癌症相关性疲乏(CRF)患者疲劳的特征与中医辨证(TCM)的临床研究

Clinical investigation on fatigue characteristics and syndrome differentiation of TCM in patients with CRF

目的:运用测评量表对癌症患者的CRF症状进行研究,探索其中医证型特点。方法:以疲劳自评量表、MDASI-TCM症状评估量表等进行问卷调查;中医证型诊断标准参照《中医证候的临床研究指导原则》。运用网络自评系统、Excel及SPSS13.0软件对数据进行统计分析。结果:CRF患者常伴随困倦、睡眠不安、健忘、烦躁、疼痛、出汗、口干、食欲差、气短、麻木感、心慌等症状;健康人躯体疲劳分值11.88±12.89,CRF患者51.38±28.13(P<0.05),健康人疲劳后果16.92±14.76,CRF患者39.00±25.64(P<0.05);CRF患者辨证常出现两证(如肺肾两虚证)或三证(如肾阴虚气血两虚证)相兼的情况,在证型频次中,气虚证及脾、肺气虚证占43.43%,血虚及阴虚证占36.36%,阳虚证占8.08%,实证(湿热蕴脾、寒湿困脾证)占12.12%。结论:CRF患者的疲劳类型以躯体疲劳为主,程度重,通常不能通过睡眠或休息缓解。中医辨证常见多证相兼情况,分型以虚证多,实证少,尤以气虚为主,血虚次之,实证均为脾受湿邪之累而致。不同证型间的疲劳特征无显著性差异。

Objective：To investigate the symptom of TCM in patients with CRF by using the assessment tables.Methods：Using MDASI-TCM and FSAS to conduct a survey on patients with CRF and healthy people.On the basis of 《TCM Syndrome Clinical Study Guiding principles》,we elementary formulate the diagnostic criterion of the syndrome differentiation on CRF,in order to summarize the types of syndrome differentiation of TCM.Statistical analyses were performed with,SPSS and Excel software.Results：Patients with CRF suffer varying degrees of symptoms,such as sleepy,disturbed sleeping,forgetfulness,dysphoria,pain,sweating,dry mouth,anorexia,shortness of breath,numbness,palpitation and so on.The scores of physical fatigue of healthy people and patients with CRF were 16.92 ± 14.76 and 51.38 ± 28.13（P 0.05）,the consequences of fatigue 16.92 ± 14.76 and 39.00 ± 25.64（P 0.05）.The situation of syndrome differentiation is complicated when there＇re two or there concurrent syndromes.According to the frequency,the proportion of syndrome of qi deficiency,deficiency of spleen qi and deficiency of lung qi was 43.43%,syndrome of blood deficiency and deficiency of kidney yin was 36.36%,syndrome of deficiency of kidney yang was 8.08%,syndrome of dampness-heat stagnating in spleen and cold-dampness disturbing spleen was 12.12%.Conclusion：Contrast in healthy people,the type of fatigue in patients with CRF is mainly the physical fatigue,which is more serious,usually can＇t be relieved by sleep or rest.It＇s common to see two or there concurrent syndromes in syndrome differentiation of TCM.Deficiency syndrome is more than excess syndrome and mainly in syndrome of qi deficiency,followed by syndrome of blood deficiency.Generally speaking,there are no significant differences of fatigue characteristics in different types of syndrome differentiation.