结直肠癌靶向治疗患者的核心症状群与生活质量关系的研究

doi:10.3761/j.issn.0254-1769.2026.16.004

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (16): 2189-2195.DOI: 10.3761/j.issn.0254-1769.2026.16.004

• 消化系统疾病护理专题 • 上一篇下一篇

结直肠癌靶向治疗患者的核心症状群与生活质量关系的研究

史佳琦¹(), 刘医豪², 李颖³, 许惠靖⁴, 吴善玉¹^,^*(), 金头峰²

¹ 延边大学护理学院吉林省延吉市 133000
² 延边大学附属医院胃肠外科吉林省延吉市 133000
³ 延边大学附属医院肿瘤内科吉林省延吉市 133000
⁴ 首尔大学护理学院韩国首尔市 08826

收稿日期:2025-11-24 出版日期:2026-08-20 发布日期:2026-08-14
*通讯作者: 吴善玉，E-mail：wusy@ybu.edu.cn
作者简介:史佳琦：女，硕士，护士，E-mail：2608882032@qq.com
第一联系人：作者贡献声明
史佳琦：研究资料的收集与整理、论文撰写；刘医豪、李颖、许惠靖：表格的编辑、整理；吴善玉、金头峰：论文审校与修订、监督管理

Identification of core symptom clusters in patients with colorectal cancer undergoing targeted therapy and their predictive effect on quality of life

SHI Jiaqi¹(), LIU Yihao², LI Ying³, XU Huijing⁴, WU Shanyu¹^,^*(), JIN Toufeng²

¹ School of Nursing， Yanbian University，Yanji， Jilin Province 133000， China
² Department of Gastrointestinal Surgery， Yanbian University Affiliated Hospital，Yanji， Jilin Province 133000， China
³ Department of Oncology， Yanbian University Affiliated Hospital，Yanji， Jilin Province 133000， China
⁴ College of Nursing， Seoul National University， Seoul 08826， Republic of Korea

Received:2025-11-24 Online:2026-08-20 Published:2026-08-14
* Corresponding author: WU Shanyu，E-mail：wusy@ybu.edu.cn

摘要/Abstract

摘要：

目的构建结直肠癌靶向治疗患者的症状网络，探索核心症状群，并分析其对生活质量的影响，为制订针对性的症状管理方案、改善患者生活质量提供依据。方法采取便利抽样法，选取2024年12月—2025年4月在吉林省2所三级甲等医院肿瘤内科住院的260例结直肠癌靶向治疗患者作为调查对象，采用一般资料调查表、安德森症状评估量表-大肠癌模块、癌症治疗功能评价普适性量表进行调查。采用探索性因子分析提取症状群，采用R语言构建症状网络分析中心性指标，并通过分层回归明确对患者生活质量的影响较大的症状群。结果共发放调查问卷260份，回收254份，问卷有效回收率为97.69%。结直肠癌靶向治疗患者常见的症状是疲乏（85.83%）、食欲不振（81.89%）、睡眠不安（77.56%）。探索性因子分析提取出5个症状群，累计方差贡献率为58.188%。症状网络中强度最大的症状为恐惧（r_S=2.414）。分层回归分析结果表明，代谢-情绪相关症状群（P<0.001）和消化道相关症状群（P=0.029）对生活质量的影响有统计学意义，症状群可解释总变量的26.5%。结论结直肠癌靶向治疗患者存在多个症状群，而恐惧是维系整个症状网络的核心节点。其中代谢-情绪相关症状群与消化道相关症状群是影响生活质量的关键因素，临床干预应聚焦于2个症状群的控制，实现靶向治疗期症状的精准管理，提升患者的生活质量。

关键词: 结直肠癌, 症状网络, 生活质量, 护理, 靶向治疗

Abstract:

