Pathogenesis Of Pulmonary Nodules In The Main Urban Area Of Kunming And TCM Constitution Clinical Flow Study

Objective: Preliminary observations on the quality of survival of patients with pulmonary nodules in the main urban area of Kunming,analysis of the pathogenetic characteristics and exploration of the distribution pattern of TCM body masses.Methods:A clinical epidemiological survey was used to distribute questionnaires to patients with lung nodules attending the outpatient clinics of the department of respiratory and critical care medicine at the Third Affiliated Hospital of Yunnan University of Traditional Chinese Medicine,Kunming First People’s Hospital and Kunming Yan’an Hospital from November 2021 to February 2023,and to collect data on their general condition,TCM constitution and quality of survival after the patients’ informed consent;at the same time,retrospective screening was conducted to collect data from Kunming The data were divided into nodule and control groups according to the presence or absence of lung nodules and entered into Excel to establish a database.The data were collated and then statistically analysed by SPSS 26.0 software.Results: A total of 214 patients with pulmonary nodules in Kunming and 203 physical examiners without pulmonary nodules were ultimately included in this study.1.General factors: The ratio of men to women in the collected patients with pulmonary nodules was0.6:1,and the prevalence of pulmonary nodules in Kunming was higher in women compared with controls(P=0.003);the median age of patients with pulmonary nodules was49.5 years,with a higher distribution of those aged >45 years(P<0.001);in terms of marital status,a higher proportion of patients with pulmonary nodules were divorced or widowed than those with physical examinations without pulmonary nodules(P=0.004);the prevalence of body mass The prevalence of a thin or normal body mass index was higher than that of those examined without pulmonary nodules(P=0.001);the greatest proportion of patients with pulmonary nodules had blood type O(34%)and the least amount of AB(10%).The smallest proportion of the 214 patients with pulmonary nodules had a master’s degree or higher in education(5%),and the proportion increased with higher education in the bachelor’s degree or lower range;the proportion of patients with pulmonary nodules was higher among those who were retired or unemployed(P=0.002);in terms of diet,the distribution of patients with pulmonary nodules was similar between those with a light diet and those with a partial diet(0.91:1);the 214 patients with pulmonary nodules The ratio of active/passive smokers to non-smokers was 0.95:1;the ratio of patients with pulmonary nodules who exercised consistently for more than six months to those who hardly exercised was 1:1;there was no statistical difference in the overall distribution of nodules and controls with and without comorbidities;Multivariate logistic regression analysis showed that age >45 years(OR=1.664,95% CI: 1.056 to 2.623),married status(OR=2.829,95% CI=1.435 to 5.576),divorced or widowed(OR=4.129,95% CI=1.263 to 13.502),mental work(OR=2.668,95% CI=1.667 to 4.269),retired or unemployed(OR=5.443,95%CI=2.521 to11.748)were independent risk factors for developing pulmonary nodules.2.The proportion of TCM patients with pulmonary nodules,in descending order,is:qi stagnation(133,62%),yang deficiency(127,59%),qi deficiency(121,57%),dampness heat(119,56%),phlegm dampness(110,51%),blood stasis(103,48%),special(95,44%),yin deficiency(50,23%),and peaceful constitution(12,6%),with more female patients than male patients in all types of biased constitution and more males than females in the balanced;3.Survival quality: the quality of survival of patients with lung nodules without comorbidities was lower than the norm only in general health(GH)(P< 0.001).Conclusions: 1.Age > 45 years,low body mass index,normal or divorced marital status,not engaged in manual labour had a higher probability of having pulmonary nodules;the largest proportion of patients with pulmonary nodules had blood type O,the smallest proportion had education at master’s level and above.Within the educational range of bachelor’s degree and below,the higher the level of education,the greater the proportion of patients with lung nodules.2.Patients with pulmonary nodules have the following TCM constitution in descending order: qi stagnation,yang deficiency,qi deficiency,dampness heat,phlegm dampness,blood stasis,special,yin deficiency,and peaceful constitution.There were more females than males in all the biased constitutions,and more males than females in the pacified constitutions.3.Nodules have little impact on the quality of survival.Patients with no previous history of pulmonary nodules were equal to or higher than the norm in all dimensions of quality of survival,except for general health status,which was lower than the norm.