Abstract: Background　Traditional Chinese medicine（TCM） theory suggests a close relationship between syndromes and geographical regions. However，clinical research investigating regional variations in clinical characteristics and TCM syndrome distributions among lung cancer patients remains insufficient. Objective　To analyze regional differences in clinical characteristics and TCM syndrome distributions among lung cancer patients across various regions in China，providing evidence to support clinical syndrome differentiation. Methods　A cross-sectional survey was conducted，distributing questionnaires to outpatient or inpatient lung cancer patients from June 2020 to June 2024 in 11 hospitals：the Affiliated Hospital of Liaoning University of traditional Chinese medicine，Guang'anmen Hospital of the China Academy of Chinese Medical Sciences，Longhua Hospital affiliated with Shanghai University of traditional Chinese medicine，the Affiliated Hospital of Shandong University of traditional Chinese medicine，the First Affiliated Hospital of Henan University of traditional Chinese medicine，Henan Provincial Hospital of traditional Chinese medicine，Henan Cancer Hospital，the First Affiliated Hospital of Guangxi University of traditional Chinese medicine，the Second Affiliated Hospital of Guizhou University of traditional Chinese medicine，the Affiliated Hospital of Chengdu University of traditional Chinese medicine，and the Affiliated Hospital of Shaanxi University of traditional Chinese medicine. Patients were grouped into seven geographical regions：Northeast，North China， East China，South China，central China，Northwest，and Southwest. General characteristics among the seven regions such as age，gender，ethnicity，tumor node metastasis（TNM） staging，pathological type，treatment methods，and distribution of fundamental Traditional Chinese Medicine syndromes（lung qi deficiency syndrome，blood stasis syndrome，lung yin deficiency syndrome，etc.） were compared. Results　A total of 2 400 questionnaires were distributed，and 2 340 valid responses were collected. There were significant regional differences among seven regions of patient age，gender，ethnicity， TNM stage，pathological type，treatment modality，smoking history，chronic respiratory diseases，family history of tumors， living environment，and patient self-assessment scores（pain，quality of life，functional status，physical condition，anxiety， depression）（P<0.05）. The overall frequency of basic lung cancer syndromes across the seven regions ranked from highest to lowest as follows：lung qi deficiency，blood stasis，lung yin deficiency，spleen qi deficiency，phlegm dampness，and phlegm heat syndrome，with significant regional differences（P<0.05）. Specifically，the predominant syndromes were lung qi deficiency（37.11%），lung yin deficiency（33.51%），and phlegm-dampness（20.10%） in the Northeast region，lung qi deficiency（85.19%），blood stasis（72.84%），and lung yin deficiency（44.44%） in North China，lung qi deficiency （69.15%），lung yin deficiency（44.47%），spleen qi deficiency（19.15%），and blood stasis（19.15%） in East China， lung qi deficiency（58.50%），lung yin deficiency（37.00%），and phlegm dampness（21.00%） in South China，lung qi deficiency（51.51%），blood stasis（35.92%），and spleen qi deficiency（35.92%） in Central China； lung qi deficiency （74.00%），spleen qi deficiency（58.00%），and blood stasis（51.00%） in Northwest China； and blood stasis（31.34%）， lung qi deficiency（28.26%），and lung yin deficiency（18.41%） in Southwest China. Conclusion　Regional variations exist in the clinical characteristics and TCM syndrome distributions among lung cancer patients in China. TCM syndrome differentiation and treatment should therefore consider both geographical and individual factors to enhance clinical efficacy.

Key words: lung cancer, Traditional Chinese medicine, Syndrome, Regional differences, Clinical research

摘要： 背景　中医理论认为证候分布与区域存在密切联系，但目前尚缺少不同区域的肺癌患者临床特征及证候分布差异的相关临床研究。目的　分析我国不同区域肺癌患者临床特征及中医证候分布差异，为临床辨证提供参考。方法　采用横断面调查方式，选取 2020 年 6 月—2024 年 6 月于辽宁中医药大学附属医院、中国中医科学院广安门医院、上海中医药大学附属龙华医院、山东中医药大学附属医院、河南中医药大学第一附属医院、河南省中医院、河南省肿瘤医院、广西中医药大学第一附属医院、贵州中医药大学第二附属医院、成都中医药大学附属医院、陕西中医药大学附属医院共 11 家医院门诊或住院的肺癌患者发放调查表，根据区域分布，将患者分为东北、华北、华东、华南、华中、西北、西南共 7 个区域，收集患者年龄、性别、民族、肿瘤淋巴结转移（TNM）分期、病理类型、治疗方式等一般资料及肺气虚证、血瘀证、肺阴虚证等中医证候，比较 7 个区域患者一般资料和中医证候分布差异。结果　共发放调查表 2 400 份，有效回收 2 340 份。7 个区域患者年龄、性别、民族、TNM 分期、病理类型、治疗方式、吸烟史、合并慢性呼吸疾病、肿瘤家族史、居住环境、患者自我评估（疼痛、生存质量、功能状态、体力状况、焦虑、抑郁评分）比较，差异均有统计学意义（P<0.05）；7 个区域内肺癌常见基础证候频率由高到低依次为肺气虚证、血瘀证、肺阴虚证、脾气虚证、痰湿证、痰热证等，具体分布存在区域差异（P<0.05）。其中，东北区域常见基础证候依次为肺气虚证（37.11%）、肺阴虚证（33.51%）、痰湿证（20.10%）等，华北区域为肺气虚证（85.19%）、血瘀证（72.84%）、肺阴虚证（44.44%）等，华东区域为肺气虚证（69.15%）、肺阴虚证（44.47%）、脾气虚证（19.15%）、血瘀证（19.15%）等，华南区域为肺气虚证（58.50%）、肺阴虚证（37.00%）、痰湿证（21.00%）等，华中区域为肺气虚证（51.51%）、血瘀证（35.92%）、脾气虚证（35.92%）等，西北区域为肺气虚证（74.00%）、脾气虚证（58.00%）、血瘀证（51.00%）等，西南区域为血瘀证（31.34%）、肺气虚证（28.26%）、肺阴虚证（18.41%）等。结论　不同区域肺癌患者临床特征及证候分布存在差异，中医辨证论治应注意因地、因人制宜，以提高临床疗效。

关键词: 肺癌, 中医, 证候, 区域差异, 临床研究