不同中医证型甲状腺结节患者C-TIRADS 分级的关联性分析

Correlation Analysis Between C-TIRADS Classification and Different Traditional Chinese Medicine Syndrome Types in Patients with Thyroid Nodule

摘要:

目的：分析不同中医证型甲状腺结节与中国甲状腺成像报告和数据系统（C-TIRADS） 分级的相关性，为甲状腺结节患者中医辨证提供客观参考依据。方法：选取2024年1—12月于赣南医学院第一附属医院接受甲状腺超声检查且被确诊为甲状腺结节的320例患者为研究对象。比较分析320例甲状腺结节患者性别、中医证型与C-TIRADS分级分布情况，分析甲状腺结节不同中医证型与C-TIRADS分级之间的相关性。结果：纳入320例甲状腺结节患者中男89例（27.8%），女231例（72.2%）；肝郁痰凝型占126例（39.4%）、阴虚内热型占82 例（25.6%）、痰瘀互结型占67 例（20.9%）、脾肾阳虚型占45 例（14.1%）； C-TIRADS 分级2 级占78 例（24.4%）、3级占142例（44.4%）、4级占82例（25.6%）、5级占18例（5.6%）。不同中医证型间C-TIRADS分级分布差异存在统计学意义（P＜0.05）；进一步两两比较显示，阴虚内热型患者C-TIRADS分级高于肝郁痰凝型（P＜0.05），亦高于痰瘀互结型（P＜0.05）；其余各个中医证型组间C-TIRADS分级分布比较，差异无统计学意义（P＞0.05）。甲状腺结节患者中医证型与其C-TIRADS分级之间存在显著相关性（P＜0.05）。结论：不同中医证型甲状腺结节患者C-TIRADS分级差异具有统计学意义，且中医证型与C-TIRADS分级存在显著的相关性。

Abstract:

Abstract：Objective：To analyze the correlation between different traditional Chinese medicine syndrome types and the China Thyroid Imaging Reporting and Data System （C-TIRADS） classification in patients with thyroid nodules， thereby providing an objective reference for traditional Chinese medicine syndrome differentiation in these patients ． Methods： A total of 320 patients who underwent thyroid ultrasound examination and were diagnosed with thyroid nodules at the First Affiliated Hospital of Gannan Medical University from January to December 2024 were enrolled. The gender distribution and the distribution of traditional Chinese medicine syndrome types and C-TIRADS classifications among the 320 patients with thyroid nodules were compared and analyzed． The correlation between different traditional Chinese medicine syndrome types and C-TIRADS classifications was statistically analyzed ． Results：Among the 320 patients with thyroid nodules，there were 89 males（ 27.8%） and 231 females（ 72.2%）．The distribution of traditional Chinese medicine syndrome types was as follows： liver depression and phlegm coagulation type in 126 cases （39.4%），yin deficiency and internal heat type in 82 cases （25.6%），phlegm blended with blood stasis type in 67 cases（ 20.9%），and spleen and kidney yang deficiency type in 45 cases（ 14.1%）．The distribution of C-TIRADS classifications was as follows： grade two in 78 cases （24.4%）， grade three in 142 cases （44.4%）， grade four in 82 cases （25.6%），and grade five in 18 cases （5.6%）．There was a statistically significant difference in the distribution of C-TIRADS classifications among different traditional Chinese medicine syndrome types （P＜0.05）． Further pairwise comparisons showed that the C-TIRADS classification in patients with yin deficiency and internal heat type was higher than that in patients with liver depression and phlegm coagulation type （P＜0.05） and also higher than that in patients with phlegm blended with blood stasis type （P＜0.05）；no statistically significant differences were found in the distribution of C-TIRADS classifications among the other traditional Chinese medicine syndrome type groups （P＞ 0.05）． There was a significant correlation between traditional Chinese medicine syndrome types and C-TIRADS classifications in patients with thyroid nodules （P＜0.05）．Conclusion：There are statistically significant differences in C-TIRADS classifications among patients with different traditional Chinese medicine syndrome types of thyroid nodules， and a significant correlation exists between traditional Chinese medicine syndrome types and C-TIRADS classifications.