大肠癌与中医体质及相关危险因素 Logistic 回归分析

目的观察郑州地区大肠癌不同危险程度人群及不同筛查结果人群的中医体质分布,探讨大肠癌在中医体质、性别、年龄方面的主要危险因素。方法采用横断面现场调查法与方便抽样法在调查区域内社区卫生服务机构进行筛查,应用χ~2检验、秩和检验分析不同大肠癌危险程度人群及不同大肠癌筛查结果人群的一般情况及中医体质的差异性分布;分别以大肠癌两种不同危险程度、两种不同大肠癌筛查结果作为因变量,9种中医体质类型、性别、年龄作为自变量,采用逐步回归法将以上变量部分或全部纳入两项逻辑回归模型得到多个模型,分析大肠癌与中医体质类型及相关因素的关系。结果共纳入19 759例研究对象,其中高危人群3 084例,非高危人群16 675例,癌及癌前病变275例;不同大肠癌危险程度人群及不同大肠癌筛查结果人群中的性别分布无差异(P>0.05);阳虚质、老年(60～74岁)是大肠癌高危人群的危险因素(P=0.000),平和质(P=0.000)、痰湿质(P=0.025)是大肠癌高危人群的保护因素,阳虚质是大肠癌及癌前病变人群的危险因素(P=0.011)。结论大肠癌与中医体质、性别、年龄之间存在一定关联,但仍需设计严谨、样本量充足的研究予以验证补充。

Logistic Regression Analysis between Colorectal Cancer and Traditional Chinese Medicine Constitutions and Related Risk Factors

Objective To observe the TCM constitutions distribution of different risk groups and different screening outcome groups on colorectal cancer in Zhengzhou, and to explore the main risk factors for colorectal cancer in TCM constitutions, gender, and age. Methods A cross-site survey and convenient sampling method were used to screen in community health service agencies of the survey areas. The chi-square test, nonparametric test were used to analyze the differences of general situation and the TCM constitutions distribution in different risk groups and different screening outcome groups;the two risk degree and the two screening outcomes of colorectal cancer were taken as the dependent variable respectively, 9 kinds of TCM constitutions, gender, and age were taken as independent variables, stepwise regression was used to incorporate part or all of the above independent variables in the two Logistic regression models, and then several models were obtained to explore the relationship between colorectal cancer and TCM constitutions and related factors. Results A total of 19 759 subjects were enrolled in this study, among which 3 084 subjects belong to high-risk group, 16 675 subjects belong to non-high-risk group, and 275 subjects were checked out with colorectal cancer or precancerous lesions. There was no difference in gender distribution among different risk groups and different screening outcome group of colorectal cancer.(P>0.05);Yang deficiency and the aged(60-74 years old) are risk factors for high-risk group with colorectal cancer(P=0.000), mildness(P=0.000), and dampness(P=0.025) were protective factors for high-risk group with colorectal cancer, Yang deficiency is a risk factor for people with colorectal cancer and precancerous lesions(P=0.011). Conclusion There are certain relationships among colorectal cancer, TCM constitutions, gender, and age, but researches with rigorous design and ample sample size are still necessary to verify and supplement these results.