Investigation Of The Influencing Factors And Analysis On TCM Patterns Of Syndrome Of Postoperative Fatigue

ObjectivePostoperative fatigue evidencely affected the recovery time of patients who accepted abdominal surgery, however the aetiology of the symptom remains poorly understood. There are two points most commonly cited, ie. psychologic or emotional factors and physiologic factors. It has been not found effected ideas in dealing with fatigue by modern medicine at present, but a few experiences by TCM have been collected. This research are to collect factors which may be related to the etiology of postoperative fatigue, and to analyze the correlation between these factors and POF utilizing the VAS, POMS and ICFS. Outcome of this research may supply sufficient theory of TCM for resonablely interventing on POF.MethodsPatients undergoing middle or big abdominal surgery in GuangDong province hospital of TCM from Octo. 2007 to Feb. 2008 were assessed preopratively and 1, 3, 7 and 14days postoperatively using VAS, POMS, ICFS to evaluate the degree of fatigue and emotional state. Data from scale scores, general information, operation information, postoperative dialectical typing of TCM and postoperative compositions et al were entried into SPSS13.0 data software. Logistic regression analysis and t-test were used to evaluate their correlation.ResultsThirty seven patients were collected, three cases who did not accept operation because of uncontrolled composition were exclueded; Thirty four cases entried the research containing 17 males and 17 females with an average age of 59. 53±19. 47. Postoperative scores of VAS and ICFS were higher than preoperative with an p value <0. 05 through T-test. Scores of patients suffering from malignant disease are higher than patients suffering from benign disease. In addition, factors of modus operandi, operative site and whether or not to detain analgesia pump were not statistically significant with a p value >0.05 compared to the degree of postoperative fatigue. Preoperative symptom questionaire of TCM indicated that stagnation of liver-QI with deficiency of the spleen was the main type of syndrome. However, further research is needed to determine whether the result are reasonable because of the small sample.No evidence was found to support the theory that preoperative nutritional state, lasting time of the operation and hemorrhage volume affected the degree of postoperative fatigue. Preoperative scores of POMS, ICFS and the 14 day ' POMS scores are positive correlation with it, especially the preoperative ICFS scores with r value =0. 504, which indicate the degree of postoperative fatigue had close relationship with preoperative fatigue.Conclusion1. the degree of postoperative fatigue is higher than preoperative, fatigue existed in nearly all of the postoperative patients. And the degree of the fatigue is mostly correlated with the degree of preoperative fatigue, and others such as the preoperative and postoperative emotional type, the character of disease as well. It has no corelation with the sex, nutritional state, modus operandi, lasting time of the operation and hemorrhage volume.2. the typing of TCM is mainly the stagnation of liver-QI with deficiency of the spleen, other typings are relatively scattered; because of the small sample of the research, following large sample cluster analysis is needed.