| Background and Objective:With the vigorous promotion of national prevention and control of lung cancer and the gradual improvement of residents’ health awareness,low-dose CT has been widely used in lung cancer screening,and the detection rate of pulmonary nodules has increased significantly.For patients who have not undergone surgery,the waiting for regular followup review has brought varying degrees of psychological pressure to patients and even some unnecessary waste of medical resources.Traditional Chinese medicine uses syndrome differentiation and treatment combined with the holistic view to treat diseases,focusing on the combination of conditioning the body and treating diseases.However,there are many patients with pulmonary nodules without abnormal symptoms and signs in the actual clinical diagnosis and treatment process.The traditional syndrome differentiation and treatment model based on symptoms of traditional Chinese medicine is facing the situation of "no symptoms to follow,"resulting in the dilemma of "no evidence to distinguish " in clinical prescription medication.Based on the perspective of visual diagnosis of traditional Chinese medicine,this study explores the signs of eye collaterals in patients with pulmonary nodules and their clinical significance in physical identification.Modern technology is used to digitize the characteristics of eye collaterals,and the color,shape and location of eye collaterals in patients with pulmonary nodules are explored.On the basis of traditional tongue and pulse data,it is expected to provide some reference for physical identification and clinical diagnosis and treatment of patients with pulmonary nodules.Methods:This study retrospectively analyzed the physical examination information of patients who underwent the physical examination of the four diagnostic instruments and the white eye shadowless imaging examination of the visual inspection instrument in the physical examination center of the Dongfang Hospital of Beijing University of Traditional Chinese Medicine from February 2020 to March 2023.The digital eye collateral characteristics,tongue parameters,pulse parameters,and constitution of patients with pulmonary nodules were collated.The white eye collateral characteristics of patients with pulmonary nodules and non-pulmonary nodules were compared and analyzed.The patient’s physical distribution and tongue and pulse parameters of the four diagnostic instruments were analyzed to explore the correlation between white eye collaterals and constitution.Result:This study finally included 373 patients,including 235 males and 138 females;there were 177 cases in pulmonary nodule group and 196 cases in control group.The average age of the pulmonary nodule group was 51.52±12.05 years,and the average age of the control group was 52.28±4.02 years.According to the analysis of interrogation symptoms and living habits,27.1%of patients with pulmonary nodules in this study had a history of smoking,and 72.9%had no history of smoking.Statistical analysis of sedentary and exercise in patients with pulmonary nodules,daily sedentary>8h accounted for 72.3%,and daily sedentary 4-6h accounted for 4.5%;exercise frequency statistics,3-5 times a week accounted for 61.6%,while the daily exercise accounted for 16.4%;statistical analysis of the symptoms of patients found that most patients showed no obvious discomfort,followed by chills,bitter mouth and difficulty falling asleep tied for third,dry cough and palpitations tied for tenth.There was a significant difference in the characteristic score of blood vessel’ between the two groups(P=0.003).There were statistically significant differences in the color feature scores of ’dark’(P=0.046)and ’pale’(P=0.001)between the pulmonary nodule group and the control group.The difference between the pulmonary nodule group and the control group was statistically significant(P=0.028)and ’H area’(P=0.009).The analysis of physical distribution of patients found that the proportion of patients with gentleness was the highest,reaching 30%;followed by phlegm dampness 17%,Yang deficiency 16%,Qi stagnation 12%;Compared with patients with mild pulmonary nodules,there were statistically significant differences in tongue color and coating color between patients with pulmonary nodules of qi deficiency,qi stagnation,damp heat,phlegm dampness and yang deficiency,while there were statistically significant differences in coating color between patients with pulmonary nodules of yin deficiency and patients with mild pulmonary nodules.In terms of pulse parameters,the t value of patients with qi deficiency of pulmonary nodules was higher than that of patients with mild pulmonary nodules,and the h1 value,h5 value,As value and Ad value were lower than those of patients with mild pulmonary nodules.The t value and h5 value of patients with damp-heat pulmonary nodules were lower than those of patients with mild pulmonary nodules,and the t4 value,h3 value and h4 value were higher than those of patients with mild pulmonary nodules.The t value,h5 value,As value and Ad value of patients with phlegm-dampness pulmonary nodules were lower than those of patients with gentleness,and the h3 value and h4 value were higher than those of patients with gentleness.The pulse parameters t value,h5 value,As value and Ad value of patients with pulmonary nodules of blood stasis constitution were lower than those of patients with mild constitution,and their h3 value and h4 value were higher than those of patients with mild constitution.The t value,h5 value,As value and Ad value of patients with Yang deficiency were lower than those of patients with gentleness,and the h3 value and h4 value were higher than those of patients with gentleness.The t value and h5 value of patients with yin deficiency were lower than those of patients with gentleness,and the h3 value and h4 value were higher than those of patients with gentleness.There were differences in ’patch’(P<0.05)and ’hill’(P<0.05)of eye collaterals between patients with qi stagnation and patients with gentleness.There was a difference in the ’plaque’ of eye collaterals between patients with blood stasis and patients with gentleness(P<0.05).There was a correlation between the patients with pulmonary nodules of qi stagnation and the ’blood vessels’ of the eye collaterals(r=0.519,P<0.05),and there was a correlation with the ’dark color’ of the eye collaterals(r=0.444,P<0.05).There was also a correlation between the patients with pulmonary nodules of blood stasis and the ’dark’ color of eye collaterals(r=0.998,P<0.05).Conclusion:The important characteristics of eye collaterals in patients with pulmonary nodules are ’A area’ and ’H area’,which correspond to the spleen,stomach and liver of traditional Chinese medicine,suggesting that deficiency of spleen and stomach and stagnation of liver qi are important pathogenesis.There is a certain correlation between the ’blood vessel’ of eye collaterals and the patients with pulmonary nodules of qi stagnation,and there is a certain correlation between the ’dark color’ of eye collaterals and the patients with pulmonary nodules of qi stagnation and blood stasis,suggesting that the patients with pulmonary nodules of qi stagnation and blood stasis have the pathogenesis of blood stasis syndrome;the tongue parameters and pulse parameters can identify the characteristics of syndrome types of patients with different constitutions,suggesting that digital tongue and pulse information can provide some reference for the identification of TCM syndrome types. |
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