Clinical study on exploration of characteristics of traditional Chinese medicine syndromes in patients with pulmonary nodules based on DNA methylation
Objective To explore characteristics of traditional Chinese medicine syndromes in patients with pulmonary nodules based on DNA methylation,provide reference for standardization of traditional Chinese medicine syndrome and differentiation and treatment of pulmonary nodules.Methods A total of 298 patients with pulmonary nodules admitted to Wangjing Hospital,China Academy of Chinese Medical Sciences from March 2023 to March 2024 were selected as the research subjects.Based on the results of DNA methylation testing,they were divided into the positive group(95 cases)and the negative group(203 cases).Patients of the two groups were matched in 1∶1 ratio by using propensity score matching,resulting in 81 patients in each group.Nodules characteristics and clinical symptoms of patient from medical records were extracted,syndrome differentiation and factor analysis were used to summarize traditional Chinese medicine syndrome elements and name syndrome signs.Nodules characteristics and traditional Chinese medicine characteristics of the two groups were compared.Results There was no statistically significant difference in nodule size between the two groups(P＞0.05).There were statistically significant differences in nature and number of nodules between the two groups(P＜0.05).The proportion of symptoms such as yellowish complexion,emaciation,fatigue,obvious sweating,greasy coating,thin pulse,sinking pulse,loss of appetite and urinary incontinence in the positive group were higher than those in the negative group,and the differences were statistically significant(P＜0.05).The proportion of symptoms such as white sputum color,multiple and thick phlegm,dentate marks,tongue and smooth pulse in the positive group were lower than those in the negative group,and the differences were statistically significant(P＜0.05).The proportion of syndrome elements such as spleen,kidney,yin,qi deficiency,yin deficiency and yang deficiency in the positive group were higher than those in the negative group,and the differences were statistically significant(P＜0.05).There were a total of six common factors with eigenvalues more than one in the positive group,and the cumulative variance contribution rate was 80.021％;there were a total of five common factors with eigenvalues more than one in the negative group,and the cumulative variance contribution rate was 74.043％.The positive group was mainly characterized by spleen kidney(heart)weakness syndrome,while the negative group was mainly characterized by phlegm retention obstructing lung syndrome.Conclusion Pulmonary nodules have the characteristics of mixture of deficiency and excess,and patients with positive methylation are mainly deficient,and the retention of pathogens in deficiency is an important factor that promotes accumulation of toxins.In treatment,the priority is to remove excess in negative patients,while the main focus is on tonifying the positive patients.Treatment principles include supplementing qi and blood,nourishing yin and reducing fire,warming yang and dispelling cold,strengthening the spleen and eliminating dampness,and softening the liver and promoting blood circulation.
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