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上海中医药大学附属市中医医院(上海 200071)
陈皖晴,女,博士,主治医师,主要从事中医药防治恶性肿瘤临床及基础研究工作
郭鹏,副主任医师;E-mail:2352756505@qq.com
收稿:2024-10-28,
纸质出版:2025-12-10
移动端阅览
陈皖晴,李心怡,徐静,等.乳腺癌术后患者中医证型分布特点及与脂代谢相关性研究[J].上海中医药杂志,2025,59(12):54-60.
CHEN Wanqing,LI Xinyi,XU Jing,et al.Correlation between distribution characteristics of traditional Chinese medicine syndromes and lipid metabolism in postoperative breast cancer patients[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(12):54-60.
陈皖晴,李心怡,徐静,等.乳腺癌术后患者中医证型分布特点及与脂代谢相关性研究[J].上海中医药杂志,2025,59(12):54-60. DOI: 10.16305/j.1007-1334.2025.z20241028007.
CHEN Wanqing,LI Xinyi,XU Jing,et al.Correlation between distribution characteristics of traditional Chinese medicine syndromes and lipid metabolism in postoperative breast cancer patients[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(12):54-60. DOI: 10.16305/j.1007-1334.2025.z20241028007.
目的
2
探讨乳腺癌术后患者中医证型的分布规律及其与脂代谢指标的相关性。
方法
2
采用回顾性研究的方法,收集乳腺癌术后患者的相关资料,分析中医症状、中医证型分布特点;采用简单对应分析及logistic回归分析方法,分析乳腺癌术后患者中医证型与脂代谢指标的相关性。
结果
2
①半数以上的患者有乏力(79.76%)、情绪抑郁(75.40%)、腹胀(72.62%)、寐差(61.90%)、头晕(51.19%)症状,肝郁脾虚证是乳腺癌术后患者最常见的中医证型。②不同中医证型乳腺癌术后患者年龄、化学疗法、内分泌治疗分布情况比较,差异有统计学意义(
P
<
0.05),但上述因素与患者脂代谢异常无显著相关性。③不同中医证型的乳腺癌术后患者三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白-A1(Apo-A1)、载脂蛋白-B(Apo-B)及脂蛋白(a)[Lp(a)]水平差异有统计学意义(
P
<
0.05);血脂异常类型亦存在差异(
P
<
0.05),肝郁脾虚证与高TG血症关联性较强,肝肾阴虚证与低高密度脂蛋白胆固醇(HDL-C)血症关联性较强,气血亏虚证、脾胃虚弱证与正常血脂关联性较强。④Apo-A1升高是脾胃虚弱证的危险因素(
P
<
0.05);TG、Apo-A1、Lp(a)升高是肝郁脾虚证的保护因素(
P
<
0.05),HCL-C升高是肝郁脾虚证、肝肾阴虚证的危险因素(
P
<
0.05)。
结论
2
乳腺癌术后患者中医证型以肝郁脾虚证为主,中医证型与脂代谢指标存在不同程度的相关因素特征,血脂水平和中医证型之间有双向预测价值。
Objective
2
To explore the distribution pattern of traditional Chinese medicine (TCM) syndromes in postoperative breast cancer patients and its correlation with lipid metabolism indicators.
Methods
2
A retrospective study was conducted to collect relevant data from postoperative breast cancer patients, analyzing the distribution characteristics of TCM symptoms and syndromes. Simple correspondence analysis and logistic regression analysis were used to analyze the correlation between the distribution of TCM syndromes and lipid metabolism indicators in postoperative breast cancer patients.
Results
2
①More than half of the patients showed symptoms such as fatigue (79.76%), emotional depression (75.40%), abdominal distention (72.62%), poor sleep (61.90%), and dizziness (51.19%). The most common TCM syndrome among postoperative breast cancer patients was liver depression and spleen deficiency syndrome. ②Statistically significant differences were observed in the distribution of age, chemotherapy, and endocrine therapy among postoperative breast cancer patients with different TCM syndromes (
P
<
0.05), but these factors did not show a significant correlation with lipid metabolism abnormalities. ③Statistically significant differences in the levels of triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (Apo-A1), apolipoprotein B (Apo-B), and lipoprotein(a) [Lp(a)] were found among postoperative breast cancer patients with different TCM syndromes (
P
<
0.05). Additionally, differences in lipid abnormalities were observed (
P
<
0.05). Liver depression and spleen deficiency syndro
me had a stronger correlation with hypertriglyceridemia, liver-kidney yin deficiency syndrome was more closely correlated with low levels of high-density lipoprotein cholesterol (HDL-C), and qi-blood deficiency syndrome and spleen-stomach deficiency syndrome were more strongly correlated with normal lipid levels. ④Apo-A1 increase was identified as a risk factor for spleen-stomach deficiency syndrome (
P
<
0.05); elevated TG, Apo-A1, and Lp(a) were protective factors for liver depression and spleen deficiency syndrome (
P
<
0.05), while high HDL-C was a risk factor for both liver depression and spleen deficiency syndrome, and liver-kidney yin deficiency syndrome (
P
<
0.05).
Conclusions
2
Postoperative breast cancer patients predominantly present with liver depression and spleen deficiency syndrome. There are varying degrees of correlation between different TCM syndromes and lipid metabolism indicators, with blood lipid levels and TCM syndromes having bidirectional predictive value.
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