| 1.Research purpose and significanceObjective to explore the prognostic factors of postoperative survival of patients with breast cancer after bone metastases.Meanwhile,based on the data mining technology of traditional Chinese medicine heritage support platform(V2.5),we explored the characteristics of medication in Dongzhimen Hospital of Beijing University of Chinese Medicine.The aim is to give full play to the strengths of both Chinese and Western medicine in the treatment of postoperative breast cancer bone metastases,and to alleviate the pain and side effects of treatment.2.Research methods2.1 Patients with bone metastases after breast cancer surgeryThe inclusion criteria and exclusion criteria were used to screen 67 patients with bone metastases from breast cancer after surgery in Dongzhimen hospital from January 1,2010 to March 1,2021.Systematic review was conducted to collect the general information including age,gender,menstrual status,tumor diameter,axillary lymph node metastasis,clinical stage,and so on,which were confirmed in breast cancer in Dongzhimen.Pathological type,molecular classification,location and quantity of bone metastasis,whether it is accompanied by metastasis of other sites,time of bone metastasis,treatment of bone metastasis,survival time of patients,use of traditional Chinese medicine,etc.the general situation of patients was recorded by Microsoft Excel software,and the data were analyzed by SPSS.25.0 software,Single factor COX proportional hazards regression model was used to analyze the factors that may affect the survival of patients with breast cancer after operation.The factors of p<0.2 were further analyzed by multivariate COX regression model to find out the possible factors affecting the survival of patients with breast cancer after operation.The survival curves were described by Kaplan Meier method and compared by log rank test.2.2 Analysis of Chinese and Western medicine in the treatment of postoperative bone metastases from breast cancerBased on the traditional Chinese medicine heritage support platform(V2.5)system,we collected 62 cases of 67 cases of bone metastases from breast cancer patients in Dongzhimen Hematology Oncology Department of Beijing University of Chinese Medicine from January 1,2010 to March 1,2021.The data of 85 prescriptions were entered into the traditional Chinese Medicine Inheritance auxiliary platform,and a standardized database was established.The data were counted by using the root value correlation analysis and cluster analysis functions in the "statistical report" and "data analysis" of the system,After excavation,the frequency,four Qi and five flavors,meridian tropism,drug pair combination and core combination of the prescription in the bone metastases of breast cancer patients were excavated,and potential new prescriptions were finally excavated.Other types of traditional Chinese medicine treatment and Western medicine treatment were input by Microsoft Excel software,and then frequency statistics were used,and statistical charts were made.3.Research results3.1 Survival analysis of patients with bone metastases after breast cancer surgeryThere were 67 cases of breast cancer patients with bone metastases following the inclusion criteria,45 cases(67.2%)died,22 cases(32.8%)survived,the median survival time was 48 months,and the average survival time was 107.6 months.Single factor COX regression analysis showed that age,menstruation,molecular typing and ER were related to the prognosis of patients with postoperative bone metastases.The size of tumor,the number of axillary lymph nodes,pathological types,clinical stages,PR,HER-2,the number of bone metastases,and the metastasis of other locations were not related to the prognosis.The factors of P<0.2,such as age,menstruation,molecular type,number of axillary lymph node metastasis,er,HER-2 and tumor size,were included in the Cox regression model.The results showed that there were significant differences in age,menstruation,molecular type and ER.3.2 Analysis of Chinese and Western medicine in the treatment of postoperative bone metastases from breast cancer3.2.1 analysis of modern medicine and Chinese patent medicine treatmentThe treatment of postoperative bone metastases from breast cancer includes analgesics,radiotherapy and chemotherapy,surgery,bisphosphonates,Chinese medicine and symptomatic support therapy.67 cases of postoperative breast cancer patients with bone metastases were treated with analgesic drugs in 32 cases.There were 58 patients with regular use of bisphosphonates,6 with radiotherapy,2 with surgery and 1 with gamma knife.50 cases used Chinese patent medicine.3.2.2 drug analysis of traditional Chinese Medicine Inheritance auxiliary platformA total of 67 patients with bone metastases after breast cancer surgery were included in this study.Among them,62 patients received oral Chinese medicine prescriptions in 85 cases.