A Study On TCM Constitution Typing In Patients With Depression Associated With Primary Bronchial Lung Cancer

Objective:The aims of this study are to clarify the incidence of lung cancer-related depression(LCRD)and the distribution of TCM Constitution,and to clarify the susceptible TCM constitution and risk factors of LCRD.Methods:From September 2020 to December 2020,350 patients with primary bronchogenic carcinoma were included in this study.The basic information questionnaire of lung cancer patients,history data collection form of lung cancer patients,patient health questionnaire self rating scale(PHQ-9),hospital anxiety and depression Scale(HADS)and TCM constitution classification and judgment scale were used to collect data.Patients with depression were classified as LCRD group,otherwise they were classified as non-LCRD group.After checking,the collected data were imported into spss 20.0 statistical software for statistical analysis.Objective to discuss the incidence of LCRD,physical distribution,susceptible constitution and risk factors.Results:1.350 patients with lung cancer were enrolled in this study,the incidence rate of LCRD was 26%.Among them,47 were mild depression,30 were moderate depression,12 were moderate and severe depression,2 were severe depression.2.Among 350 lung cancer patients,Qi deficiency constitution was the most,accounting for 29.14%,followed by mild constitution(26.86%)and Yang deficiency constitution(20.57%),and the first three constitutions accounted for 76.57%.The TCM Constitution of LCRD group was mainly biased constitution(93.41%).with Qi deficiency constitution(39.56%),Yang deficiency constitution(19.78%),Qi-stagnation constitution(10.99%)and Yin deficiency constitution(7.69%),accounting for 78.02%.In the non-LCRD group,33.98%of them were mild constitution,followed by Qi deficiency(26.64%),Yang deficiency(20.85%)and phlegm dampness(5.02%).There was significant difference between LCRD group and non-LCRD group(P<0.01).Among the 9 types of TCM Constitution,the incidence rate of LCRD with mild constitution was 6.4%,while the incidence rate of LCRD in Qi stagnation,Yin deficiency and Qi deficiency lung cancer patients were 58.8%,50%and 34.3%respectively.3.Univariate chi square test results showed that patient type(outpatient/ward).degree of knowledge of the disease,IASLC clinical stage,M stage,duration of diagnosis,lymph node metastasis,brain metastasis,lung metastasis,no Western medicine treatment,surgery,had finished western medicine treatment,in progress of targeting therapy or immunotherapy,gastrointestinal reaction after chemotherapy,fatigue after chemotherapy,cancer still exist,treatment by Chinese herbs,intervention time of Chinese herbs,educational level,personal monthly income,Karnofsky score,degree of pain,mild constitution,Qi deficiency constitution,Qi-stagnation constitution and Yin deficiency constitution were related to the occurrence of LCRD(P<0.05).The results of multivariate binary logistic regression analysis showed that course of disease ranged from 6 to 12 months(OR=0.133,95%CI:0.043～0.409)and mild constitution(OR=0.220,95%CI:0.070～0.693)were the protective factors/constitution of LCRD(P<0.05).Brain metastasis(OR=4.790,95%CI:1.442～15.912),no Western medicine treatment(OR=10.624,95%CI:1.649～68.432),in progress of targeting therapy or immunotherapy(OR=5.042,95%CI:1.571～16.178),gastrointestinal reactions after chemotherapy(OR=2.491,95%CI:1.024～6.056),low Karnofsky score(Karnofsky score 60(OR=10.822,95%CI:1.376～85.122),Karnofsky score 70(OR=15.065,95%CI:2.271～99.956)),Qi-stagnation constitution(OR=8.125,95%CI:2.152～30.676)and Yin deficiency constitution(OR=4.427,95%CI:1.065～18.403)were the risk factors/constitution of LCRD(P<0.05).Conclusion:1.The incidence rate of LCRD is 26%,mainly with mild depression.2.Among lung cancer patients,Qi deficiency is the most common constitution,followed by mild constitution and Yang deficiency constitution.The TCM Constitution of LCRD group was mainly biased constitution,with Qi deficiency,Yang deficiency,Qi-stagnation and Yin deficiency in the majority.Among the 9 types of TCM Constitution,the incidence rate of LCRD in patients with mild lung cancer is the lowest,is the protective constitution of LCRD.The incidence rate of LCRD in patients with Qi deficiency,Qi-stagnation and Yin deficiency is higher,and they are the dangerous constitution of LCRD.3.Multivariate binomial logistic regression analysis showed that course of disease ranged from 6 to 12 months is the protective factor of LCRD,while brain metastasis,no Western medicine treatment,in progress of targeting therapy or immunotherapy,gastrointestinal reactions after chemotherapy,and low Karnofsky score were the risk factors of LCRD.