The Study On The Correlation Between TMC Phlegm And Blood Stasis Syndrome And Pathological Classification Of SPN

Objective: To analyze the possible correlation between traditional Chinese medicine(TCM)phlegm and blood stasis syndrome and pathological classification of solitary pulmonary nodules(SPN),and to analyze and discussion the distribution of TCM phlegm,blood stasis and phlegm and blood stasis syndrome in benign and malignant classification of SPN,To explore the evaluation and judgment value of phlegm and blood stasis syndrome in the diagnosis of malignant lesions of SPN,To evaluate the value of sputum and phlegm syndrome in evaluating and judging the malignant lesions of SPN.By this study,we can provide ideas for the individualized TCM syndrome differentiation treatment of SPN in the future,resulting in providing basis for treatment of SPN patients in the early stage,and Chinese medicine intervention.Methods:This study cross-sectional method was applied in this study,Develop a case questionnaire,Collected patients with SPN who were admitted to the department of pulmonary disease and department of oncology in Yunnan Provincial Hospital of Traditional Chinese Medicine and Yunan Cancer Hospital,from Dec.2017 to Dec.2018.At last,The collected 132 patients with solitary pulmonary nodules confirmed by informed consent biopsy as benign or malignant and meeting the inclusion criteria were analyzed.The relevant information of SPN patient's medical record questionnaire and the data collected from the research contents were input into Excel table,and the basic information(gender,age,smoking history)of TCM syndromes,benign and malignant nodules,and patients' basic information of SPN patients,chest CT information database were established.Statistical methods were used to analyze the possible correlation between traditional Chinese medicine(TCM)phlegm and blood stasis syndrome and pathological classification of SPN patients.Results: 1.Among 132 patients with SPN,74(56.1%)were males and 58(43.9%)were females.The benign average age was 50.72±9.15 years old,and the malignant average age was 58.13±9.16 years old.49 smokers(37.1%)and 18 had smoking history(13.6%)in the past.There were significant differences in the distribution of benign and malignant in the pathological results between SPN patients' age and smoking history.2.The minimum diameter of nodules in 132 patients was 7 mm,the maximum diameter was 30 mm,the average diameter of benign nodules was 13.13±7.90 mm,and the average diameter of malignant nodules was 19.59±8.63 mm.Most of the nodules in SPN patients were located in the upper lobe,and the distribution of nodules in each lobe was 72 cases in the upper lobe,42 cases in the lower lobe,15 cases in the middle lobe and 3 cases in the hilum.There was significant difference in the distribution of benign and malignant lesions in the pathological results between SPN patients.3.The TCM syndrome types of SPN patients were phlegm syndrome in 52 cases(39.4%),blood stasis syndrome in 21 cases(15.9%),phlegm and blood stasis syndrome in 41 cases(31.1%)and non-phlegm and blood stasis syndrome in 18 cases(13.6%).59 cases(44.7%)had benign lesions and 73 cases(55.3%)had malignant lesions.There were significant differences in the distribution of benign and malignant in the pathological results between SPN patients' TCM syndrome,The probability of malignant occurrence was phlegm syndrome > phlegm-stasis syndrome > Blood Stasis Syndrome > non-phlegm-stasis syndrome.except blood Stasis Syndrome,There are significant differences in benign and malignant distribution between phlegm syndrome,phlegm and blood stasis syndrome and non-phlegm and blood stasis syndrome.4.Multivariate logistic regression analysis of 132 SPN patients with TCM syndrome.The malignant transformation of phlegm syndrome was 1.319 times of non-phlegm-stasis syndrome,1.146 times of non-phlegm-stasis syndrome.The results indicated that the phlegm syndrome > phlegm-stasis syndrome had an judgment and evaluation effect on the prediction of malignant SPN lesions.Among them,phlegm syndrome are more likely to affect the malignant transformation of nodules.5.The prediction model of malignant lesion probability of SPN was established,Used the ROC curve for analysis,When the sensitivity was 83.8%,the specificity was 82.8%,the optimal threshold was obtained.The area under the characteristic curve of the prediction model is 0.874(>0.5).The TCM phlegm and blood stasis syndrome have certain accuracy to evaluation and judgment effect in the diagnosis of malignant SPN lesions.Conclusion: 1.The age,smoking history,and nodule size of SPN patients in this study had certain evaluation value for identifying the benign and malignant SPN.2.The probability of malignant occurrence is phlegm syndrome > phlegm and blood stasis syndrome > blood stasis syndrome > non-phlegm and blood stasis syndrome,Compared with non-phlegm-stasis syndrome,except blood Stasis Syndrome,there was significant difference between each group and non-phlegm-stasis syndrome group.3.Phlegm syndrome,phlegm-stasis syndrome are positively correlated with malignanttransformation of nodules,The correlation between phlegm syndrome and malignant transformation of nodules is greater,The effect of phlegm-stasis syndrome on malignant transformation of SPN is only inferior to that of phlegm syndrome.4.Phlegm syndrome,phlegm-stasis syndrome have certain evaluation value in the evaluation and judgment of SPN malignant lesions.The predictive model of the probability of SPN malignant lesions and the ROC curve established in this study show that the Phlegm syndrome,and phlegm-stasis syndrome have certain accuracy to evaluation and judgment effect in the diagnosis of malignant SPN lesions.