(1)The commonly used drugs for bone metastases after breast cancer surgery are Poria,tangerine peel,bupleurum root,Radix Astragali,Pinellia ternate,Codonopsis pilosula,chicken gall,Paeonia lactiflora,Radix Glycyrrhizae,Rhizoma Atractylodis Macrocephalae,radix paeoniae rubra,turtle shell,Salvia miltiorrhiza,Fructus aurantii,Curcuma longa,Amomum villosum,Rhizoma Atractylodis Macrocephalae,Radix Ophiopogon,angelica,Magnolia officinalis,Radix Astragali,Radix Acorus calamus,and 37.(2)The main drugs used were warm drugs(39.2%),cold drugs(35.2%),mild drugs(21.5%),bitter drugs(38.2%),sweet drugs(35.6%)and pungent drugs(29.1%).(3)Through the analysis of "prescription rule" in the traditional Chinese Medicine Inheritance auxiliary platform system,the "number of support" is set to 10,and the"confidence" is set to 0.7.The statistical analysis of "medication mode" is carried out,which is arranged from large to small according to the frequency of occurrence.The common drug combinations with the frequency of more than 12 were "tangerine peel,Poria cocos","Pinellia ternata,Poria cocos","Pinellia ternata,Pericarpium Citri Reticulatae","Radix Paconiae Alba,Radix Bupleuri","Radix Bupleuri,Poria cocos","tangerine peel,fried Rhizoma Atractylodis Macrocephalae","dangshen,Poria cocos","Pinellia ternata,dangshen","dangshen,fried Rhizoma Atractylodis Macrocephalae","Angelica sinensis,Poria cocos","Pinellia ternata,Radix Bupleuri".(4)Based on the improved mutual information method,the "correlation degree" was set to 6,and the "punishment degree" was set to 2.The cluster analysis showed that the two commonly used drug pairs included "coix seed,tangerine peel","Agrimonia pilosa,raw Astragalus","Angelica sinensis,Poria cocos","Acorus tatarinowii,tangerine peel","Panax notoginseng,raw Astragalus".(5)based on complex system entropy clustering and unsupervised entropy hierarchical clustering method,the core combination of 10 cases of bone metastases after breast cancer surgery in Dongzhimen hospital hematology oncology department was obtained.Acorus tatarinowii_Stir fried Atractylodes macrocephala and turtle shell_Fried Radix Astragali_Salvia miltiorrhiza,Zizyphus jujuba_Semen Lepidii_Loquat leaf and jujube_Semen Lepidii_Fangji,Tinglizi_White mustard seed_Mirabilite,Tinglizi_White mustard seed_"Fangji","shenghuangqi"_Panax notoginseng_"Tangerine peel","raw Astragalus membranaceus"_Ramulus Cinnamomi_Ganoderma lucidum,Cistanche deserticola_Fritillaria cirrhosa_"Huomaren","Chuanbeimu"_Anemarrhena asphodeloides_Poria cocos.The five new methods are:1_Acorus tatarinowii_Stir fried Atractylodes macrocephala_Turtle shell_Fried Radix Astragali_Salvia miltiorrhiza Bge;②Jujube_Semen Lepidii_Loquat leaf_Semen stephaniae-White mustard seed_Mirabilite_Self defense;④Raw Astragalus_Panax notoginseng_Tangerine peel_Ramulus Cinnamomi_Ganoderma lucidum.⑤Cistanche deserticola_Fritillaria cirrhosa_Hemp seed_Anemarrhena asphodeloides_Poria cocos.4.Research conclusion4.1 Survival analysis of patients with bone metastases after breast cancer surgery(1)this study shows that the median survival time of patients with breast cancer after bone metastases is 48 months.The most common locations of bone metastases after breast cancer are spine,rib,pelvis,sternum and extremities.(2)multivariate analysis showed that age at onset,menstrual status,molecular typing and ER were independent prognostic factors for postoperative breast cancer patients with bone metastases.The age of onset is more than 50 years old.Menopause and ER negative.HER-2 high expression and three yin type are independent risk factors for survival of patients with bone metastases after breast cancer surgery.4.2 Analysis of Chinese and Western medicine in the treatment of postoperative bone metastases from breast cancerThe Dongzhimen Hospital of Beijing University of Chinese Medicine treated the postoperative bone metastases of breast cancer with the characteristics of combination of Chinese and Western medicine and the combination of Chinese and Western medicine.Combined with comprehensive therapy in the treatment of postoperative bone metastases of breast cancer,combined with the basic theory of traditional Chinese medicine,the system of syndrome differentiation and treatment was based on the principle of invigorating the spleen and tonifying the kidney,with the principles of activating blood circulation to dissipate blood stasis,resolving phlegm and dispersing stagnation,dispersing liver and regulating qi,dredging collaterals and relieving pain,strengthening tendons and strengthening bones.The treatment is flexible and flexible.So that Chinese and Western medicine can cooperate and complement each other. |
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