【摘要】 目的：系统评价肺结节患者中医体质的分布情况，探讨肺结节发病病机，为肺结节的防治决策提供循证依据。方法：检索中国知网、万方数据、重庆维普、中国生物医学文献数据库、PubMed、Cochrane Library、Web of Science和Embase数据库，检索时限均从建库至2022年1月22日。由2名研究者独立筛选文献，提取资料并评价纳入研究的文献质量。采用R软件（版本4.1.1）进行单组率Meta分析，并以率（Rate）及其95%置信区间（CI）表达效应值。结果：共纳入9项横断面研究和2项病例对照研究，样本量总计3 149例。Meta分析结果显示，气虚质、阳虚质、气郁质是肺结节患者中的主要偏颇体质，其比率分别为19%[95%CI(13%,26%)]、14%[95%CI(11%,18%)]、11%[95%CI(8%,15%)]；亚组结果显示，南方地区肺结节患者的主要偏颇体质为气虚质18%[95%CI(10%,29%)]、阳虚质14%[95%CI(10%,20%)]、气郁质13%[95%CI(10%,18%)]，北方地区为气虚质19%[95%CI(11%,32%)]、阳虚质16%[95%CI(10%,24%)]、阴虚质11%[95%CI(9%,13%)]；男性肺结节患者的主要偏颇体质为气虚质16%[95%CI(8%,29%)]、阳虚质13%[95%CI(9%,18%)]、湿热质11%[95%CI(9%,14%)]，女性为气虚质23%[95%CI(15%,34%)]、阳虚质13%[95%CI(9%,19%)]、气郁质13%[95%CI(8%,19%)]。结论：气虚、阳虚是肺结节的基本病机；补气莫忘温阳，温阳仍念补气，当是防治肺结节的重要治法；在南方及女性患者中气机郁滞是肺结节形成的重要病理因素，在男性患者中则以湿热胶着为主。受纳入研究样本量及原始文献质量等因素所限，上述结论可能存在一定的偏倚风险，有待进一步纳入更高质量的研究，从年龄、肺结节类型及危险分层等多角度深入分析。更多还原

【Abstract】 Objective: To systematically evaluate the distribution of TCM constitution in patients with pulmonary nodules, to explore the pathogenesis of pulmonary nodules, and to provide evidence-based basis for the prevention and treatment of pulmonary nodules. Methods: CNKI, Wanfang Data, Chongqing VIP, China Biomedical Literature Database, PubMed, Cochrane Library, Web of Science and Embase databases were searched from the establishment date to January 22, 2022. Two researchers independently screened the literature, extracted the data and evaluated the quality of the included studies. R software(version 4.1.1) was used for single-rate Meta-analysis, and the effect value was expressed by rate and 95% confidence interval(CI). Results: A total of 9 cross-sectional studies and 2 case-control studies were included, with a total sample size of 3 149 cases. The results of Meta-analysis showed that qi deficiency constitution, Yang deficiency constitution and qi stagnation constitution were the main biased constitutions in patients with pulmonary nodules, and the ratios were 19% [95%CI(13%, 26%)], 14%[95%CI(11%, 18%)] and 11% [95%CI(8%, 15%)], respectively. The results of the subgroup showed that the main biased constitutions of patients with pulmonary nodules in the southern region were qi deficiency constitution,Yang deficiency constitution and qi stagnation constitution, with the rate of 18% [95%CI(10%, 29%)], 14% [95%CI(10%, 20%)], 13% [95%CI(10%, 18%)], and the northern region were qi deficiency constitution, Yang deficiency constitution and Yin deficiency constitution, with the rate of 19% [95%CI(11%, 32%)], 16% [95%CI(10%, 24%)],11% [95%CI(9%, 13%)], respectively. The main biased constitution of male patients with pulmonary nodules were qi deficiency constitution, Yang deficiency constitution and damp-heat constitution, with the rate of 16% [95%CI(8%, 29%)], 13% [95%CI(9%, 18%)] and 11% [95%CI(9%, 14%)], respectively. The main biased constitutions of female patients with pulmonary nodules were qi deficiency constitution, Yang deficiency constitution and qi stagnation constitution, with the rate of 23% [95%CI(15%, 34%)], 13% [95%CI(9%, 19%)] and 13% [95%CI(8%, 19%)],respectively. Conclusion: Qi deficiency and Yang deficiency are the basic pathogenesis of pulmonary nodules.Buqi should not forget to warm Yang, and warming Yang is still an important treatment for preventing and treating pulmonary nodules. Qi stagnation is an important pathological factor in the formation of pulmonary nodules in southern China and female patients, while damp-heat stagnation is the main pathological factor in male patients.Due to the sample size of included studies and quality of original literature, the above findings may be subject to some risk of bias, which needs to be further included in higher-quality studies, and analyzed in depth from the perspectives of age, type of pulmonary nodules and risk stratification.更多还原