现代中医临床2025，Vol.32Issue(6)：51-58,8.DOI:10.3969/j.issn.2095-6606.2025.06.010
晚期肿瘤患者多线治疗后贫血程度影响因素及中医证素特点分析
Analysis of factors influencing the degree of anemia and characteristics of Traditional Chinese Medicine pattern elements in advanced cancer patients after multiple lines of treatment
摘要
Abstract
Objective To investigate the influencing factors of anemia severity in advanced cancer patients after multiple lines of treatment,and to explore the distribution and combination rules of Traditional Chinese Medicine(TCM)pattern elements.Methods A retrospective collection of clinical and four diagnostic data was conducted on advanced cancer patients who received multiple lines of treatment at Guang'anmen Hospital,China Academy of Chinese Medical Sciences,from November 2021 to November 2023.Frequency statistics and cluster analysis were employed to extract the characteristics and combination rules of syndrome elements,the correlation between pattern elements and the severity of anemia was assessed,and logistic regression was used to analyze the influencing factors of anemia severity.Results A total of 100 patients were included in the analysis.There were 40 males(40%)and 60 females(60%);the median age was 68 years.Gynecological tumors accounted for 38 cases(38%),lung cancer for 36 cases(36%),digestive system tumors for 23 cases(23%),and lymphoma for 3 cases(3%).Anemia grading:Grade 1 in 51 cases(51%),Grade 2 in 42 cases(42%),Grades 3-4 in 7 cases(7%).The average hemoglobin was 98 g/L(64 g/L～119 g/L),primarily normocytic anemia.The main disease location pattern elements were spleen,lung,and kidney.The main disease location pattern elements are spleen,lung,and kidney,and the main disease nature pattern elements are blood deficiency,qi deficiency,yang deficiency,and dampness.The location of the disease in the spleen,heart,and the severity of(cancer-related anernial,CRA)were correlated with yang deficiency(P<0.05).High frequency syndrome clustering analysis identified five combinations:Qi deficiency-blood deficiency;Spleen-yang deficiency-dampness;Lung-phlegm;Heart-liver-kidney;Stomach qi-stagnation-yin deficiency-blood stasis.Multivariate logistic regression analysis showed that Karnofsky Performance Status(KPS)scores(OR=3.057,95%CI:1.067-8.756,P=0.037),serum albumin levels(OR=0.785,95%CI:0.665-0.925,P=0.004),gynecological tumors(OR=4.012,95%CI:1.109-14.509,P=0.034),and lymph node metastasis(OR=3.490,95%CI:1.162-10.477,P=0.026)were independently associated with grade 2 and above anemia.Conclusion After multi-line treatment,the anemia sites in advanced cancer patients are mainly in the spleen,lung,and kidney,with blood deficiency,qi deficiency,yang deficiency,and dampness as the main pathological factors.KPS score,serum albumin level,tumor type,and lymph node metastasis are independently correlated with the degree of anemia.关键词
肿瘤相关性贫血/多线治疗/中西医治疗/回顾性研究Key words
tumor associated anemia/multiple lines of treatment/Traditional Chinese and Western Medicine treatment/retrospective study分类
医药卫生引用本文复制引用
杨景淇,徐泓鲲,张文政,任似梦,卢婷婷,金嘉悦,韩宝瑾,侯炜,刘杰..晚期肿瘤患者多线治疗后贫血程度影响因素及中医证素特点分析[J].现代中医临床,2025,32(6):51-58,8.基金项目
中国中医科学院科技创新工程重大攻关项目(No.CI2021A05502) （No.CI2021A05502）
中央高水平中医医院临床研究和成果转化能力提升项目(No.HLCMHPP2023019) （No.HLCMHPP2023019）
