| Research background:The latest data in 2020 show that breast cancer has replaced lung cancer as the world’s largest cancer.Among them,the number of new cases in my country ranks fourth in the world.At present,breast cancer has become the biggest threat to women’s health in the world.Nowadays,chemotherapy is still the main treatment for breast cancer,but the commonly used chemotherapy drugs for breast cancer can easily lead to bone marrow suppression in patients.In severe cases,the chemotherapy dose will be reduced or stopped,which will affect the progress of anti-tumor treatment,and eventually the tumor will appear uncontrollable.The disease progresses and endangers the patient’s life.Therefore,prevention and treatment of bone marrow suppression is the key to the success of chemotherapy.Research purposes:Through the TCM constitution questionnaire survey of patients who are planning to undergo“AC”adjuvant chemotherapy after breast cancer surgery and determine their temperament type,the blood routine results of patients with bone marrow suppression after chemotherapy are collected,and the white blood cells(WBC)and neutrophils are studied.The relationship between the changes of cell absolute value(ANC),platelet(PLT),hemoglobin(HGB),red blood cell(RBC)and the distribution of TCM constitution,so as to analyze the correlation between TCM constitution and bone marrow suppression after breast cancer chemotherapy.research method:This study conducted a physical survey on patients who underwent breast cancer surgery in Jiangsu Provincial Hospital of Traditional Chinese Medicine from April 2020 to February 2021 and planned to undergo "AC" adjuvant chemotherapy after the operation,and determined their physical type,and collected the first chemotherapy The basic conditions of 100 patients with myelosuppression afterwards:age,body mass index(BMI),prognostic factors of breast cancer(menarche age,menopausal status,fertility status,family history of malignant tumors,HER-2,ER,PR expression,Ki-67 index,axillary lymph node metastasis,breast mass size,postoperative pathological TNM staging;as well as the white blood cell count,absolute value of neutrophils,platelet count,hemoglobin count,and red blood cell count in the blood routine results,all are based on the highest grade during chemotherapy Statistical analysis was included to explore the correlation between the constitution of traditional Chinese medicine and the bone marrow suppression in breast cancer patients after chemotherapy.Research result:In 100 cases of breast cancer patients with myelosuppression after chemotherapy:1.Qi deficiency qualitative accounted for 32%,Yang deficiency qualitative accounted for 23%,and Qi stagnation qualitative accounted for 18%.2.Less than 42 years old accounted for the lowest proportion(15%),49 years old and above accounted for the highest proportion(67%).3.The age distribution of patients with calm quality and blood stasis quality is relatively even;Qi deficiency quality(68.75%),Qi stagnation quality(61.11%),phlegm-dampness quality(75%),Yang deficiency quality(82.61%)and Yin deficiency quality(80%)The patients are mostly over 49 years old;there is only one patient with damp-heat quality,younger than 35 years old.4.The BMI of patients with calm quality(100%),Qi stagnation quality(72.22%),blood stasis quality(100%),Yin deficiency quality(80%)is mostly at a normal level;BMI of patients with Qi deficiency quality is mostly normal(65.63%),Followed by overweight(34.38%);patients with phlegm and dampness were mostly overweight(75%);patients with yang deficiency were mostly overweight(47.83%)or normal(39.13%);there was only one patient with damp-heat and normal BMI.5.Menarche age ≥ 14 years(66%),menopause(61%),no family history of malignant tumors(86%),childbirth(97%),HER-2 negative(57%),ER(70%)),PR(71%)positive,Ki-67>30%(61%),axillary lymph node negative(62%),breast mass>2cm(65%),postoperative pathology stage II(53%)patients accounted for the most.6.There was no significant difference between different physiques and various factors affecting the prognosis of breast cancer(P>0.05),but it can be seen from the results of this study that most of the menopausal patients have Qi deficiency and Yang deficiency;the age at menarche is less than 14 Breast cancer patients with age,family history of malignant tumors,breast masses>2 cm,Ki-67>30%,and axillary lymph node positive breast cancer patients are the most common with Qi deficiency;the physique of breast cancer patients with HER-2,ER,and PR positive breast cancer is also Deficiency of Qi.7.