Objective To construct a symptom network for colorectal cancer patients undergoing targeted therapy，identify core symptom clusters，and analyze their impact on quality of life，thereby providing a basis for developing targeted symptom management strategies to improve patients’ quality of life. Methods A total of 260 colorectal cancer patients receiving targeted therapy in the oncology departments of 2 tertiary hospitals in Jilin Province from December 2024 to April 2025 were conveniently selected as the study subjects. The formal survey used the General Information Questionnaire，the MD Anderson Symptom Inventory-Colorectal Cancer Module，and the Functional Assessment of Cancer Therapy-General. Exploratory factor analysis was used to extract symptom clusters；R language was used to construct symptom networks and analyze centrality indicators；hierarchical regression was used to identify the symptom clusters that had the greatest impact on patients’ quality of life. Results A total of 260 questionnaires were distributed and 254 were collected，with an effective recovery rate of 97.69%. The most common symptoms in colorectal cancer patients receiving targeted therapy were fatigue（85.83%），decreased appetite （81.89%），and sleep disturbance（77.56%）. Exploratory factor analysis identified 5 symptom clusters，which explained 58.188% of the total variance. In the symptom network，fear was the symptom with the highest strength（r_s=2.414）. Hierarchical regression analysis showed that the metabolic-emotional symptom cluster（P<0.001） and the gastrointestinal symptom cluster（P=0.029） had statistically significant effects on quality of life，and the symptom clusters together explained 26.5% of the total variance. Conclusion Colorectal cancer patients receiving targeted therapy experience multiple symptom clusters，and fear is the core node maintaining the entire symptom network. The metabolic-emotional symptom cluster and the gastrointestinal symptom cluster are key factors affecting quality of life. Therefore，clinical interventions should prioritize the control of these 2 symptom clusters to achieve precise symptom management during targeted therapy，and improve patients’ quality of life.

Key words: Colorectal Cancer, Symptom Network, Quality of Life, Nursing Care, Targeted Therapy

史佳琦, 刘医豪, 李颖, 许惠靖, 吴善玉, 金头峰. 结直肠癌靶向治疗患者的核心症状群与生活质量关系的研究[J]. 中华护理杂志, 2026, 61(16): 2189-2195.

SHI Jiaqi, LIU Yihao, LI Ying, XU Huijing, WU Shanyu, JIN Toufeng. Identification of core symptom clusters in patients with colorectal cancer undergoing targeted therapy and their predictive effect on quality of life[J]. Chinese Journal of Nursing, 2026, 61(16): 2189-2195.

图/表 4

表1 结直肠癌靶向治疗患者的一般资料及其对生活质量影响的单因素分析（n=254）

Table 1 Univariate analysis of demographic characteristics and quality of life in colorectal cancer patients（n=254）

表2 结直肠癌靶向治疗患者症状发生率、得分和症状群提取结果（n=254）

Table 2 Incidence，scores of symptoms and extraction of symptom clusters in patients with colorectal cancer receiving targeted therapy（n=254）

图1 结直肠癌靶向治疗患者的症状网络图注：表示代谢-情绪相关症状群，1为体重下降，10为情绪低落，7为恐惧，9为悲伤，15为食欲不振，17为苦恼；表示特异症状群，5为大便习惯改变，18为里急后重，6为大便性状改变；表示疾病行为症状群，3为口干，19为麻木，12为疲乏，14为睡眠不安；表示消化道相关症状群，16为腹泻，4为呕吐，8为恶心；表示缺氧-神经功能紊乱症状群，2为健忘，11为气短，13为疼痛。

Figure 1 Symptom network of patients with colorectal cancer receiving targeted therapy

表3 结直肠癌靶向治疗患者症状群与生活质量的分层回归结果（n=254）

Table 3 Hierarchical regression results of symptom clusters and quality of life in patients with colorectal cancer receiving targeted therapy（n=254）

