基于交叉滞后网络分析胃癌化疗病人体质对症状网络的影响

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Impact of physical constitution on the symptom network of gastric cancer patients undergoing chemotherapy based on cross⁃lagged network analysis

LI Siyu1， ZHU Kaili1， XIA Chao2， YANG Ling2， DUAN Peibei2*

1.School of Nursing， Nanjing University of Chinese Medicine， Jiangsu 210023 China；2.The Affiliated Hospital of Nanjing University of Chinese Medicine

*Corresponding Author  DUAN Peibei， E⁃mail： yfy0033@njucm.edu.cn

Abstract  Objective：To construct a dynamic network using data on physical constitution and symptoms of gastric cancer patients at three time points， explore the evolution patterns of these factors during chemotherapy， and identify potential intervention targets.Methods： A total of 386 gastric cancer patients undergoing chemotherapy were recruited from four tertiary⁃grade A hospitals in Jiangsu Province from July 2021 to February 2024. Measurements of physical constitution and symptoms were carried out in the early stage of chemotherapy （after the second chemotherapy， T1）， the middle stage of chemotherapy （after the fourth chemotherapy， T2）， and the late stage of chemotherapy （after the sixth chemotherapy， T3）. Cross⁃lagged network analysis was used to explore the interaction between physical constitution and symptoms over time. Results： The balanced constitution acted as a protective factor against symptoms such as sadness， taste change， and loss of appetite. During the period from T1 to T2， the blood⁃stasis constitution and yang⁃deficiency constitution mainly predicted fatigue and sadness in the T2 period， and the path "sadness→fatigue" was the strongest predictive path.From T2 to T3， the phlegm-dampness constitution promoted taste change， which further predicted persistent loss of appetite. Conclusion： The study reveals a significant causal relationship between physical constitution and symptoms through dynamic network analysis. Based on the theory of "adjustable physical constitution"，early management of blood⁃stasis constitution，yang-deficiency constitution， and phlegm⁃dampness constitution can be carried out， and the focus of symptom intervention can be changed in a timely manner.

Keywords    gastric cancer; chemotherapy; traditional Chinese medicine constitution; symptom network; cross⁃lagged analysis; temporal sequence relationship; causal relationship

摘要  目的：利用胃癌化疗病人3个时间点的体质和症状数据构建动态网络，探讨胃癌化疗病人体质和症状的演变规律，并识别干预靶点。（剩余12803字）