(1)There is a significant difference in the degree of white blood cell decline in breast cancer patients with different constitutions after chemotherapy(P≦0.01).Among them,the decline of yang deficiency type(60.85%)is the most significant,followed by qi deficiency type(53.09%),indicating qi deficiency and qi deficiency.In breast cancer patients with yang-deficiency constitution,the white blood cell decline is more obvious after chemotherapy than other constitutions(2)There was no significant difference in the degree of red blood cell decline in breast cancer patients with different constitutions after chemotherapy(P>0.05),but this study showed that the degree of red blood cell decline in patients with yin deficiency(11.44%)was the largest,followed by blood stasis(11.27)%),it can be seen that patients with breast cancer with yin deficiency and blood stasis may be more likely to have red blood cell decline after chemotherapy;(3)There was no significant difference in the degree of hemoglobin decrease in breast cancer patients with different constitutions after chemotherapy(P>0.05),but this study showed that the hemoglobin decrease in patients with yin deficiency(16.22%)was the largest,followed by yang deficiency(11.08)%),indicating that breast cancer patients with yin and yang deficiency may be more likely to develop anemia after chemotherapy;(4)There was no significant difference in the degree of platelet decline in breast cancer patients with different constitutions after chemotherapy(P>0.05).The platelet decline(19.84%)in patients with yang-deficiency type was the most obvious,indicating that platelet decline occurred in patients with yang-deficiency type breast cancer after chemotherapy.The risk is higher;(5)The absolute value of neutrophils in breast cancer patients of different constitutions decreased significantly after chemotherapy(P≦ 0.01).The absolute value of neutrophils in patients with yang-deficiency constitution decreased(72.42%)most significantly,followed by qi-deficiency constitution(66.06%),indicating that breast cancer patients with Yang-deficiency and Qi-deficiency are more likely to have absolute neutrophil reduction after chemotherapy.8.There is a significant difference in the incidence of myelosuppression of breast cancer patients with different constitutions after chemotherapy(P≦0.01).Among them,the probability of severe myelosuppression(65.21%)in breast cancer patients with yang-deficiency constitution after chemotherapy is much higher than other constitutions Type,indicating that patients with Yang-deficiency breast cancer have the highest risk of severe myelosuppression after chemotherapy.Analysis conclusion:1.In this study,breast cancer patients older than 49 years old are more likely to develop bone marrow suppression after chemotherapy.2.Most breast cancer patients with biased physique in this study are over 49 years old.3.In this study,patients with bone marrow suppression after breast cancer chemotherapy are more likely to have bone marrow suppression after chemotherapy.Breast cancer patients with qi deficiency,yang deficiency,and qi depression are more likely to develop bone marrow suppression after chemotherapy.4.The BMI of breast cancer patients in this study are mostly normal or overweight.Among them,patients with Qi deficiency are mostly normal or overweight;patients with phlegm dampness and Yang deficiency are more likely to be overweight or obese.5.In this study,breast cancer patients were mostly older than 14 years old at menarche,most had a history of childbirth,and were currently menopausal,and most of them had no family history of malignant tumors.Among them,HER-2 expression is negative,ER and PR are positive,Ki-67>30%,axillary lymph nodes are negative,and breast cancer patients with breast masses>2cm are more common,and most of the postoperative pathological TNM staging belong to stage II.Deficiency of Qi may be related to the positive expression of HER-2,ER,PR,breast masses>2 cm,Ki-67>30%,positive axillary lymph nodes and other prognostic factors for breast cancer.6.Breast cancer patients with Yang-deficiency and Qi-deficiency are more likely to have a decrease in the absolute value of neutrophils after chemotherapy;Yin-deficiency is more common in red blood cells and hemoglobin decline;Yang-deficiency may be related to the decline of platelets.7.The risk of severe myelosuppression is highest in patients with breast cancer with yang deficiency type after chemotherapy. |
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