乳腺癌患者术后中医体质与其心理弹性和生命质量的关系

李青; 张春彬; 王妹; 程婷婷; 郭康萍; 潘龙; 周玉; 童宗培

doi:10.16766/j.cnki.issn.1674-4152.004166

乳腺癌患者术后中医体质与其心理弹性和生命质量的关系

doi: 10.16766/j.cnki.issn.1674-4152.004166

李青¹,
张春彬²,
王妹¹,
程婷婷¹,
郭康萍^3, ,,
潘龙¹,
周玉¹,
童宗培¹

1.
滁州市中西医结合医院普外科，安徽滁州 239000
2.
滁州市中西医结合医院药剂科
3.
滁州市中西医结合医院护理部

基金项目:

安徽省卫生健康科研项目 AHWJ2022c052

滁州市卫生健康科研项目 CZWJ2023C009

详细信息

通讯作者:
郭康萍，E-mail：13705503262@163.com

中图分类号: R737.9
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- 文章访问数: 3
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- 被引次数: 0
出版历程
- 收稿日期: 2024-09-25
- 网络出版日期: 2025-11-17

Relationship among TCM constitution and psychological resilience, life quality of breast cancer patients after surgery

1.
Department of General Surgery, Chuzhou Hospital of Integrated Traditional Chinese and Western Medicine, Chuzhou, Anhui 239000, China

摘要

摘要: 目的研究乳腺癌患者术后中医体质与其心理弹性、生命质量的关系，为调整乳腺癌患者中医体质、改善其心理弹性、提高生活质量提供依据。方法选取2021年1月—2024年4月在滁州市中西医结合医院接受手术治疗的乳腺癌患者150例，评估其中医体质、心理弹性及生命质量，采用Spearman秩相关分析研究中医体质与心理弹性、生命质量的相关性。结果 (1) 150例乳腺癌患者术后中医体质以平和质、气郁质、阳虚质及气虚质较常见，分别占22.00%(33例)、18.67%(28例)、18.00%(27例)、12.00%(18例)；(2)浸润性肿瘤、临床分期为Ⅳ期的乳腺癌术后患者气郁质占比高于其他体质，伴有肿瘤转移的乳腺癌术后患者阳虚质占比高于其他体质(P＜0.05)；(3)平和质乳腺癌患者术后心理弹性及生活质量评分均较其他体质高(P＜0.05)；(4)乳腺癌术后患者平和质与心理弹性、生活质量均呈正相关关系(P < 0.05)，气郁质、阳虚质、气虚质与心理弹性、生活质量均呈负相关关系(P < 0.05)；(5)乳腺癌患者肿瘤浸润深度、临床分期、是否伴肿瘤转移是影响中医体质的相关因素(P < 0.05)。结论乳腺癌患者术后常见的中医体质为平和质、气郁质、阳虚质及气虚质，其受肿瘤类型、临床分期及肿瘤转移情况的影响，且其中医体质与术后心理弹性、生命质量均存在相关性。
- 乳腺癌 /
- 中医体质 /
- 心理弹性 /
- 生命质量 /
- 相关性
Abstract: Objective To study the relationship among traditional Chinese medicine (TCM) constitution and psychological resilience, life quality of patients with breast cancer after surgery, so as to provide basis for adjusting TCM constitution, improving their psychological resilience and quality of life. Methods A total of 150 patients with breast cancer who received surgical treatment in Chuzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2021 to April 2024 were randomly selected. The TCM constitution, psychological resilience and quality of life were evaluated, and their correlation was studied by Spearman rank correlation. Results (1) TCM constitution of 150 patients with breast cancer after surgery was mainly gentleness, Qi stagnation, Yang deficiency and Qi deficiency, accounting for 22.00% (33 cases), 18.67% (28 cases), 18.00% (27 cases)and 12.00% (18 cases), respectively; (2) The proportion of Qi stagnation in patients with invasive tumor and clinical stage Ⅳ was higher than that of other constitutions, and the proportion of Yang deficiency in patients with tumor metastasis was higher than that of other constitutions (P < 0.05); (3) The scores of psychological resilience and quality of life of patients with gentleness constitution were higher than other patients (P < 0.05); (4) Gentleness constitution was positively correlated with psychological resilience and quality of life of patients (P < 0.05). Qi stagnation, Yang deficiency and Qi deficiency were negatively correlated with psychological resilience and quality of life (P < 0.05); (5) The depth of tumor invasion, clinical stage and tumor metastasis in breast cancer patients were related factors affecting TCM constitution (P < 0.05). Conclusion The common TCM constitution of breast cancer patients after surgery is gentleness, Qi stagnation, Yang deficiency and Qi deficiency, which are affected by tumor type, clinical stage and tumor metastasis, and their TCM constitution is correlated with postoperative psychological resilience and quality of life.
- Breast cancer /
- TCM constitution /
- Psychological resilience /
- Quality of life /
- Correlation

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表 1 150例乳腺癌患者中医体质判定情况

Table 1. TCM Constitution determination of 150 patients with breast cancer

中医体质	例数(%)
平和质	33(22.00)
气郁质	28(18.67)
阳虚质	27(18.00)
气虚质	18(12.00)
血瘀质	13(8.67)
湿热质	10(6.66)
痰湿质	9(6.00)
阴虚质	7(4.67)
特禀质	5(3.33)
合计	150(100.00)

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表 2 不同中医体质乳腺癌患者一般资料比较[例(%)]

