The Effect Of Operation And Chemotherapy On TCM Constitution Of Breast Cancer

ObjectiveThe complex treatments of the breast cancer include surgery, chemo-treatment, radiation treatment, endocrine therapy and molecular target therapy, etc.These treatments can make certain impact on the physical condition, but the impact on TCM(Traditional Chinese Medicine) constitution type has not been proved. This research will do a pilot study according to the TCM constitution condition alteration among those first-diagnosed breast cancer patients with therapies of surgery and chemo-treatment. Therefore the rule will be summarized and supplied as the theory basis for the TCM individualized treatment.MethodSelecting the breast cancer inpatients qualified to the revenue standard in mammary gland department of Guangdong Provincial TCM Hospital from year 2008 December to year 2010 February. Each inpatient received a "TCM constitution and health state questionnaire" preoperatively referred to the measuring scale complied by professor Wangqi in medical examination center of our hospital. The questionnaire was filled in by the inpatients themselves and retook on the spot. The researcher would fill in the questionnaire with consultation to those inpatients who could not write. Within one month after the inpatients'six systemic chemo-therapies (before the radiation treatment), the inpatients would fill in the questionnaire in the same way, then the information was collected subsequently. There were in total 161 medical cases up to the standard. The researcher evaluated TCM constitution by grading the marks according to the criterion of nine TCM constitutional types compiled by professor Wangqi. The information was complete. The data was evaluated by the descriptive analysis, chi square test, rank-sum test with the help of SPSS 17.0 for Windows software package.Results1. The breast cancer inpatients'constitution prior-treatment were mainly normal constitution(27.3%), qi-obstruction constitution (19.9%), qi-deficiency constitution, yang-deficiency constitution, which took up 78.2% totally. Pathological constitution——qi-obstruction constitution, qi-deficiency constitution, yang-deficiency constitution took up 50.9%; blood-stasis constitution(6.2%), phlegm-damp constitution(5.6%);yin-deficiency const i tut ion (4.3%), damp-heat constitution (4.3%), special constitution(1.2%), the five kinds of constitution took up 21.6%; After the treatment, TCM constitution were mainly qi-obstruction constitution(26.7%), yang-deficiency constitution(19.9%), blood-stasis constitution(8.2%), the four kinds of pathological constitution took up 81.5%, normal constitution(4.3%), phlegm-damp constitution(4.3%), yin-deficiency constitution (5.6%), damp-heat constitution (3.1%), special constitution (1.2%), the four pathological constitution took up 14.2%.The comparison on the constituent ratio of the constitution type between prior-treatment and post-treatment had statistical significance (P=0.01<0.05)2. The constitution of the breast cancer inpatients in this group has changed after the treatment, the normal constitution changed to qi-deficiency constitution, qi-deficiency constitution, qi-obstruction constitution, yang-deficiency constitution remained the same as what prior-treatment were. blood-stasis constitution changed to qi-obstruction constitution after the treatment, phlegm-damp constitution changed to qi-obstruction constitution after the treatment. The sample size in yin-deficiency constitution, damp-heat constitution and special constitution was small. There were 54 inpatients remained the same constitution after the treatment.3. There was no statistical significance on breast cancer inpatients' constitution in different age brackets. In these four treatment:there were 20 cases with the breast conserving treatment and CEF×6,9 cases with the modified radical mastectomy TAC×6,72 cases with the modified radical mastectomy and TAC×6, there was no statistical significance for the constitution alteration among these four kinds of treatment.4. The special constitution in the breast cancer inpatients group was only up to 1.2%during the whole process, the ratio was small.conclusion1. The distribution on prior-treatment constitution of the breast cancer inpatients in this group mainly were normal constitution, qi-obstruction constitution, qi-deficiency constitution and yang-deficiency constitution. The distribution on post-treatment constitution of the breast cancer inpatients mainly were qi-obstruction constitution, qi-deficiency constitution, yang-deficiency constitution, blood-stasis constitution.2. The constitution of the breast cancer inpatients in this group has changed after the treatment, the normal constitution changed to qi-deficiency constitution, qi-deficiency constitution, qi-obstruction constitution, yang-deficiency constitution remained the same as what prior-treatment were.blood-stasis constitution changed to qi-obstruction constitution after the treatment, phlegm-damp constitution changed to qi-obstruction constitution after the treatment.3. There was no statistical significance on breast cancer inpatients' constitution in different age brackets during the whole process. There was no statistical significance on breast cancer inpatients'constitution alteration with these four kinds of treatment.