Clinical Research Of Characteristics Of TCM Syndromes Types In Cancer Patients With Cancer-related Fatigue

ObjectiveTo explore of characteristics of TCM syndromes types.MethodsThis study is a cross-sectional survey, collecting cancer patients with cancer-related fatigue symptoms in Oncology outpatient service and inpatient area in the first affiliated hospital of Guangzhou University of traditional Chinese medicine through visiting and filling in the questionnaires. The capture of four diagnostic methods of traditional Chinese medicine, general demographic information, disease and treatment-related information, and Piper fatigue scale, which is to evaluate fatigue level in patients are needed to complete. Then the collected data were entered and accounted. By means of cluster analysis the main syndrome types in patients with cancer-related fatigue were concluded.ResultsThe results showed that generally the fatigue degree in patients with cancer-related fatigue were in the light level(1～3) and medium (4～6) level. Scores from high to low as follows:emotional fatigue,behavior fatigue, physical fatigue, cognitive fatigue. Sex, cost, the degree of understanding of the disease, pathology, the main treatments, had no significant differences with cancer-related fatigue. Age, clinical staging, physical exercise, KPS score and CRF were significantly different. Collected 65 traditional Chinese medicine symptoms and physical signs in patients with CRF were analyzed by using hierarchical clustering method. Based on clinical practice and expertise, 200 patients with cancer-related fatigue was divided into six syndromes. Their major symptoms were concluded as follows:(1)Syndrome of yang deficiency of kidney:white in the face, lips with color light, frequent urination at night, soreness and weakness of waist and knees, forgetful, less coating on the tongue, weak pulse;(2)Syndrome of excess liver qi stagnated:abdominal heavy after meal, indigestible, hiccup and regurgitation, dizzy, irritable anger, nausea, numbness of limb, depressed, bitter taste, and string like pulse; (3)Syndrome of ying deficiency of spleen and stomach:dry mouth, and dry stool, and red tongue has crack; (4)Syndrome of stagnated damp abundance of spleen:heavy cumbersome head and body,thick coating on the tongue, slippery pulse; (5) Syndrome of qi deficiency of lung:cough, and white sputum, and short of breath; (6)Syndrome of qi deficiency of spleen:fatigued spirit and lack of strength, yellow in the face, thin and weak, lazy, loose stools, poor appetite, enlarged tongue with teeth marks, thready pulse and tongue pale. In these syndromes, Syndromes of qi deficiency of spleen occur up to the most, followed by the other syndromes. In some one document for syndromes cases there were 108 cases, total case 54%. Two documents of cases occurred to 40.5%. Three documents of cases had 11 cases, total case 5.5%. There were no significant differences of fatigue characteristics in different types of syndrome differentiation. (P >0.05).ConclusionLevels of fatigue in cancer patients with cancer-related fatigue in general were from mild to moderate. According to the study, common clinical traditional Chinese medicine syndromes types of cancer-related fatigue in cancer patients were classified with six types:Syndrome of yang deficiency of kidney, Syndrome of excess liver qi stagnated, Syndrome of ying deficiency of spleen and stomach, Syndrome of stagnated damp abundance of spleen, Syndrome of qi deficiency of lung, Syndrome of qi deficiency of spleen. Among these syndromes, Syndrome of qi deficiency of spleen had the highest incidence. There were no significant differences of fatigue characteristics in different types of syndrome differentiation.