宏-微观辨证结合，基于"中医临床表型"构建乳腺癌化疗风险预测数学模型

项目名称： 宏-微观辨证结合，基于"中医临床表型"构建乳腺癌化疗风险预测数学模型

项目编号： No.81202672

项目类型： 青年科学基金项目

立项/批准年度： 2013

项目学科： 医学八处

项目作者： 刘昳

作者单位： 西安交通大学

项目金额： 23万元

中文摘要： 一旦严重或致死性化疗毒性发生，可直接导致化疗中止；恐惧化疗毒性发生，甚至使部分患者放弃化疗。优化个体化化疗方案的关键是平衡化疗风险与获益。如能准确预测个体化疗风险，就可避免选风险高的方案，拟定针对性强的防治化疗毒性策略，还能减轻患者恐惧，提高化疗依从性。项目采用文本挖掘，引入中医"宏观"辨证、辨体质来丰富对患者机体状态的认识，再结合乳腺癌"微观"信息-相关病理及生物标志物，提取乳腺癌"中医临床表型"要素。据此设计调查表，并以之为工具，在乳腺癌患者中采用心理物理学等方法开展多中心临床研究，形成乳腺癌患者中医临床表型数据库；首次应用计量经济学新方法Granger因果分析及协整分析，探寻乳腺癌中医临床表型中与化疗不良反应发生相关的"因素"；再以之构建预测乳腺癌化疗风险协整模型。避免了现有模型对"未知但可能相关危险因素"无法认知局限。项目将为优化中西医乳腺癌个体化治疗方案，确保化疗顺利实施奠定基础

中文关键词： 乳腺癌；化疗风险预测模型；化疗不良反应；因果关系分析；宏-微观辨证

英文摘要： Though increasing evidences show that patients could benefit from chemotherapy, serious or fatal toxic effect of chemotherapy could lead to the suspension of medication, and even some patients refuse chemotherapy because they fear the toxicity of chemotherapy. The toxic effects of chemotherapy is fairly important in optimizing individual therapeutic regimen and patients often express fear of the side effects, so this study is devoted to researching on this important aspect of chemotherapy. This study is aimed to develop an accurate predictive model of chemotherapy risk to help clinicians inform breast cancer patients with risks of chemotherapy, and thus to help the informed patient to alleviate their fear and anxiety about toxicity of chemotherapy. Furthermore, this predictive model will be built to help clinicians to assess whether serious or fatal events will happen, and determine whether the chemotherapy regimen is appropriate to the patients. And then specific treatment will be given to possible adverse reactions of chemotherapy to achieve optimal individualized treatment program and to ensure smooth implementation of chemotherapy. Firstly, we'll extract the "macro" information about physical condition, which comes from syndrome-constitutional differentiation in the light of TCM theory. Then combined with th

英文关键词： breast cancer；predictive model of chemotherapy risk；adverse effects of chemotherapy；Granger causality and cointegration analysis；macro-micro differentiation of syndrome-constituti