基于“天运当以日光明”探讨中晚期浸润性乳腺癌患者复发季节与预后关系的研究  

Relationship Between Recurrence Season and Prognosis in Patients with Advanced Invasive Breast Cancer Based on the Concept of Normal Movement of the Heavens Depending on the Normal Shining of the Sun

作　　者：李秋华[1,2,4] 莫艳芳 史国峰[2,4] 万小莎 任路 LI Qiu-hua;MO Yan-fang;SHI Guo-feng;WAN Xiao-sha;REN Lu(Liaoning University of Traditional Chinese Medicine,Shenyang Liaoning 110847;Shenzhen Hospital of Guangzhou University of Chinese Medicine(Futian),Shenzhen Guangdong 518034;Ethnomedicine Hospital of Guangxi Zhuang Autonomous Region,Nanning Guangxi 530001;The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang Liaoning 110034)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]广州中医药大学深圳医院(福田),广东深圳518034 [3]广西壮族自治区民族医院,广西南宁530001 [4]辽宁中医药大学附属第二医院,辽宁沈阳110034

出　　处：《世界中西医结合杂志》2024年第8期1485-1490,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：中国博士后科学基金(2021MD703842);国家中医药管理局中医药国际合作专项(0610-2140NF020629);辽宁省自然科学基金计划重点项目(20180540043)。

摘　　要：目的基于“天运当以日光明”理论,探讨复发季节对中晚期浸润性乳腺癌病患者预后的影响。方法选取2012年1月—2022年1月期间辽宁中医药大学附属第二医院和广西医科大学附属民族医院收治的78例中晚期浸润性乳腺癌患者的临床资料,具体分组如下,将辽宁中医药大学附属第二医院的48例患者作为观察组,广西医科大学附属民族医院的30例患者作为对照组。根据患者乳腺癌复发的季节,第一步,观察组分为春夏季组、秋冬季组,对照组也如此。第二步,再次细化分层,观察组分为春季组、夏季组、秋冬季组;对照组分为春夏季组、秋季组、冬季组。预后结局事件分别设定为从复发(取首次复发)到死亡的生存期、总生存期、无进展生存期。应用Cox单因素、多因素回归分析及生存分析,探析相关不良预后影响因素及复发季节与预后的关系。结果中医证候、首次复发转移部位是影响观察组中晚期乳腺癌患者预后的独立危险因素。观察组春夏复发的患者中位总生存期55个月,秋冬复发的患者中位总生存期18个月,观察组中,春夏复发的患者,其从复发后的生存优势及总生存期均优于秋冬组(P<0.01),春夏及秋季复发的患者进展后生存期及总生存期均优于冬季复发者(P<0.01)。对照组春夏及秋季复发的患者进展后生存期优于冬季复发的患者(P<0.05)。结论复发季节对中晚期浸润性乳腺癌患者的生存期具有一定的影响。Objective To explore the impact of the season of recurrence on the prognosis of patients with advanced invasive breast cancer based on the theory of normal movement of the heavens depending on the normal shining of the sun.Methods Clinical data of 78 patients with advanced invasive breast cancer treated between January 2012 and January 2022 were selected from the Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine and the Ethnomedicine Hospital of Guangxi Medical University.The patients were divided into an observation group(48 patients from the Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine)and a control group(30 patients from the Ethnomedicine Hospital of Guangxi Medical University).In the first step,patients in both groups were categorized into spring-summer and autumn-winter groups based on the season of cancer recurrence.In the second step,the groups were further subdivided as follows:the observation group into spring,summer,and autumn-winter groups,and the control group into spring-summer,autumn,and winter groups.Prognostic outcomes included survival time from the first recurrence to death,overall survival,and progression-free survival.Cox univariate and multivariate regression analysis,as well as survival analysis,were used to explore the factors influencing adverse prognosis and the relationship between the season of recurrence and prognosis.Results Traditional Chinese medicine(TCM)syndromes and the initial site of metastasis were independent risk factors affecting the prognosis of patients with advanced breast cancer in the observation group.In the observation group,the median overall survival was 55 months for patients who recurred in spring-summer and 18 months for those who recurred in autumn-winter.The survival advantage and overall survival time after recurrence were significantly superior for patients who recurred in spring-summer to those who recurred in autumn-winter(P<0.01).Both progression survival and overall survival for patient

关 键 词：浸润性乳腺癌 转移 季节 预后 生存分析 

分 类 号：R737.9[医药卫生—肿瘤]