Analysis Of Syndrome Characteristics And Related Factors Of Cancer-related Fatigue In Patients With Colorectal Cancer

Background:Cancer Related Fatigue(CRF)is a high incidence event which is in connection with cancer itself and treatment.Colorectal Cancer(CRC)is a common malignant tumor of the digestive tract.With the progress in diagnosis and treatment technology,the number of survivors of colorectal cancer patients is increasing,and the survival period is prolonged,and the demand for improving the quality of life is also growing.However,there is still a lack of relevant research on the TCM syndrome characteristics and related factors analysis of CRF in colorectal cancer patients..Purpose:Through the current situation investigation,this paper describes the incidence and distribution of CRF,as well as the TCM deficiency syndrome characteristics in colorectal cancer patients,explores the related influencing factors of the incidence and fatigue degree of CRF,so as to provide a clinical basis for the clinical diagnosis and treatment of CRF in colorectal cancer patients and later relevant studies.Methods:By means of convenient sampling,anonymous status survey was conducted on patients who met the eligibility criteria,including evaluating participants fatigue status and collecting relevant data.The survey tools were composed of general data questionnaire and patient self?rating scale,containing patient demographic data and clinical oncology data.The self-rating scale included CRF diagnostic screening form,fatigue cognition questionnaire,Piper Piper fatigue scale,Edmonton symptom assessment scale,International physical activity questionnaire(short volume)and TCM deficiency syndrome symptom form.EpiData software was used for logging data and SPSS 25.0 software was used for data description and correlation analysis.Results:1.151 colorectal cancer patients were effectively included,and the prevalence of CRF was 33.1%.The fatigue score of CRF patients measured by Piper fatigue scale was 5.23±1.93,belonging to moderate fatigue.2.There were differences between the distribution of CRF patients and non-CRF patients in the distribution of disease stage(including TNM clinical stage,disease treatment stage,whether they were tumour-free survivors),supportive treatment,ECOG score and physical activity level;The symptoms of pain,depression,anxiety,sleepiness,shortness of breath,poor appetite,sleep disorder and weak sense of well-being in CRF patients were more serious than those in non-CRF patients.In the regression analysis results,the demographic data and ECOG score,clinical TNM stage,level of physical activity associated with the risk of CRF.With ECOG score ascending,the risk of CRF patients was increased(OR=2.838,95%CI:1.797-4.482).High intensity of physical activity level is the protection factor in the risk of CRF(OR=0.534,95%CI0.303-0.938).The later clinical TNM stage,the higher risk of CRF(OR=1.870,95%CI:1.162-3.008).In the ESAS scale,pain(OR=1.228,95%CI:1’035-1.456),depression(OR=1.461,95%CI:1.168-1.827),sleep(OR=1.250,95%CI:1.067-1.464)and low sense of well-being(OR=1.241,95%CI:1.019-1.512)were associated with CRF.The regression analysis results of fatigue degree related factors showed that gender,occupation,primary site,BMI level,TNM clinical stage were correlated with the fatigue degree of CRC patients.Nausea,depression,and sleep disturbance were associated with increased fatigue on the ESAS scale.3.CRF patients had more symptoms of TCM deficiency than no-CRF patientsm,the top five symptoms were fatigue,mental weakness,dry mouth and throat,palpitation and chills.Compared with non-CRF patients,the proportion of deficiency syndromes in CRF patients was high and severe.The fatigue degree of behavior/severity,emotion and sensation of the patients with qi deficiency syndrome was heavy.In Yang deficiency patients,the fatigue degree of cognitive/emotional dimension was more serious;In kidney deficiency patients syndrome,the fatigue degree of behavior/severity and emotional dimension was severe.Regression analysis results of TCM deficiency syndrome and CRF disease showed that,after correction of clinical data,the symptom score(standardized)of qi deficiency syndrome and kidney deficiency syndrome was closely related to CRF disease.Comprehensive patients clinical data,ESAS scale,and regression analysis of the deficiency syndrome of traditional Chinese medicine on CRF illness,compared with the pain,depression,deficiency syndrome,demographic and clinical variables of patients with CRC weak effect on CRF sicken.Qi deficiency syndrome group:depression,sleep disorders,qi deficiency syndrome associated with CRF illness symptoms integral,the deficiency of the symptoms of 1 points,CRF risk was 1.525 times of the original(OR= 1.525,95%CI:1.254-1.855).In the blood deficiency syndrome group,depression,weak sense of well-being,and the symptom score of blood deficiency syndrome were correlated with the incidence of CRF.The symptom score of blood deficiency syndrome increased by 1 point,and the risk of CRF was 1.334 times(OR=1.334,95%CI:1.107-1.607).In the group with spleen-deficiency syndrome,depression,sleep disorder,weak sense of well-being and the symptom score of spleen-deficiency syndrome were associated with the disease of CRF.The symptom score of spleen-deficiency syndrome increased by 1 point,and the risk of CRF was 1.138 times(OR=1.138,95%CI:0.998-1.298).In the kidney-deficiency syndrome group,pain,depression,sleep disorder,weak sense of well-being and the symptom score of kidney-deficiency syndrome were correlated with the incidence of CRF.The symptom score of kidney-deficiency syndrome increased by 1 point,and the risk of CRF was 1.203 times(OR=1.203,95%CI:1.005-1.439).The analysis results of deficiency syndrome and fatigue degree in traditional Chinese medicine showed that the fatigue degree of patients with deficiency syndrome was severe,in which qi deficiency syndrome was significantly correlated with the aggravation of fatigue degree(OR=7.270,95%CI:1.985-26.620).4.Fatigue cognition survey results showed that 50.7%of patients were in need of improving fatigue status,46.4%of patients thought fatigue was related to tumor.11.9%had received fatigue assessment,and only 5.3%had received fatigue guidance or training.In terms of fatigue cognition,49.7%of patients believed that exercise can alleviate fatigue,and 14.6%of patients believed that exercise was ineffective or even aggravates fatigue.Patients’cognitive level of exercise had nothing to do with patients’physical activity level,and fatigue level did not vary due to fatigue cognition.Conclusion:ECOG score,TNM clinical stage,presence or absence of tumor,level of physical activity,pain,depression,sleep disorder,weak sense of well-being are correlated with CRF in colorectal cancer patients.Factors affecting fatigue degree include gender,occupation,primary site,BMI,TNM clinical stage,nausea,depression and sleep disorders.The incidence of TCM deficiency syndrome is high and severe in CRF patients.The degree of Qi deficiency and Kidney deficiency is related to CRF in patients with colorectal cancer.Compared with pain,depression and deficiency syndrome,demographic and oncology data of colorectal cancer patients have less impact on CRF.After stratification of asthenia syndrome,different types of asthenia syndrome and different factors affecting CRF were found.