宫颈癌患者焦虑、抑郁症状的中医证型分布规律及其风险预测模型构建OA

Objective:To analyze the distribution rules of TCM syndromes types in anxiety and depression symptoms among patients with cervical cancer,and to construct a risk prediction model integrating TCM syndrome elements with western medicine clinical parameters,thereby providing novel insights and quantitative evidence for early identification of high-risk patients and implementation of individual-ized interventions.Methods:A cross-sectional survey was conducted involving 300 patients with cervical cancer admitted to The First Af-filiated Hospital of Henan Medical University from May 2023 to May 2025.The Chinese version of the hospital anxiety and depression scale(HADS)was used to assess anxiety(HADS-A)and depression(HADS-D)status(with a score of≥8 defined as positive).TCM syndrome elements were extracted and categorized into five syndrome types:qi stagnation and blood stasis syndrome,liver-kidney yin deficiency syndrome,phlegm-dampness accumulation syndrome,spleen-kidney yang deficiency syndrome,and syndrome of down-pouring dampness-heat.Univariate analysis(P<0.10)was performed to screen potential related factors,which were then incorporated into a multivariate binary logistic regression model(forward stepwise method)to identify independent risk factors.Predictive models for anxiety and depression status were constructed accordingly,and their discriminative performance was evaluated using receiver operating characteristic(ROC)curves.Results:Among the 300 enrolled patients,the incidences of anxiety and depression were 49.00%and 52.00%respectively.Qi stagnation and blood stasis syndrome was the most common TCM one,accounting for 46.33%of all cases and reaching as high as 60.90%among patients with depression.Multivariate analysis revealed that age below 45 years old,FIGO stageⅢ-Ⅳ,history of radiotherapy,nulliparity,and disease duration≤6 months were independent risk factors for both anxiety and depres-sion.The area under the curve(AUC)of the anxiety prediction model was 0.887,with a sensitivity of 84.2%and a specificity of 82.6%at the optimal cut-off value.The AUC of the depression prediction model was 0.786,with a sensitivity of 78.5%and a specific-ity of 75.3%at the optimal cut-off value.Conclusion:The incidence of anxiety and depression among patients with cervical cancer is high,with qi stagnation and blood stasis syndrome representing the core TCM pathogenesis.The prediction models constructed in this study can effectively identify high-risk patients and supply evidence for psychological intervention of integrated Chinese and Western medicine based on TCM syndrome classification.