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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

基于益气温阳理论应用中药沐足联合电艾灸治疗癌因性疲乏(CRF)临床疗效及安全性观察

目的:探究益气温阳理论指导下的中药沐足联合电艾灸治疗癌因性疲乏(CRF)的临床疗效及安全性。方法:研究纳入118例CRF患者,均由住院部2019年08月-2021年03月收治,采用随机数字表法将患者分为3组,对照组(40例)仅采用对症支持治疗,观察A组(39例)采用中药沐足+对症支持治疗,观察B组(39例)采用中药沐足+电艾灸+对症支持治疗。比较3组临床疗效、Piper疲乏量表积分、功能状态评分(KPS)、生活质量(QOL,食欲、精神、睡眠、疲乏、疼痛等)及T淋巴细胞亚群变化,并从临床症状体征及常规检查做安全性评价。结果:观察A组(82.1%,32/39)、B组(89.7%,35/39)患者总体有效率均高于对照组(57.5%,23/40)(P<0.05),观察B组优于观察A组(P<0.05);治疗后KPS评分提高率对比,观察A组(79.5%,31/39)、B组(94.9%,37/39)患者均高于对照组(52.5%,31/39),观察B组优于观察A组(P<0.05);治疗前3组QOL评分比较(P>0.05),治疗后3组组内前后对比(P<0.05),观察A、B组均优于对照组(P<0.05),观察B组优于A组(P<0.05);在QOL量表条目中,治疗后患者在食欲、精神、睡眠、疲乏、对治疗态度、日常生活及面部表情7个方面,观察A组和B组均优于对照组(P<0.05),其中在精神、睡眠、疲乏、治疗副作用方面,观察B组优于观察A组(P<0.05);治疗前3组免疫功能状况比较(P>0.05),治疗后在CD3^(+)T、CD3^(+)CD4^(+)T、CD3^(+)CD4^(+)T/CD3^(+)CD8^(+)T、NK细胞免疫指标中,观察A、B组均优于对照组(P<0.05),在NK细胞状态观察B组优于A组(P<0.05)。观察A组出现Ⅰ度皮肤瘙痒1例,治疗B组出现1例Ⅰ级血压升高,对照组出现1例治疗相关恶心呕吐,3组不良反应率比较(P>0.05)。结论:益气温阳理论指导下联合应用中药沐足及电艾灸治疗CRF,有效改善了患者功能状态、生存质量及免疫功能状态,安全性好,值得进一步深入探索研究。

节约体能法对宫颈癌同步放化疗病人癌因性疲乏的干预效果

目的:探讨节约体能法对宫颈癌同步放化疗病人癌因性疲乏(CRF)的干预效果。方法:采用方便抽样法,选取2018年4月—12月在西安交通大学第一附属医院放疗病区住院治疗的108例宫颈癌病人作为研究对象,按入院时间分为对照组和干预组,每组54例。对照组给予放疗科常规护理,干预组在放疗科常规护理基础上给予节约体能法的干预。于治疗开始前、放疗5次结束、放疗10次结束、放疗15次结束、放疗20次结束及放疗25次结束后采用中文版Piper疲乏修订量表(RPFS)对病人CRF严重程度进行评价。结果:干预期间对照组流失3例病人,干预组流失4例病人,最终对照组51例病人完成研究,干预组50例病人完成研究。中文版RPFS总分及行为疲乏、情感疲乏、感知疲乏、认知疲乏维度得分的干预主效应、时间主效应均有统计学意义(P<0.05)。在治疗开始前和放疗5次结束2个时间点,对照组与干预组的中文版RPFS总分及各维度得分差异无统计学意义(P>0.05)。在放疗10次结束、放疗15次结束、放疗20次结束及放疗25次结束4个时间点,对照组与干预组的中文版RPFS总分及各维度得分差异有统计学意义(P<0.05)。结论:宫颈癌同步放化疗病人CRF水平在治疗期间升高,节约体能法可有效降低各时间点宫颈癌同步放化疗病人的CRF水平。

基于中医传承辅助平台探讨国医大师治疗癌因性疲乏用药规律

目的 探讨国医大师治疗癌因性疲乏的用药规律。方法 收集三大数据库(知网、万方、维普)、古今医案云平台、公开出版的中国医大师治疗癌因性疲乏的成功案例,筛选、整理处方数据后录入中医传承辅助平台(V2.5)分析用药规律。结果 共纳入15位国医大师的87则医案,涉及228味中药,药物四气分布以温热、寒凉为主,且二者比例相当;五味分布以甘、苦、辛为主;归经频次靠前的是脾、肝,肺、胃、肾、心稍居其后;使用频次最多的是补虚药,且以补气药为主,其次是清热药;使用频次前10的药物为黄芪、白术、炙甘草、茯苓、陈皮、白花蛇舌草、当归、女贞子、麦芽、党参,常用对药、角药有“黄芪-白术-茯苓”“陈皮-黄芪-白术”“白花蛇舌草-黄芪”“黄芪-当归”等;基于复杂系统熵聚类得到5组新方。结论 国医大师治疗癌因性疲乏区别传统虚劳疾病的治疗原则,从“虚-毒-瘀”的肿瘤病机出发,辛温补虚之药与苦寒解毒之药并用,巧配甘味药缓补机体,重视健脾疏肝,兼顾肺、肾、心三脏,以治气为题眼展开解题思路。

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.