参考文献 18

[1]	Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2024, 74(3):229-263.
[2]	袁之俊, 来茂德. 结直肠癌分子分型与免疫治疗和靶向治疗[J]. 临床与实验病理学杂志, 2024, 40(6):561-566.
	Yuan ZJ, Lai MD. Molecular typing of colorectal cancer and immunotherapy and targeted therapy[J]. J Clin Exp Pathol, 2024, 40(6):561-566.
[3]	刘亭. 贝伐珠单抗联合化疗治疗转移性结直肠癌疗效及安全性的长期随访观察[D]. 蚌埠: 蚌埠医学院, 2021.
	Liu T. Long-term follow-up study of the efficacy and safety of bevacizumab combined with chemotherapy in the treatment of metastatic colorectal cancer[D]. Bengbu: Bengbu Medical College, 2021.
[4]	祝龙玲, 蒋晓莲, 彭维雪, 等. 乳腺癌术后化疗患者症状群的纵向研究[J]. 护理学杂志, 2022, 37(20):23-27.
	Zhu LL, Jiang XL, Peng WX, et al. Longitudinal analysis of symptom clusters in chemotherapy patients after breast cancer surgery[J]. J Nurs Sci, 2022, 37(20):23-27.
[5]	Hevey D. Network analysis:a brief overview and tutorial[J]. Health Psychol Behav Med, 2018, 6(1):301-328. DOI URL
[6]	Epskamp S, Borsboom D, Fried EI. Estimating psychological networks and their accuracy:a tutorial paper[J]. Behav Res Methods, 2018, 50(1):195-212. DOI PMID
[7]	Wang XS, Wang Y, Guo H, et al. Chinese version of the M.D.Anderson Symptom Inventory:validation and application of symptom measurement in cancer patients[J]. Cancer, 2004, 101(8):1890-1901. DOI URL
[8]	顾铭. 安德森症状评估量表大肠癌模块的编制及应用研究[D]. 上海: 上海中医药大学, 2019.
	Gu M. Development and application of the colorectal cancer module based on M.D. Anderson Symptom Inventory[D]. Shanghai: Shanghai University of Traditional Chinese Medicine, 2019.
[9]	Cella DF, Tulsky DS, Gray G, et al. The Functional Assessment of Cancer Therapy Scale:development and validation of the general measure[J]. J Clin Oncol, 1993, 11(3):570-579. DOI PMID
[10]	万崇华, 孟琼, 汤学良, 等. 癌症患者生命质量测定量表FACT-G中文版评介[J]. 实用肿瘤杂志, 2006(1):77-80.
	Wan CH, Meng Q, Tang XL, et al. The Chinese version of FACT-G form in evaluation of quality of life for patients with cancer[J]. J Pract Oncol, 2006(1):77-80.
[11]	郑存风, 王峥, 刘海静, 等. 结直肠癌术后化疗患者核心症状的纵向研究及护理对策[J]. 中华护理杂志, 2025, 60(11):1309-1315. DOI
	Zheng CF, Wang Z, Liu HJ, et al. Longitudinal study on core symptoms and nursing strategies for patients with colorectal cancer undergoing postoperative chemotherapy[J]. Chin J Nurs, 2025, 60(11):1309-1315. DOI
[12]	Cremolini C, Rossini D, Dell’Aquila E, et al. Rechallenge for patients with RAS and BRAF wild-type metastatic colorectal cancer with acquired resistance to first-line cetuximab and irinotecan:a phase 2 single-arm clinical trial[J]. JAMA Oncol, 2019, 5(3):343-350. DOI PMID
[13]	邹炎铃, 李易, 张紫嫣, 等. 基于体质特征的胃癌化疗患者核心症状及影响因素研究[J]. 中华护理杂志, 2024, 59(18):2238-2243.
	Zou YL, Li Y, Zhang ZY, et al. Examining core symptoms and influencing factors of patients with gastric cancer undergoing chemotherapy:the role of Traditional Chinese Medicine constitutional traits[J]. Chin J Nurs, 2024, 59(18):2238-2243.
[14]	陈亚琼, 周建荣, 杨靖. 鼻咽癌患者同步放化疗期间的症状群及影响因素研究[J]. 重庆医科大学学报, 2014, 39(12):1830-1834.
	Chen YQ, Zhou JR, Yang J. Symptom clusters and influencing factors for patients with nasopharyngeal carcinoma undergoing concurrent chemoradiation therapy[J]. J Chongqing Med Univ, 2014, 39(12):1830-1834.
[15]	冯芳茗, 张伟英, 何佳倩, 等. 消化道癌症患者化疗期间症状群及影响因素分析[J]. 解放军护理杂志, 2020, 37(9):13-17.
	Feng FM, Zhang WY, He JQ, et al. Symptom clusters and influencing factors for patients with gastrointestinal cancer during chemotherapy[J]. Nurs J Chin PLA, 2020, 37(9):13-17.
[16]	周海英, 张玉侠, 陈潇, 等. 肝癌患者术后恶心呕吐发生现况及影响因素研究[J]. 中华护理杂志, 2022, 57(2):182-187. DOI
	Zhou HY, Zhang YX, Chen X, et al. The incidence and risk factors of postoperative nausea and vomiting in liver cancer[J]. Chin J Nurs, 2022, 57(2):182-187. DOI
[17]	Gressett SM, Shah SR. Intricacies of bevacizumab-induced toxicities and their management[J]. Ann Pharmacother, 2009, 43(3):490-501. DOI PMID
[18]	Van Cutsem E, Köhne CH, Hitre E, et al. Cetuximab and che-motherapy as initial treatment for metastatic colorectal cancer[J]. N Engl J Med, 2009, 360(14):1408-1417. DOI URL

结直肠癌靶向治疗患者的核心症状群与生活质量关系的研究

Identification of core symptom clusters in patients with colorectal cancer undergoing targeted therapy and their predictive effect on quality of life

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