The Study Of Syndrome Differentiation Type Of Consolidate Period Of Breast Cancer And The Relationship Of Blood Lipid,Body Mass Index And Prognosis Of Breast Cancer

Breast cancer already becomes the most common malignancy to imperil women' s health.The clinical practice in long period attested to that traditional Chinese medicine cure to breast cancer can improve clinical symptoms and advance the quality of life.But the Differentiation Type standard and treatment based on syndrome are not canonical and unitive. So we devide the curative course to the period of operation,the period of chemotherapy,the period of actinotheraphy and the consolidate Period. Thereinto the consolidate period is an important period to Chinese Medicine, because Chinese Medicine have particular curative effects to fatigue,poor appetite,insomnia,the blues and fidget from the worry about disease and the side-effect of endocrinotherapy.So we select the consolidate period to study syndrome differentiation type and macroscopic and microcosmic syndrome constitutions which can provide foundation to syndrome differentiation and treatment;Though following-up patients of the consolidate period,we found that most of them have blood lipid abnormity. At the same time blood lipid and body mass index(BMI) are considered the high risk factors of breast cancer,but the relationship of blood lipid,BMI and prognosis of breast cancer is not clear.We studied the relationship of blood lipid,BMI and prognosis of breast cancer though following-up patients of the consolidate period which can provide foundation to prevent and monitor the recrudescence and metastasis of breast cancer.PartⅠ:The study of syndrome differentiation type in consolidate period of breast cancer Aims:To study the syndrome differentiation type in consolidate period of breast cancer,and discuss the primary syndrome of them.And It will be compared with the result of syndrome differentiation type through reformative Delphi method.To explore the the syndrome differentiation type distributing law of ER negative and PR negative breast cancer and triple negative breast cancer.To study the relationship of blood lipid,body mass index(BMI) and the syndrome differentiation type of breast cancer,which is the microcosmic syndrome of Chinese Medicine.Methods:The study of syndrome differentiation type in consolidate period of breast cancer,we use cross-sectional observing,Descriptive statistical analysis,chi-sguare(X2) test,variance analysis,Rank sum test,Cluster analysis,frequency normalization method weight numeration,etc.Exploring the the syndrome differentiation type distributing law of ER negative and PR negative breast cancer and triple negative breast cancer,we use Ward method,and use variance analysis or Rank sum test to study the relationship of blood lipid,body mass index(BMI) and the syndrome differentiation type of breast cancer.Results:Through statistics analysis and expert consultantion,the result show that cluster four type in consolidate period of breast cancer is compatible: spleen-kidney deficiency type,has a disease no syndrome type,kidney deficiency with blood stasis type and Deficiency of liver-kidney yin type. And then we confirm the main syndrome of the four type based on weight.The main clinical syndrome of spleen-kidney deficiency type are sweat,agitated and easy anger,withered-yellowish face,suffering upper limb numbness, waist and knee ache,hectic fever,fatigue,forgettery,the tongue is weak, tongue moss are infertile,a string pulse or a thin pulse.The main clinical syndrome Of has a disease no syndrome type are no obvious discomfort,the tongue is weak,tongue moss are infertile,a string pulse or athin pulse. The main clinical syndrome of kidney deficiency with blood stasis type are easy to wake,forgettery,waist and knee ache,operation wound numbness, suffering upper limb numbness,excessive dream,fatigue,agitated and easy anger,hectic fever,undersexed,dry mouth,insomnia,wine catamenia color, dismal tongue,venation under the tongue is wine,tongue moss are infertile, a thin pulse.The main clinical syndrome of deficiency of liver-kidney yin type are upper and lower limb numbness,fatigue,dry mouth and laryngopharynx,easy to wake,waist and knee ache,head and body lumbersome, forgettery,agitated and easy anger,operation wound numbness,suffering upper limb numbness,limbs feel cold,be light in the head,breast feel fuggy, operation wound ache,excessive dream,hectic fever,insomnia,fauces swollen and ache,tinnitus,undersexed,dumps and