TCM Classification Of Hand-foot Syndrome Caused By Anticancer Drugs And Analysis Of Related Factors

BACKGROUND AND OBJECTIVE:Hand-foot syndrome caused by anticancer drugs is a common hand and foot skin lesion in the anti-tumor treatment process.Although it is not life-threatening,it can have a serious effect on the physical,psychological and social interactions of patients.The serious adverse reactions often lead to interruption or reduction of treatment,which then affects the curative effect,reduces the quality of life of patients,and even affects the survival benefit of patients.Because the specific mechanism is still unclear,the current treatment methods of Western medicine mainly rely on symptomatic support and reduction or even withdrawal of anticancer drugs,and there is no clear and effective treatment.As a new disease in the clinical treatment of cancer,Chinese medicine has carried out a series of related researches in the prevention and treatment of hand-foot syndrome caused by anticancer drugs in recent years.Because there is no clear corresponding record in the traditional classics of traditional Chinese medicine,each medical doctors have their own opinions about the understanding of its pathogenesis.Some doctors believe that the pathogenesis should be "syndrome of dual deficiency of qi and blood,obstruction of collaterals by blood stasis",some doctors believe it is "syndrome of qi deficiency with blood stasis,cold coagulation meridians",and some doctors have summarized as "syndrome of spleen-stomach weakness,dampness-heat resistance with blood stasis",some doctors think it is "syndrome of blood stasis and heat accumulation,deficiency of qi and yin”,some doctors have also dignosed it as "syndrome of blood heat and wind,blood deficiency complicated by stasis ".Due to the lack of TCM syndrome analysis of its symptoms,the clinical intervention methods are diversified,so it is impossible to truly summarize the effective prevention and treatment methods for clinical application.In this study,we analyzed the factors related to the TCM syndrome type of hand-foot syndrome to explore the influence of relevant factors on TCM syndromes.To provide more intuitive dialectical classification for TCM external treatment,and provide theoretical evidence and guidance for understanding of C hinese medicine and TCM external treatment of hand-foot syndrome.METHODS:(1)This study classified the TCM syndrome type of hand-foot syndrome into three syndrome types which consisted of deficiency cold and blood stasis syndrome,heat toxicity skin syndrome and blood deficiency and wind-dryness syndrome by observing the skin lesion and self-conscious symptom.We collected 132 clinical data of patients with hand-foot syndrome caused by anticancer drugs,including gender,age,tumor type and drug type.The distribution of TCM syndromes in 132 patients was statistically analyzed among their gender,age,tumor type and drug type.(2)Using the method of single factor and multi-factor unconditional logistic regression analysis explored risk factors associated with TCM syndromes of hand-foot syndrome caused by anticancer drugs.RESULTS:(1)TCM syndromes:Among the 132 patients,The TCM syndromes were mainly distributed in deficiency cold and blood stasis syndrome(46.21%),blood deficiency and wind-dryness syndrome(28.79%),the proportion of heat toxicity skin syndrome was the least(250).(2)There were more women than men in the three syndromes of this study.Most people were aged between 45 and 59(50%).There were no differences in the distribution of TCM syndromes between different genders and age groups.(3)There were significant differences among the three TCM syndrome types in the distribution of different tumor types and different drugs(P<0.01).(4)There were no differences in the distribution of TCM syndromes between hand-foot syndrome grading and pain grading.(5)Single factor unconditional logistic regression analysis showed that tumor types and drugs were related risk factors for the occurrence of deficiency cold and blood stasis syndrome,blood deficiency and wind-dryness syndrome(P<0.05),only the drug was related risk factor for the occurrence of heat toxicity skin syndrome(P<0.05).(6)Multi-factor unconditional logistic regression analysis showed that only the drug was related risk factor for the occurrence of deficiency cold and blood stasis syndrome,heat toxicity skin syndrome(P<0.01).Among them,the deficiency cold and blood stasis syndrome caused by chemotherapy drugs was 13.289 times that of the targeted drugs.The heat toxicity skin syndrome caused by targeted drugs was 7.35 times that of chemotherapy drugs.No relevant risk factors were found to cause blood deficiency and wind-dryness syndrome.CONCLUSIONS:(1)Confirmed the TCM syndrome of hand-foot syndrome caused by anti-cancer drugs were classified deficiency cold and blood stasis syndrome,heat toxicity skin syndrome and blood deficiency and wind-dryness syndrome.(2)There were significant differences among the three TCM syndrome types in the distribution of different tumor types and different drugs.The drug type was unique risk factor for different TCM syndromes of hand-foot syndrome.Chemotherapy drugs were more likely to cause deficiency cold and blood stasis syndrome,and targeted drugs were more likely to cause heat toxicity skin syndrome.