Efficacy of ginseng-based Renshenguben oral solution for cancer-related fatigue among patients with advanced-stage hepatocellular carcinoma:A prospective multicenter cohort study

Background:Cancer-related fatigue(CRF)is a common and debilitating symptom experienced by patients with advanced-stage cancer,especially those undergoing antitumor therapy.This study aimed to evaluate the efficacy and safety of Renshenguben(RSGB)oral solution,a ginseng-based traditional Chinese medicine,in alleviating CRF in patients with advanced hepatocellular carcinoma(HCC)receiving antitumor treatment.Methods:In this prospective,open-label,controlled,multicenter study,patients with advanced HCC at BCLC stage C and a brief fatigue inventory(BFI)score of≥4 were enrolled.Participants were assigned to the RSGB group(RSGB,10 mL twice daily)or the control group(with supportive care).Primary and secondary endpoints were the change in multidimensional fatigue inventory(MFI)score,and BFI and functional assessment of cancer therapy-hepatobiliary(FACT-Hep)scores at weeks 4 and 8 after enrollment.Adverse events(AEs)and toxicities were assessed.Results:A total of 409 participants were enrolled,with 206 assigned to the RSGB group.At week 4,there was a trend towards improvement,but the differences were not statistically significant.At week 8,the RSGB group exhibited a significantly lower MFI score(P<0.05)compared to the control group,indicating improved fatigue levels.Additionally,the RSGB group showed significantly greater decrease in BFI and FACT-Hep scores at week 8(P<0.05).Subgroup analyses among patients receiving various antitumor treatments showed similar results.Multivariate linear regression analyses revealed that the RSGB group experienced a significantly substantial decrease in MFI,BFI,and FACT-Hep scores at week 8.No serious drug-related AEs or toxicities were observed.Conclusions:RSGB oral solution effectively reduced CRF in patients with advanced HCC undergoing antitumor therapy over an eight-week period,with no discernible toxicities.These findings support the potential of RSGB oral solution as an adjunctive treatment for managing CRF in this patient population.

Identifying relevant factors influencing cancer-related fatigue in patients with diffuse large B-cell lymphoma during chemotherapy

BACKGROUND Diffuse large B-cell lymphoma(DLBCL)is a rapidly growing malignant tumor,and chemotherapy is one of the treatments used to combat it.Although advancements of science and technology have resulted in more and more patients being able to receive effective treatment,they still face side effects such as fatigue and weakness.It is important to thoroughly investigate the factors that contribute to cancer-related fatigue(CRF)during chemotherapy.AIM To explore the factors related to CRF,anxiety,depression,and mindfulness levels in patients with DLBCL during chemotherapy.METHODS General information was collected from the electronic medical records of eligible patients.Sleep quality and mindfulness level scores in patients with DLBCL during chemotherapy were evaluated by the Pittsburgh Sleep Quality Index and Five Facet Mindfulness Questionnaire-Short Form.The Piper Fatigue Scale was used to evaluate the CRF status.The Self-Rating Anxiety Scale and Self-Rating Depression Scale were used to evaluate anxiety and depression status.Univariate analysis and multivariate regression analysis were used to investigate the factors related to CRF.RESULTS The overall average CRF level in 62 patients with DLBCL during chemotherapy was 5.74±2.51.In 25 patients,the highest rate of mild fatigue was in the cognitive dimension(40.32%),and in 35 patients the highest moderate fatigue rate in the behavioral dimension(56.45%).In the emotional dimension,severe fatigue had the highest rate of occurrence,34 cases or 29.03%.The CRF score was positively correlated with cancer experience(all P<0.01)and negatively correlated with cancer treatment efficacy(all P<0.01).Tumor staging,chemotherapy cycle,self-efficacy level,and anxiety and depression level were related to CRF in patients with DLBCL during chemotherapy.CONCLUSION There was a significant correlation between CRF and perceptual control level in patients.Tumor staging,chemotherapy cycle,self-efficacy level,and anxiety and depression level influenced CRF in patients with DLBCL during chemotherapy.