easy to suspire, stomatitis,feverish sensation over five centers,dismal tongue,tongue moss are thin,feint tongue,a thin pulse.The syndrome differentiation type distributing of ER negative and PR negative breast cancer and triple negative breast cancer is equipotent,The difference has no statistics meaning through chi-sguare(X2) test.The average mulriple compare of blood lipid,body mass index(BMI) and the syndrome differentiation type show that the difference has no statistics meaning.Conclusions:1.Cluster four type in consolidate period of breast cancer is compatible, :spleen-kidney deficiency type,has a disease no syndrome type,kidney deficiency with blood stasis type and Deficiency of liver-kidney yin type. And confirm the main syndrome of the four type based on weight.2.Cluster result compared with the result of syndrome differentiation type through reformative Delphi method,part of them were same,part of them were different.Two of them in clinical are reinforce each other,and we hope receive same and credible result in future study.3.The syndrome differentiation type distributing of ER negative and PR negative breast cancer and triple negative breast cancer is equfpotent,we Should syndrome differentiation and treatment in clinical practice.4.6 blood lipids and BMI can not discriminate an index as microcosmic syndrome differentiation of cluster four type in consolidate period of breast cancer.PartⅡThe influence of the Blood lipid,BMI on prognosis Aims:We follow-up ER negative and PR negative breast cancer in consolidate period and study the relationship of Blood lipid,BMI and prognosis,and explore the relationship of Blood lipid metabolize diversification and recrudescence and metastasis of breast cancer.Methods:Comparing of the Blood lipid,BMI normal group and abnormal group patients of ER negative and PR negative breast cancer before operation,we use T test,variance analysis and Rank sum test.The correlation analyse of the Blood lipid,BMI and recrudescence and metastasis of breast cancer, we use logistic regression analyse.The compare of the Blood lipid of before operation,in consolidate period(1 year after operation) and after recrudescence and metastasis of ER negative and PR negative breast cancer who have appear recrudescence and metastasis of tumor,we use T test,variance analysis or Rank sum test.Results:The recrudescence and metastasis rateratio of Blood lipid abnormal group is obvious higher than the Blood lipid,BMI normal group.The statistics results show the difference has statistics meaning,P＜0.05. The recrudescence and metastasis rateratio and mortality of BMI≥25 group is higher than BMI＜25 group,the difference has statistics meaning,P＜0.05. The logistic regression analyse of the Blood lipid,BMI and recrudescence and metastasis of breast cancer show that TG,suckle time and HDL-C enter the equation.Wald and P are 14.705(P＜0.001),4.517(P=0.034),4.919 (P=0.027).The compare of three period of time Blood lipid of ER negative and PR negative breastcancer,such.as TG,LDL-C,Apo-A,Apo-B,show that the difference has statistics meaning.The difference of TCH before operation and in consolidate period has no statistics meaning,but the difference of TCH before operation and after recrudescence and metastasis, TCH in consolidate period and after recrudescence and metastasis have statistics meaning(P＜0.001,P=0.005).The difference of HDL-C of three period has no statistics meaning.Conclusions:The high value of non-HDLC including TG,TCH,LDL-C,Apo-A and Apo-B, and recrudescence and metastasis of breast cancer is relational.The increasing of non-HDLC in desease couse clue to not good to prognosis of breast cancer.The consanguineousest relation to recrudescence and metastasis of breast cancer is TG and HDL-C.BMI increase is not good to prognosis of breast cancer.In conclusion,we did some good exploration to the syndrome differentiation type in consolidate period of breast cancer,and we consider that cluster four type in consolidate period of breast cancer is compatible, and then confirm the main syndrome of the four type based on weight.6 blood lipids and BMI can not discriminate an index as microcosmic syndrome differentiation of cluster four type in consolidate period of breast cancer. Through following-up consolidate period patients,we found that blood lipids,BMI and recrudescence and metastasis of breast cancer has correlation.It may leave something recrudescence and metastasis of breast cancer if adopt correlative measure to depress blood lipids and BMI.