面，Apriori算法分析得出，气郁证与气虚证、气郁证与寒证、气虚证与寒证关联性较强。【结论】 肺结节症状以疲乏、 咳嗽、白痰、烦躁苦恼为主，主要证候以寒热错杂证、气虚证、气郁证、痰证为主，证候分布与结节大小及新发结节有关， 常见复合证型为气郁气虚证、气郁寒证、气虚寒证。

Objective To investigate the clinical symptoms and distribution characteristics of traditional Chinese medicine （TCM） syndromes in patients with pulmonary nodules，and to analyze the associations among different TCM syndrome types. Methods A total of 384 patients with pulmonary nodules treated at Zhumadian Traditional Chinese Medicine Hospital between March 2024 and March 2025 were selected as the study subjects. The clinical symptoms and distribution of TCM syndromes （including cold-heat syndrome differentiation and disease-nature syndrome differentiation） were analyzed. The Apriori algorithm was employed to analyze the associations among different TCM syndrome types. Results （1） Regarding high-risk factors，among the 384 patients，those with one high-risk factor were the most numerous （144 cases，37.50%），followed by patients with no significant high-risk factors （117 cases， 30.47%）.（2） Regarding nodule characteristics （including nodule number，size，nature， stability，and newly-developed nodules），the vast majority of patients had multiple nodules，nodules ＜10 mm， pure ground-glass nodules，stable nodules，and no newly-developed nodules.（3） Regarding clinical symptoms， among the ten most common symptoms， fatigue had the highest incidence（44.01%）， followed by cough （40.10%），white sputum （34.38%），and irritability/distress （33.59%）.（4） Regarding TCM syndromes，cold-heat syndrome differentiation showed that the cold-heat complex syndrome accounted for the highest proportion （63.54%）. The disease-nature syndrome differentiation showed that the qi deficiency syndrome was the most prevalent （88.02%）， followed by qi stagnation syndrome （83.07%） and phlegm syndrome （70.83%）. The proportions of cold syndrome and dampness syndrome were significantly high in patients with nodule sizes of 10-30 mm compared to those with nodules ＜10 mm （P＜0.05）. The proportions of cold-heat complex syndrome and qi counterflow syndrome were significantly high in patients with newly-developed nodules compared to those without （P＜0.05 or P＜0.01）.（5） Regarding associations， the Apriori algorithm analysis revealed strong associations between qi stagnation syndrome and qi deficiency syndrome，between qi stagnation syndrome and cold syndrome， and between qi deficiency syndrome and cold syndrome. Conclusion The main symptoms in patients with pulmonary nodules are fatigue，cough，white sputum，and irritability/distress. The primary TCM syndromes are cold-heat complex syndrome， qi deficiency syndrome， qi stagnation syndrome， and phlegm syndrome. The distribution of syndromes is related to nodule size and the presence of newly-developed nodules. Common composite syndrome types include qi stagnation with qi deficiency syndrome，qi stagnation with cold syndrome， and qi deficiency with cold syndrome.

R259.639

河南省中医药拔尖人才培养项目专项课题（编号：2022ZYBJ30）