基于交叉滞后网络分析胃癌化疗病人体质对症状网络的影响  

Impact of physical constitution on the symptom network of gastric cancer patients undergoing chemotherapy based on cross⁃lagged network analysis

作　　者：李思宇 朱凯丽 夏超[2] 杨玲[2] 段培蓓[2] LI Siyu;ZHU Kaili;XIA Chao;YANG Ling;DUAN Peibei(School of Nursing,Nanjing University of Chinese Medicine,Jiangsu 210023 China;The Affiliated Hospital of Nanjing University of Chinese Medicine)

机构地区：[1]南京中医药大学护理学院,江苏210023 [2]南京中医药大学附属医院

出　　处：《护理研究》2025年第5期705-715,共11页Chinese Nursing Research

基　　金：江苏省中医药科技发展计划重点项目,编号:ZD202005;江苏省研究生科研与实践创新计划项目,编号:SJCX24_0828。

摘　　要：目的:利用胃癌化疗病人3个时间点的体质和症状数据构建动态网络,探讨胃癌化疗病人体质和症状的演变规律,并识别干预靶点。方法:以2021年7月—2024年2月在江苏省4所三级甲等医院招募386例胃癌化疗病人为研究对象,在化疗早期(第2次化疗后,T1)、化疗中期(第4次化疗后,T2)、化疗后期(第6次化疗后,T3)进行体质和症状测量,利用交叉滞后网络分析探讨体质和症状随时间变化的交互作用。结果:平和质是悲伤、味觉改变、食欲下降等症状的保护性体质。在T1→T2时期,血瘀质和阳虚质主要预测T2时期的疲乏和悲伤,“悲伤→疲乏”是最强的预测路径。在T2→T3时期,痰湿质能够促进味觉改变的发生。味觉改变能预测T3时期食欲缺乏的发生。结论:通过动态网络分析揭示了体质与症状之间的动态关系,可基于“体质可调”理论,早期进行血瘀质、阳虚质及痰湿质的体质调护,并及时转变症状的干预重点。Objective:To construct a dynamic network using data on physical constitution and symptoms of gastric cancer patients at three time points,explore the evolution patterns of these factors during chemotherapy,and identify potential intervention targets.Methods:A total of 386 gastric cancer patients undergoing chemotherapy were recruited from four tertiary⁃grade A hospitals in Jiangsu Province from July 2021 to February 2024.Measurements of physical constitution and symptoms were carried out in the early stage of chemotherapy(after the second chemotherapy,T1),the middle stage of chemotherapy(after the fourth chemotherapy,T2),and the late stage of chemotherapy(after the sixth chemotherapy,T3).Cross⁃lagged network analysis was used to explore the interaction between physical constitution and symptoms over time.Results:The balanced constitution acted as a protective factor against symptoms such as sadness,taste change,and loss of appetite.During the period from T1 to T2,the blood⁃stasis constitution and yang⁃deficiency constitution mainly predicted fatigue and sadness in the T2 period,and the path"sadness→fatigue"was the strongest predictive path.From T2 to T3,the phlegm-dampness constitution promoted taste change,which further predicted persistent loss of appetite.Conclusion:The study reveals a significant causal relationship between physical constitution and symptoms through dynamic network analysis.Based on the theory of"adjustable physical constitution",early management of blood⁃stasis constitution,yang-deficiency constitution,and phlegm⁃dampness constitution can be carried out,and the focus of symptom intervention can be changed in a timely manner.

关 键 词：胃癌 化疗 中医体质 症状网络 交叉滞后分析 时序关系 因果关系 

分 类 号：R473.73[医药卫生—护理学]