A Cross-sectional Study on Traditional Chinese Medicine Syndrome Types and Distribution of Syndrome Elements in Patients with Cancer-related Fatigue

GU Shanshan; XU Yun; WANG Feiye; GONG Lutian; WANG Jinghui; GUO Xinyu; FU Li; SHI Jiyan

doi:10.16295/j.cnki.0257-358x.2023.10.009

Abstract：Objective:To investigate the prevalence of cancer-related fatigue(CRF),and to summarize the TCM syndrome types and TCM syndrome elements distribution characteristics of CRF.Methods:A cross-sectional survey was conducted among tumor patients admitted to the outpatient department and ward of Oncology Department of Xiyuan Hospital of China Academy of Chinese Medical Science from January to December 2021.Visual Analogue Fatigue Scale(VAFS)was used to screen patients with fatigue,and CRF was diagnosed according to the revised criteria of the International Classification of Diseases.The Revised Piper's Fatigue Scale-Chinese version(RPFS-CV)was used to assess fatigue severity,while TCM syndrome types and syndrome elements were collected through a self-designed CRF four-diagnostic information form.Results:A total of 306 tumor patients were included,including 229 patients with CRF(74.8％)and 77 patients without CRF(25.2％).Among the patients with CRF,94(30.7％)cases had mild fatigue,121(39.5％)cases had moderate fatigue,and 14(4.6％)cases had severe fatigue.The score of RPFS-CV was 3.93(2.67,5.05),indicating that the overall level of fatigue was mild to moderate.Distribution of TCM syndrome types:among 306 tumor patients,249 cases were of composite syndrome types,with CRF accounting for 200 cases(80.3％).Among them,147 cases were pure deficiency syndrome combinations,with CRF accounting for 120 cases(81.6％),102 cases were mixed with deficiency and excess,and CRF accounting for 80 cases(78.4％).No pure excess combination was found in this survey.There were 10 single excess cases,with CRF accounting for 5 cases(50.0％);38 cases of single deficiency syndrome,with CRF accounting for 21 cases(55.4％);Nine patients who did not meet the diagnostic criteria for any type of syndrome were identified as asymptomatic,with CRF accounting for 3 cases(33.3％).Comparison of multiple syndrome types:combination of pure deficiency syndrome＞mixed deficiency and excess(mild:58.5％＞24.5％,moderate:51.2％＞38.0％),and severe fatigue:the combination of deficiency and excess＞the combination of pure deficiency syndrome(78.6％＞21.4％).There was no statistically significant difference in the distribution of the combination of pure deficiency syndrome and mixed deficiency and excess syndrome between CRF and non CRF groups(P＞0.05).In the deficiency syndrome elements,the probability of qi deficiency,yang deficiency and blood deficiency in CRF was higher than that in non-CRF,and the probability of qi deficiency increased gradually with the increase of fatigue(P＜0.05).Among the Zangfu syndrome elements,the probability of spleen deficiency,kidney deficiency,heart deficiency and lung deficiency in CRF was higher than that in non CRF,and the probability of spleen deficiency and heart deficiency gradually increased with the aggravation of fatigue(P＜0.05);In addition,the occurrence probability of liver deficiency and cold dampness syndrome elements also increased with the aggravation of fatigue(P＜0.05).The probability of non-CRF blood stasis and yin deficiency syndrome elements was slightly higher than that of CRF,but the difference was not statistically significant(P＞0.05).Conclusions:The incidence rate of CRF is high,which is mainly mild to moderate fatigue,and it is mainly deficiency syndrome.Spleen deficiency and qi deficiency syndrome elements are highly distributed in different degrees of fatigue.The heavier the degree of fatigue is,the higher the proportion of deficiency syndrome is,and the trend of mixed deficiency and excess syndrome is more.