Effect of Individualized Exercise Therapy on Cancer-related Fatigue and Negative Emotion in Patients with Gastrointestinal Tumor during Perioperative Period

[Objectives]To investigate the effect of exercise therapy in gastric cancer patients during perioperative period.[Methods]100 patients with gastric cancer who underwent elective operation in the Department of Gastrointestinal Surgery of Taihe Hospital Affiliated to Hubei University of Medicine were divided into observation group and control group by convenience sampling.The control group received routine nursing measures,and the experimental group received exercise therapy intervention measures on the basis of the control group.The patients were evaluated by the General Information Questionnaire,Self-Rating Anxiety Scale,Self-Rating Depression Scale and Cancer-related Fatigue Scale at the time of admission,the second week and the sixth week after operation.[Results]The time effect,intervention effect and interaction effect of anxiety score,depression score and cancer-related fatigue score were significant(all P<0.05)and the index of enhanced recovery after surgery was significant(P<0.05)in the two groups at the second and sixth week after operation.[Conclusions]Exercise therapy is beneficial to promoting the enhanced recovery after surgery in advance,reduce cancer-related fatigue,negative emotion and accelerate rehabilitation in patients with gastrointestinal tumors.

Jianpi Fuzheng Decoction in the Treatment of Gastric Cancer-Related Fatigue

Objective:To observe the clinical effects of Jianpi Fuzheng Decoction in patients with gastric cancer and cancer-related fatigue(CRF).Methods:Using the random number table method as a reference,68 cases of gastric CRF were randomly divided into two groups.One group served as the control group and received basic treatment,while the other was the observation group.The observation group,in addition to the control group’s treatment,received Jianpi Fuzheng Decoction.The clinical treatment effectiveness,fatigue scores,immune function indicators,and treatment safety were compared between the two groups.Results:The total clinical treatment effectiveness of the observation group and the improvement in immune function indicators after treatment were higher than those of the control group.The fatigue score after treatment was lower in the observation group than in the control group(P<0.05).No serious adverse reactions occurred during the treatment in either group.Conclusion:Jianpi Fuzheng Decoction can enhance the clinical treatment effectiveness for gastric cancer patients with CRF.It facilitates the acceleration of fatigue symptom improvement and immune function enhancement.The medication’s safety is guaranteed,making it worthy of promotion.

Progress of Traditional Chinese Medicine Treatment for Cancer-Related Fatigue in Patients with Colorectal Cancer

Cancer-related fatigue,which is a common symptom among colorectal cancer patients,has a high incidence and it affects the quality of life of these patients.Western medicine still lacks effective treatment means.However,with various methods of intervention and treatment,Chinese medicine has made certain progress in this area,where辻has good curative effect in improving fatigue and the quality of life of patients.This article briefly summarizes the main TCM treatment methods for cancer-related fatigue in patients with colorectal cancer in order to provide reference and suggestions for clinical practice.

Symptom experience in patients with cancer-related fatigue:A systematic review and meta-synthesis

To understand the real experiences of patients with cancer-related fatigue and to promote quality of life,the researchers used computer searches of PubMed,EMbase,CINAHL,PsycINFO,Web of Science,and China National Knowledge Infrastructure,China Biology Medicine disc,Wanfang Data,China Science and Technology Journal Database for relevant qualitative studies from the inception to November 1,2021.The results showed that a total of 16 papers were included,and 57 outcomes were distilled into 9 categories,which were pooled into four integrated outcomes,such as somatic,psychological and social support and so on.It is concluded that patients with cancer-related fatigue are not only in the midst of multidimensional,unspeakable somatic experiences,and complex psychological experiences,they are also hindered in coping with fatigue symptom and social life.Therefore,healthcare professionals should provide health interventions and psychological support to those patients whenever possible.

Application of external treatment of traditional Chinese medicine in the treatment of cancer-related fatigue

External treatment of traditional Chinese medicine(TCM),also known as external treatment of internal diseases,has many advantages,such as simple,easy to operate,cost-effective and so on.Therefore,external treatment of TCM is favored by the majority of medical workers.By consulting the domestic literature reports on the treatment of cancer-related fatigue(CRF),it is found that the external treatment of TCM has a significant effect on the intervention of CRF,and has a good effect on reducing fatigue,improving the quality of life and prolonging the survival time.The purpose of this paper is to summarize the application of several external treatments in this disease,and to provide a variety of references for clinical treatment of CRF.