Effect of Tai Chi and Resistance Training on Cancer-Related Fatigue and Quality of Life in Middle-Aged and Elderly Cancer Patients

Objective:To study the effect of Tai Chi(TC)and resistance training(RT)with different intensity on the cancer-related fatigue(CRF)and quality of life(QoL)of middle-aged and elderly cancer patients.Methods:Totally 120 cancer patients were enrolled and randomly assigned to 4 groups by a random number table,including TC group,high-intensity 60%one repetition maximum(1-RM)RT group(HIRT),low-intensity(30%1-RM)RT group(LIRT)and control group,30 patients in each group.Participants in the TC group received 24-form simplified Yang-style TC training at a frequency of 40 min per day,3 days per week for 12 weeks.Patients in the two RT groups received 10 sessions,6 designated movements per day,3 days per week for 12 weeks.The 1-RM of 6 muscle groups,fat mass(FM),lean body mass(LBM),along with the scores of Brief Fatigue Inventory(BFI),QoL questionnaire for Chinese cancer patients receiving chemobiotherapy(QLQ-CCC),Generalized Anxiety Disorder-7(GAD-7),Patient Health Questionnaire-9(PHQ-9)and Pittsburgh Sleep Quality Index(PSQI)were measured before and after training.The adverse effect was also observed.Results:After 12-week intervention,patients in both TC and RT groups showed significant improvements in CRF and QLQ-CCC compared to pre-treatment(P<0.05).Compared with the LIRT and TC groups,patients in the HIRT group improved more significantly in increasing muscle strength and LBM,and reducing in FM(P<0.05).Patients in the TC group significantly increased in lower limb muscle strength compared with the LIRT group(P<0.05).In addition,patients in the TC group showed more significant improvements in scores of GAD-7,PHQ-9 and PSQI than 2 RT groups(P<0.05).Conclusions:TC and RT,both low-and high-intensity training,can significantly increase muscle strength,reduce CRF and improve QoL in the middle-aged and elderly cancer patients.TC has a better effect than RT in terms of sleep quality and mental health.The long-term application is needed to substantiate the effect of TC as an alternative exercise in cancer patients.

成年肿瘤患者癌因性疲乏非药物管理的最佳证据总结

目的检索、评价并总结国内外成年肿瘤患者癌因性疲乏(CRF)非药物管理的最佳证据,为临床实践提供循证依据。方法采用PIPOST工具结构化本研究的循证问题,按照“6S”金字塔证据模型,自上而下检索国内外数据库、专业协会网站、循证资源数据库中关于CRF非药物管理的指南、专家共识、证据总结及系统评价等相关文献,检索时限为数据库建库至2022年7月31日,纳入的相关文献由2名研究者进行质量评价和证据提取。结果共纳入17篇文献,包括指南5篇、临床决策2篇、系统评价10篇。最终从7个方面总结出23条最佳证据。主要包括预防、运动干预、饮食及睡眠管理等方面。结论关于成年肿瘤患者CRF非药物管理的最佳证据对临床护理人员而言安全性高且可操作性强,通过应用最佳证据,以更加系统、科学的方法管理CRF可以有效提升护理质量。

益气活血汤改善恶性肿瘤患者的癌痛及癌因性疲乏

目的:探究益气活血汤对恶性肿瘤患者癌痛及癌因性疲乏(CRF)的疗效。方法:选取2020年1月至2022年12月间安徽省中医药大学第二附属医院收治的82例确诊发生CRF的恶性肿瘤患者(气血亏虚证),采用随机数字表余数分组法将其分为对照组与观察组,每组各41例。对照组患者采用常规止痛、止吐、化痰等对症治疗及健康、心理指导,观察组患者在对照组干预的基础上联合益气活血汤治疗,4周为1个疗程。治疗前及治疗4周后,对两组患者进行中医证候积分评估,以积分变化评估中医临床疗效;采用修订版Piper疲乏量表(RPFS)评估CRF的改善情况;采用数字疼痛分级法(NRS)评分比较癌痛情况;检测患者外周血纤维蛋白原(FIB)、D-二聚体(D-D)评价凝血功能差异,检测患者肝、肾功能指标以评估益气活血汤治疗的安全性。结果:治疗前,两组患者在中医证候积分、RPFS评分、NRS评分及外周血FIB、D-D方面的差异均无显著统计学意义(均P>0.05)。治疗4周后,两组患者在神疲乏力、面色淡白或萎黄、自汗、失眠健忘、手足麻木的证候评分及总积分均较治疗前明显降低(均P<0.05),且观察组各项评分均低于对照组(均P<0.05),中医临床疗效明显高于对照组(P<0.05);两组患者RPFS各维度评分及总分均较治疗前降低(均P<0.05),观察组行为、情感、感觉维度RPFS评分及总分均低于对照组(均P<0.05),观察组CRF的改善明显优于对照组(P<0.05);两组患者NRS评分及外周血FIB、D-D指标均较治疗前降低(均P<0.05),且观察组均低于对照组(均P<0.05)。两组患者治疗期间均未发生肝功能、肾功能等明显异常,说明益气活血汤安全性良好。结论:益气活血汤可纠正气血亏虚之证,改善机体凝血功能,促进恶性肿瘤患者CRF及癌痛的减轻,临床应用价值较高。