乳腺癌术后辅助化疗患者癌因性疲劳的中医证候特点分析

Characteristics of Traditional Chinese Medicine( TCM) syndromes of cancer-related fatigue( CRF ) in breast cancer patients with adjuvant chemotherapy after operation

目的探讨乳腺癌术后辅助化疗患者癌因性疲劳的中医证候特点。方法采用描述性研究方法,对符合入选标准的325例乳腺癌患者采用Piper疲乏量表进行癌因性疲劳症的调查及测量,对确诊患有癌因性疲劳的乳腺癌患者进行中医证候的信息采集和中医辨证分型研究。3个月后对患者随访1次,观察证候的演变情况。结果乳腺癌术后辅助化疗患者癌因性疲劳的中医证候主要分为6类:肝气郁滞证、脾肾阳虚证、气血亏虚证、气阴两虚证、气滞血瘀证、痰湿凝聚证,其中出现比例较高的证型依次为:肝气郁滞证、脾肾阳虚证、气血亏虚证。3个月后肝气郁滞证患者出现较为明显的证型演变,演变为气滞血瘀证及气阴两虚证最多。结论肝气郁滞证是乳腺癌术后辅助化疗患者癌因性疲劳症最主要的中医证候。

Objective To explore the characteristics of TCM syndromes of cancer-related Fatigue （CRF） in breast cancer patients with adjuvant chemotherapy after operation. Methods With a descriptive methodology used, the demographic questionnaire Revised Piper Fatigue Scale was used for investigation and measurement of CRF among 325 cases of breast cancer patients who complied with inclusion criteria, TCM syndrome data were collected and TCM differentiation studied for breast cancer patients with adjuvant chemotherapy after operation who were diagnosed with CRF. A follow-up was done 3 months later to observe the development of syndromes. Results The TCM symptoms about cancer-related Fatigue （CRF） in breast cancer patients with adjuvant chemotherapy after operation were classified into six types, that is syndrome of stagnation of liver qi, syndrome of yang deficiency of spleen and kidney and syndrome of deficiency of both qi and blood, syndrome of deficiency of both qi and yin, syndrome of qi stagnation and blood stasis, syndrome of accumulation of phlegm-dampness. Among them, a high occurrence rate was seen in such symptoms as syndrome of stagnation of liver qi, syndrome of yang deficiency of spleen and kidney, and syndrome of deficiency of both qi and blood. After 3 months, syndrome of stagnation of liver qi appeared more obvious development to syndrome of qi stagnation and blood stasis and syndrome of deficiency of both qi and yin. Conclusion Syndrome of stagnation of liver qi is an important pathogenic factor for cancer- related fatigue（CRF） in breast cancer patients with adjuvant chemotherapy after operation.