Progress research on non-drug therapy in cancer-related fatigue

Cancer-related fatigue is the most prevalent and persistently symptom in cancer survivors than any other symptom,which is caused by both the disease and its treatment.Patients with cancer show a severe symptom of fatigue,which cannot be relieved by general rest or sleep.Cancer-related fatigue negatively impacts a patient's physical and emotional function,social ability and even patients’prognosis.At present,the mechanism of cancer-related fatigue remain unclear despite much research,and a variety of mechanisms may contribute to its occurrence and development,including inflammatory reaction,metabolism dysregulation,immune activation,hormonal changes,central nervous system dysfunction,etc.Now a broad variety of drugs and non-drugs interventions are used against cancer-related fatigue.The intervention of conventional western medicine mainly contains hematopoietic stimulants,hormones,mental stimulants,and antidepressants,but their widely clinical application is limited by their effectiveness and possible side effects to a certain degree.There are also many forms of non-drug interventions for managing cancer-related fatigue,such as exercise intervention,psychological intervention,sleep intervention,nutrition intervention,bright white light therapy,etc.The aim of this review is to provide recommendations of non-drug interventions for patients with CRF during and after cancer treatment,in order to provide an evidence-based guideline for clinicians.

Interventional effect of cognitive behavioral therapy on cancer-related fatigue in breast cancer patients: A systematic review

Objective:To evaluate the effect of cognitive behavioral therapy on cancer-related fatigue in breast cancer patients.Methods:Computer search for CNKI,VIP,Wanfang database,CBM,PubMed,Embase,CINAHL,The Cochrane library as of 2019 randomized controlled trials on October 20 for cognitive behavioral therapy intervention for breast cancer due to fatigue.Results:A total of 6 RCTs were included,472 patients.Cognitive Behavioral Therapy has a strong effect on cancer related fatigue compared with the usual care[SMD=-1.19,95%CI(-1.86,-0.53),P=0.0004].Results:Available evidence suggests that CBT can alleviate cancer-related fatigue in breast cancer patients,and the above studies still need to continue to conduct relevant studies for validation.

Effect of mindfulness therapy on the intervention of cancer-related fatigue in patients with lung cancer: a meta-analysis

Objective:To systematically evaluate the effects of mindfulness therapy on oncogenic fatigue in patients with lung cancer.Methods:Computer searching was conducted in the Cochrane Library,PubMed,Embase and other databases.Combined with manual search,randomized controlled trials about the effect of mindfulness therapy on the cancer-related fatigue in patients with lung cancer were collected.The search time was from the establishment of the database to December 2019.Two researchers independently screened the literature,extracted the data,and evaluated the risk of bias in the included study.RevMan 5.3 software was used for meta-analysis.Results:A total of 448 patients were included in 6 randomized controlled trials.Meta-analysis results show that mindfulness therapy can help reduce carcinogenic fatigue in patients with lung cancer(standardized mean difference(SMD)=−1.67,95%confidence interval(CI)(−2.09,−1.24),P<0.001),and improve anxiety(SMD=−1.33,95%CI(−2.53,−0.13),P=0.03),relieve depression(SMD=−1.43,95%CI(−2.13,−0.73),P<0.001).Conclusion:There is limited evidence that mindfulness therapy can improve cancer-related fatigue,anxiety,and depression in patients with lung cancer.Limited by the number and quality of included studies,the above conclusions need to be further validated by high-quality clinical trials.

Network Pharmacology-based Analysis on Determining the Mechanisms of Yishen Qutong Granules(益肾祛痛颗粒)in Alleviating Cancer-related Fatigue

Cancer-related fatigue(CRF)is associated with cancer-related anemia(CRA).As the common comorbidities of cancer,both of them can seriously affect the quality of patient life.Yishen Qutong Granules(益肾祛痛颗粒,YSQTG)have achieved good curative effects in the treatment of CRA.However,the mechanism of whether it can alleviate CRF needs further confirmation.We used network pharmacology and molecular docking to investigate the molecular mechanism and the effective compounds of the prescription.Through the analysis and research in this paper,we obtained 76 effective compounds and 76 drug-disease intersection targets to construct a network,indicating that quercetin,luteolin,baicalein,β-sitosterol and stigmasterol were possibly the most important compounds in YSQTG.The key targets of YSQTG for CRF were mainly enriched in IL-17 and TNF pathways.816 GO entries and 113 pathways were obtained by GO and KEGG enrichment,respectively,which proved that YSQTG might have a comprehensive therapeutic effect on CRF mainly through regulating IL-17,TNF,MAPK,NF-κB and chemokines,as well as cholinergic synapse and 5-HT synapse pathways.The results of molecular docking showed thatβ-sitosterol and stigmasterol could form PI-Alkyl or Alkyl hydrophobic interactions with CXCL8 and ESR1 at residues LEU25,ARG26,PHE65,ALA69 and LEU346,ALA350,LEU391,PHE404,LEU525,VAL533,respectively.In conclusion,the therapeutic effect of YSQTG on CRF is based on the comprehensive pharmacological effect of multicomponent,multitarget,and multichannel pathways.This study provides a theoretical basis for further experimental research.

