| Background:In the process of diagnosis and treatment,patients with pancreatic cancer often experience depression,fatigue,sleep disorders,cognitive dysfunction and other behavioral changes,which may affect the quality of life of patients,even exacerbate the disease,shorten their survival.Some studies show that about 43%of patients with pancreatic cancer have depressive symptoms,After diagnosis,the incidence of pancreatic cancer-related depression is the first in China.At present,the clinical treatment of depression in patients with pancreatic cancer mainly includes antidepressant drug therapy,psychological intervention,traditional Chinese medicine decoction,traditional Chinese medicine therapy.The side effects of antidepressant treatment were obvious and drug resistance was easy to appear.But the traditional Chinese medicine decoction,the traditional Chinese medicine method early intervention,the poisonous side effect is few,the operability is strong,the curative effect is worth affirming.Differentiation of symptoms and signs of depression patients with pancreatic cancer can be targeted treatment,understanding the factors that affect the occurrence of depression in patients with pancreatic cancer,early prevention and intervention of susceptible groups is necessary.To explore the mechanism of interaction between pancreatic cancer and depression can provide some direction for future clinical drug therapy.However,at present,there are relatively few studies on syndrome differentiation and treatment of depression of pancreatic cancer,and the influencing factors and related mechanisms of depression of pancreatic cancer are not clear,therefore,there is no specific treatment in clinical practice.Objective:1 To understand the incidence and syndrome differentiation of depression in patients with pancreatic cancer through clinical research,and to analyze the influencing factors of depression in patients with pancreatic cancer,so as to provide direction for effective prevention and treatment,in order to better guide the clinical therapy.2 To analyze the interaction mechanism between pancreatic cancer and depression through TCMIP V2.0(Integrative Pharmacology-based Network Computational Research Platform of Traditional Chinese Medicine),so as to provide direction for clinical treatment in the future.Methods:1 To investigate the incidence of depression in patients with pancreatic cancer by filling out Self-rating Depression Scale(SDS),questionnaire for basic information of patients with pancreatic cancer and collecting data of symptoms and signs of patients with pancreatic cancer,SPSS software was used to analyze the correlation between depression and various factors,and to summarize the TCM syndrome differentiation and influencing factors of depression patients with pancreatic cancer.2 The target and pathway of predicting the interaction between pancreatic cancer and depression using the platform of TCMIP V2.0,In order to provide direction for future clinical treatment.Results:1 A total of 144 patients with pancreatic cancer were enrolled in this study.The SDS score was(44.9±7.1),of which 81 were depressive patients,56.3%of the group.There were 47 patients with mild depression,32.6%of the group,24 patients with moderate depression,16.6%of the group,and 10 patients with severe depression,6,9%of the group.There were 63 non-depressive patients,43.8%of the group.Test showed that weight lose(p=0.000),smoking(p=0.026),physical exercise(p=0.032),sleep quality(p=0.000),pain(p=0.002),chemotherapy(p=0.046),targeted therapy(p=0.009)were associated with depression.The percentage of syndrome types in patients with depression of pancreatic cancer was as follows:Qi stagnation syndrome 70.4%;Qi inverse syndrome 51.9%;yang deficiency syndrome 45.7%;QI deficiency syndrome 37.0%;phlegm coagulation syndrome 35.8%;essence deficiency syndrome 30.9%;dampness obstruction syndrome 24.7%;blood stasis syndrome 19.8%;yin deficiency syndrome 17.3%;Syndrome of excess cold(13.6%),excess heat(12.3%),blood cold(11.1%),fluid retention(11.1%),blood deficiency(8.6%),deficiency of body fluid(7.4%),blood heat(4.9%),Qi stagnation(3.7%),there were significant differences between depression group and non-depression group in Qi deficiency syndrome(p=0.010),essence deficiency syndrome(p=0.002),Qi stagnation syndrome(p=0.003),yin stop syndrome(p=0.026),excess heat syndrome(p=0.004),(p>0.05).2 The mechanism of interaction between pancreatic cancer and depression may be mediated by 42 core network targets and 48 core pathways.The pathways involved mainly include neural system-related pathway,tumor-related pathway,immune system-related pathway,metabolic pathway,etc.MAPK3,KRAS,HRAS,AKT1,NRAS and other targets may play an important role in these pathways.Conclusion:1 The incidence of depression in patients with pancreatic cancer was about 56.3%,mainly includ mild and moderate depression.The incidence of depression in pancreatic cancer was related to weight change,smoking,physical exercise,sleep quality,pain,chemotherapy,targeted therapy factors.The syndrome types of depression in patients with pancreatic cancer are mainly Qi stagnation syndrome,yang deficiency syndrome,Qi inverse syndrome,phlegm coagulation syndrome and essence deficiency syndrome.There was a certain correlation between the syndrome of essence deficiency,Qi stagnation,fluid retention,excess heat and depression of pancreatic cancer.2 The mechanism of interaction between pancreatic cancer and depression may be mediated by 42 core network targets and 48 core pathways. |
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