Table 2. Comparison of general data of breast cancer patients with different TCM constitutions[cases(%)]

项目	例数	平和质(n=33)	气郁质(n=28)	阳虚质(n=27)	气虚质(n=18)	χ²值	P值
年龄(岁)						0.834	0.841
＜50	58	18(31.03)	16(27.59)	13(22.41)	11(18.97)
≥50	48	15(31.25)	12(25.00)	14(29.17)	7(14.58)
乳腺癌病程(月)						2.901	0.407
＜12	72	26(36.11)	18(25.00)	16(22.22)	12(16.67)
≥12	34	7(20.59)	10(29.41)	11(32.35)	6(17.65)
手术类型						3.762	0.709
保乳手术	39	13(33.33)	11(28.21)	9(23.08)	6(15.38)
乳腺癌根治术	53	18(33.96)	13(24.53)	12(22.64)	10(18.87)
扩大根治术	14	2(14.29)	4(28.57)	6(42.86)	2(14.29)
婚姻状况						2.704	0.440
未婚/离异	26	5(19.23)	7(26.92)	8(30.77)	6(23.08)
已婚	80	28(35.00)	21(26.25)	19(23.75)	12(15.00)
肿瘤类型						20.179	＜0.001
非浸润性肿瘤	38	22(57.89)	5(13.16)	7(18.42)	4(10.53)
浸润性肿瘤	68	11(16.18)	23(33.82)	20(29.41)	14(20.59)
临床分期						14.537	0.024
Ⅱ期	27	16(59.26)	4(14.81)	5(18.52)	2(7.41)
Ⅲ期	66	15(22.73)	19(28.79)	18(27.27)	14(21.21)
Ⅳ期	13	2(15.38)	5(38.46)	4(30.77)	2(15.38)
乳腺癌家族史						1.159	0.763
有	24	7(29.17)	5(20.83)	8(33.33)	4(16.67)
无	82	26(31.71)	23(28.05)	19(23.17)	14(17.07)
分子分型						2.126	0.989
Luminal A型	11	4(36.36)	3(27.27)	2(18.18)	2(18.18)
Luminal B型	64	22(34.38)	16(25.00)	16(25.00)	10(15.62)
HER2过表达型	19	4(21.05)	5(26.32)	6(31.58)	4(21.05)
三阴型	12	3(25.00)	4(33.33)	3(25.00)	2(16.67)
肿瘤转移情况						10.220	0.017
有	88	22(25.00)	24(27.27)	26(29.55)	16(18.18)
无	18	11(61.11)	4(22.22)	1(5.56)	2(11.11)

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表 3 不同中医体质乳腺癌患者心理弹性比较(x±s，分)

Table 3. Comparison of mental resilience of breast cancer patients with different TCM constitutions(x±s, points)

项目	平和质(n=33)	气郁质(n=28)	阳虚质(n=27)	气虚质(n=18)	F值	P值
CD-RISC
坚韧	34.39±2.06^abc	26.86±2.42	27.24±2.56	25.94±2.67	77.630	＜0.001
自强	23.57±3.28^abc	19.69±3.54	17.79±3.63	18.33±3.24	17.000	＜0.001
乐观	11.42±0.93^abc	8.93±1.42	9.15±1.34	8.74±1.53	28.010	＜0.001
FACT-B
生理状况	19.82±2.19^abc	15.52±2.06	14.89±2.28	16.14±2.39	30.800	＜0.001
功能状况	18.76±1.84^abc	16.24±2.12	15.37±2.46	15.84±2.32	14.700	＜0.001
社会/家庭状况	20.38±2.31^abc	17.56±2.53	16.82±2.57	17.36±2.08	13.420	＜0.001
附加关注	24.34±2.76^abc	20.41±2.84	21.29±3.16	20.68±2.72	11.860	＜0.001
情感状况	17.46±1.58^abc	14.82±1.67	15.25±1.73	14.39±1.86	18.670	＜0.001
注：与气郁质比较，^aP＜0.05；与阳虚质比较，^bP＜0.05；与气虚质比较，^cP＜0.05。

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表 4 乳腺癌患者中医体质与心理弹性、生活质量的相关性(r值)

Table 4. Correlation between TCM constitution, mental resilience and quality of life of breast cancer patients(r value)

项目	平和质	气郁质	阳虚质	气虚质
CD-RISC
坚韧	0.345	-0.382	-0.334	-0.351
自强	0.329	-0.368	-0.349	-0.332
乐观	0.356	-0.371	-0.337	-0.344
FACT-B
生理状况	0.354	-3.361	-0.372	-0.348
功能状况	0.362	-0.357	-0.335	-0.346
社会/家庭状况	0.347	-0.352	-0.366	-0.353
附加关注	0.326	-0.331	-0.319	-0.324
情感状况	0.339	-0.383	-0.324	-0.331
注：均P＜0.05。

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表 5 乳腺癌患者中医体质影响因素的logistic回归分析

Table 5. Logistic regression analysis of factors influencing traditional Chinese medicine constitution in breast cancer patients

变量	B	SE	Waldχ²	P值	OR值	95% CI
浸润性肿瘤	0.693	0.264	6.891	0.009	2.000	1.192~3.355
临床分期为Ⅳ期	0.747	0.302	6.118	0.014	2.111	1.168~3.815
伴有肿瘤转移	0.584	0.213	7.517	0.006	1.793	1.181~2.722

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