Effects of Exercise on Cancer-related Fatigue and Quality of Life in Prostate Cancer Patients Undergoing Androgen Deprivation Therapy: A Meta-analysis of Randomized Clinical Trials

Objective To gain insight on how exercise affects the outcomes of prostate cancer patients treated with androgen deprivation therapy,specifically cancer-related fatigue(CRF) and quality of life(QoL). Methods Systematic searches for randomized clinical trials(RCTs) evaluating the effects of exercise on CRF and QoL of prostate cancer patients receiving androgen deprivation therapy were carried out to identify the eligible studies from EMBASE,Pub Med and Cochrane library. Related data were extracted from eligible studies and then subjected to Reviewer Manage 5.3 for analysis. Standardized mean differences(SMD) and its 95% confidence interval(CI) were calculated. Results In all,10 RCTs involving 841 prostate cancer patients(448 of whom exercised and 393 did not) were included in this study. With respect to CRF,there was good consistency among different studies,and it was remarkably reduced in the exercise group(SMD=-0.32,95% CI:-0.45 to-0.18,P<0.00001,n=784). In regards to QoL,there was also good consistency among different studies,and it was also improved significantly in the exercise group(SMD=0.21,95% CI:0.08 to 0.34,P=0.002,n=841). Conclusion Exercise both reduced CRF and improved QoL in prostate cancer patients receiving androgen deprivation therapy.

Effects of moxibustion on cancer-related fatigue: a meta-analysis

Objective: To systematically evaluate the efficacy of moxibustion in the treatment of cancer-related fatigue (CRF). Methods: Randomized controlled trials (RCTs) using moxibustion to treat cancer-related fatigue in Cochrane Library, PubMed, China Knowledge Network, Wanfang and VIP databases was searched. Two reviewers independently searched, reviewed the literature, extracted data, and evaluated the methodological quality. RevMan5.3 software was used for meta-analysis. Results: A total of 942 patients were included in 11 randomized controlled trials. The meta-analysis results showed that moxibustion can reduce fatigue score [MD =-2.04, 95% CI (-4.06,-0.33), P < 0.001], improve the score of quality of life QLQ-C30 [(MD = 8.44, 95% CI (1.85, 15.03), P < 0.001], also could boost the number of important immune-system cellular, such as CD3 [MD = 7.82, 95% CI (3.14, 12.49), P = 0.01], CD8 [MD =-3.15, 95% CI (-11.36, 5.06), P < 0.001], NK cells [MD=5.88, 95% CI (3.56, 8.20), P = 0.01];Conclusion: Moxibustion can improve the degree of cancer-related fatigue, improve the quality of life and enhance immune function.

Non-drug interventions for cancer-related fatigue: an updated review

Non-drug interventions are easy operation, no damage and with significant effects treatment for cancer-related fatigue, which also can reduce the economic burden of cancer patients and improve the quality of life. This article reviews the effects of non-drug interventions on cancer-induced fatigue including exercise intervention, long distance healthy education, cognitive behavior intervention, traditional Chinese medicine intervention and emotional intervention to provide reference for clinical medical staff and relevant scholars.

Effect of KAP Intervention Model on Resilience and Cancer-related Fatigue in Patients with Colorectal Cancer Undergoing Chemotherapy

Objective:To explore the effect of KAP intervention mode on resilience and cancer-related fatigue in patients with colorectal cancer undergoing chemotherapy.Methods:A prospective randomized trial was conducted.55 patients with colorectal cancer who received routine nursing from February 2018 to February 2019 were included in the control group,and 55 patients who received routine nursing+KAP intervention from March 2019 to March 2020 were included in the observation group.The scores of Resilience Scale and cancer-related fatigue scale(CFS)before and 6 months after intervention were compared between the two groups.Results:After 6 months of intervention,the score of resilience of the two groups was higher than that before intervention,and that of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05);The CFS score of the two groups was lower than that before intervention,and that of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion:KAP intervention model can improve the resilience of patients with colorectal cancer chemotherapy,reduce cancerrelated fatigue.

