Quality Of Life And TCM Syndrome Of Patients After Anterior Resection For Rectal Cancer

Objective:(1)to investigate the status of defecation and quality of life(QOL)of the patients after anterior resection for rectal cancer;(2)to explore theinfluencing factors of anterior resection syndrome,(3)to investigate the TCM syndromes of postoperative rectal cancer patients.Methods:100 rectal cancer patients who underwent anterior resection in Nanjing Hospital of Chinese Medicine during May 2010 and May 2016 were asked to participate a structured interview using the verified version of the LARS scale and EORTC QLQ-C30(V3.0)quality of life questionnaire,85 cases received complete data.According to LARS scale,divided the patients into major ARS and no/minor ARS,comparing the QOL of two groups,clinical parameters were analyzed against the incidence of major ARS,and 43 patients with outpatient follow-up were classified as different TCM syndromes.Results:(1)45/85 patients were had ARS(52.9%);Including 30/85 patients with major ARS(35.3%),15/85 patients with minor ARS(17.6%).The incidences of various symptoms of ARS were clustering(69.4%)>urgent defecation(57.7%)>incontinence of gas(52.9%)>frequent defecation(42.4%)>incontinence of liquid stool(38.8%)>constipation(11.7%).Comparing the score of EORTC QLQ C30 quality of life questionnaire of patients with major ARS and no/minor ARS:Global QOL,all function dimensions(physical function,role function,emotional function,congnitive function,social function),fatigue,diarrhea have significant difference(P<0.05),patients with major LARS have poor QOL.(2)In the univariate analysis,age,distance from distal edge of tumor to anal verge,radiotherapy were risk factors for major LARS(P<0.05),but In multivariate analysis,there is no individual risk factors(P>0.05).(3)in 43 cases of postoperative patients,The most common type is spleen deficiency damp syndrome(n =16,37.2%);Then followed by the spleen kidney both deficiency syndrome(n = 9,20.9%),damp-heat stasis toxin syndrome(n = 8,18.6%),liver and kidney Yin deficiency syndrome(n =6,14.0%),both qi and blood deficiency syndrome(n = 4,9.3%).Conclusion:The QOL of patients after anterior resection for rectal cancer is closely related to the occurrence of LARS,patients with major ARS have poor QOL.People with older age,lower anastomotic location and radiotherapy are more likely to suffer major ARS.Postoperative patients with rectal cancer "deficiency syndrome" or "intermingled insufficiency and excess syndrome ",clinical treatment should be given priority to "strengthening the body".