Changes of serum endocrine hormone levels in patients with cancer-related fatigue and their correlation with anti-tumor immune response and tumor load

Objective: To study the changes of serum endocrine hormone levels in patients with cancer-related fatigue (CRF) and their correlation with anti-tumor immune response and tumor load. Methods: A total of 137 patients who were diagnosed with primary lung cancer in West China Hospital, Sichuan University between June 2014 and November 2016 were selected and then divided into CRF group and control group according to their self-reported symptoms, serum was collected to determine the levels of endocrine hormones and tumor markers, and peripheral blood was collected to detect the levels of immune cells. Results: Serum ACTH and TSH levels of CRF group were significantly higher than those of control group while Cor, FT3 and FT4 levels were significantly lower than those of control group;peripheral blood CD11b+CD15-CD33+CD14+M-MDSC, CD11b+CD15-CD33+CD14-G-MDSC, CD4+CD25+CD127lowTreg and CD19+CD5+CD1d+Breg levels as well as serum CEA, Cyfra21-1, SCC-Ag, HE4, GDF-15 and PCNA levels of CRF group were significantly higher than those of control group, positively correlated with serum ACTH and TSH levels, and negatively correlated with Cor, FT3 and FT4 levels. Conclusion: The changes of thyroid hormone and adrenal cortical hormone levels in patients with cancer-related fatigue are closely related to the inhibited anti-tumor immune response and increased tumor load.

Assessment of Cancer-Related Fatigue Expression:Comparing the Expression of Fatigue in Patients with a History of Cancer,Patients with Other Chronic Diseases,and Healthy Individuals

Aims:We aimed to compare cancer survivors’fatigue expression with that of the general population and examine psychobiological factors associated with fatigue.Procedure:In this quantitative,transversal study,we analyzed clinical and sociodemographic indicators of 389 participants(68.38%females):148 cancer survivors on active treatment,55 disease-free survivors,75 patients with another chronic disease,and 111 healthy individuals.Results:Fatigue was expressed dissimilarly in patients with a previous history of cancer and participants without a history of cancer.Survivors on active treatment reported significantly higher levels of fatigue than the other clinical status groups.Nonetheless,some level of cancer-related fatigue persisted,in a similar pattern,after active treatment into the survivorship phase.Disease-free survivors showed significantly lower vigor levels when compared to patients with other chronic diseases.Psychological distress and daytime sleepiness emerged as transdiagnostic factors associated with fatigue.Conclusion:Cancer-related fatigue may have a unique pattern,characterized by reduced endurance and muscle weakness.In the present study,psychological distress and daytime sleepiness are associated with cancer-related fatigue.These findings suggest the pertinence of future studies examining whether interventions targeting those factors may help manage this burdensome complaint.

Impact of comorbid subthreshold depressive symptoms on cancerrelated fatigue and complications in adults with leukemia

BACKGROUND Patients not only experience symptoms caused by cancer but also suffer from the accompanying psychological pain.Therefore,these patients do not have high quality of life.According to the World Health Organization,the incidence of leukemia in China in 2020 was 5.1/100000,the mortality rate was 3.3/100000,and the prevalence rate was 16.7/100000.Therefore,it is important to examine the influence of comorbid subthreshold depressive symptoms on leukemia patients.AIM To determine the impact of comorbid subthreshold depressive symptoms on cancer-related fatigue and complications in leukemia patients,thereby providing a basis for early diagnosis and treatment in clinical practice.METHODS A questionnaire survey was conducted among leukemia patients admitted to a tertiary hospital in Xi'an,Shaanxi Province,China,from August 2022 to December 2023.Patients with a score>16 on the Chinese Classification of Mental Disorders(CCMD-3)and a Hamilton Depression Rating Scale score of 8-17 were classified as the subthreshold depressive group(n=95),while 100 leukemia patients admitted during the same period were classified as the control group.Data were collected using Epidata 3.1 software,and comparisons were made between the two groups regarding general clinical data,the Piper Fatigue Scale(PFS),the Pittsburgh Sleep Quality Index(PSQI),the Numeric Rating Scale for pain assessment,laboratory indicators,and the occurrence of complications.RESULTS In this survey,120 leukemia patients with depression were preliminarily screened,95 patients with subthreshold depression were ultimately selected as the subthreshold depression group,and 100 leukemia patients admitted during the same period were enrolled as the normal group.Comparison of basic clinical data between the two groups revealed no significant differences in age,sex,body mass index,cognitive function,or comorbidity with other chronic diseases.However,there were statistically significant differences in the use of radiotherapy and regular exercise between the two groups(P<0.05).Comparisons of scales and laboratory indicators revealed no significant differences in albumin or PSQI scores between the two groups,but there were statistically significant differences in pain scores,PSQI scores,PFS scores,hemoglobin levels,and C-reactive protein levels(P<0.05).Spearman’s correlation analysis indicated that cancer-related fatigue was correlated with age,hemoglobin levels,C-reactive protein levels,pain,and regular exercise among leukemia patients with subthreshold depression.Multivariate regression analysis revealed that advanced age,combined radiotherapy,pain,and low hemoglobin levels were risk factors for cancer-related fatigue in leukemia patients with comorbid subthreshold depression,while regular exercise was a protective factor against cancer-related fatigue.Follow-up comparisons revealed a significantly lower overall incidence of complications in the control group(4%)than in the depressive group(24.21%;P<0.001).CONCLUSION Leukemia patients with comorbid subthreshold depressive symptoms experience more severe cancer-related fatigue and a higher incidence of complications.These findings may be related to advanced age,combined radiotherapy,pain,and low hemoglobin levels,while regular exercise may effectively alleviate symptoms.

Clinical observation of cancer-related fatigue treated with ginger-isolated moxibustion in the patients with gastric cancer

Objective:To observe the clinical therapeutic effect of ginger-isolated moxibustion on cancer-related fa tigue(CRF)in the patients with gastric cancer.Methods:The patients in the conventional treatment group accepted conventional chemotherapy.In the ginger-isolated moxibustion group,on the base of the conventional chemotherapy,ginger-isolated moxibustion was added at Shénquè(神阙CV8),Shàngwǎn(上脘CV13),Zhóngwǎn(中脘CV12),Qìhǎi(气海CV6]and Guānyuán(关元CV4).Chemotherapy for 3 weeks was as 1 cycle and 2 cycles of chemotherapy were observed.Results:After treatment,plasma cortisol(Cor)was increased and adreno-cortico-tropic-hormone(ACTH)decreased in the ginger-isolated moxibustion group,indicating the statistical differences as compared with the levels before treatment(P<0.05),and the differences in plasma Cor and ACTH were significant statistically between the two groups(P<0.05).After treatment,the score of each item of the revised fatigue scale was reduced in the ginger-isolated moxibustion group,indicating the statistical differences as compared with the score before treatment(P<0.05).The score of the revised fatigue scale was different statistically between the two groups(P<0.05).After treatment,the score of each of the items,i.e.fatigue,nausea&vomiting,pain,dyspnea,insomnia,anorexia,constipation,diarrhea and financial difficulty,was reduced in the ginger-isolated moxibustion group,indicating the statistical differences as compared with the score before treatment successfully(P<0.05).The differences were significant statistically in fatigue,nausea&vomiting,pain,dyspnea,insomnia,anorexia,constipation,diarrhea and economic difficulty between the two groups(P<0.05).Conclusion:Ginger-isolated moxibustion achieves a satisfactory effect on CRF in the patients with gastric cancer and deserves to be promoted in clinical practice.

Traditional Chinese Medical Comprehensive Therapy for Cancer-Related Fatigue

Cancer-related fatigue （CRF） is a common and one of the most severe symptom in the period of onset, diagnosis, treatment and rehabilitation process of cancer. But there are no confirmed measures to relieve this problem at present. Traditional Chinese medical comprehensive therapy has its advantages in dealing with this condition. Based on the research status of CRF, the following problems have been analyzed and solved： the term of CRF has been defined and recommended, and the definition has been made clear; the disease mechanism is proposed, i.e. healthy qi has been impaired in the long-term disease duration, in the process of surgery, chemotherapy, radiotherapy and biology disturbing; it is clear that the clinical manifestations are related to six Chinese medicine patterns： decreased functioning of the Pi （Spleen） and Wei （Stomach）, deficiency of the Pi with dampness retention, deficiency of the Xin （Heart） and Pi, disharmony between the Gan （Liver） and Pi, deficiency of the Pi and Shen （Kidney）, and deficiency of the Fei （Lung） and Shen. Based on its severity, the mild patients are advised to have non-drug psychological intervention and sleep treatment in cooperation with appropriate exercise; diet therapy are recommended to moderate patients together with sleep treatment and acupuncture, severe patients are recommended to have herbal treatment based on pattern differentiation together with physiological sleep therapy.