| BackgroundWith the development of targeted drugs,antiangiogenic drugs have been widely used in the clinical treatment of cancer.Prevention and treatment the adverse reactions of antiangiogenic drugs plays an important role in the integrity of therapy,survival time and quality of life of intermediate and advanced cancer patients.When using antiangiogenic drugs,most cancer patients are in the middle-late clinical stage,and have been through too much treatment,which means that in the process of treatment,patients often experience serious symptoms.Therefore,symptoms of intervention to improve the quality of life of intermediate and advanced cancer patients has become the current clinical research hotspot and focusOn the other hand,the advantage of symptom cluster for scientific management of cancer symptoms has been recognized by the world,and the great advantage of TCM for cancer treatment is shown in the improvement of patients’ clinical symptoms.However,the evaluation system of TCM efficacy has always been inadequate,which limits TCM development.Based on this,we believe that the advantage of symptom cluster for the evaluation of TCM tumor efficacy therapeutic evaluation may be the objective evaluation of TCM tumor efficacy and the possible way to construct effective TCM syndrome differentiation.PurposeThrough questionnaire survey and statistical analysis,in Study 1,the frequency and severity of symptom and quality of life of intermediate and advanced cancer patients during antiangiogenic drugs treatment were summarized,and symptom cluster were extracted;To explore the relationship between quality of life and symptom cluster;In order to provide a theoretical basis for the evaluation system of TCM efficacy by symptom cluster and the value of cognition of TCM syndromes.On the other hand,in the study 2,the intermediate and advanced lung cancer patients receiving Anlotinib were analyzed to investigate TCM syndromes.It is expected to provide preliminary theoretical guidance for TCM syndrome differentiation in the treatment of intermediate and advanced lung cancer patients during the Anlotinib treatment,and lay a foundation for the formulation of reasonable and effective TCM intervention to reduce adverse reactions and improve the quality of life in the future.Method1.Investigation of symptom clusters in intermediate and advanced cancer patients during antiangiogenic inhibitorsFrom July 2020 to March 2021,106 cases of cancer patients who were receiving antiangiogenic inhibitors and were diagnosed in the outpatient or inpatient department of oncology in Guang ’ anmen Hospital were screened.General data sheet,malignant tumor related data sheet,MDASI+antiangiogenic inhibitors specific module of and EORTC QLQ-C30 scale was filled out to analyze the incidence and severity of each symptom during antiangiogenic drugs in cancer patients,and the symptom clusters were extracted.Quality of life and its association with each symptom clusters were analyzed.SPSS24.0 was used for statistical analysis,and frequency,mean median and quaternary[M(Q25,.Q75)]were used for statistical description.Exploratory factor analysis was used to extract the symptom cluster.Spearman correlation analysis was used to study the correlation between symptom cluster and quality of life.2.Preliminary study on TCM syndrome of intermediate and advanced lung cancer patients during Anlotinib treatment60 cases of lung cancer patients who were being treated with Anlotinib and were clearly diagnosed in the outpatient or inpatient department of oncology of Guang’anmen Hospital from July 2020 to March 2021 were screened.Patients filled in the general data table,lung cancer related data table and TCM syndrome scale.SPSS24.0 was used for statistical analysis of TCM syndrome and distribution of syndrome types in lung cancer patients undergoing Anlotinib treatment,and the statistical methods were mainly as follows:frequency,mean median and quaternary[M(Q25,Q75)]Results1.Investigation of symptom clusters in intermediate and advanced cancer patients during antiangiogenic inhibitors(1)Fatigue symptoms are most common(92.45%),most followed by appetite(78.30%),pain(77.36%),dry mouth(76.42%),sadness(72.64%),sleepy(68.87%),sleep uneasy(64.15%),pain(61.32%),amnesia(58.49%)and shortness of breath(56.60%).Symptoms of higher severity includes fatigue,sleep uneasy,distressed,appetite,sleepiness,dry mouth.(2)Emotional disturbance was the highest(83.96%),followed by general activity(81.13%),working(79.25%),walking(76.42%)joy of life(75.47%)and relationships with others(63.21%),the relationship between the severity of the highest for emotions and relationships with others,followed by general activity and walking,the lowest for the work and life fun 5 points,the highest incidence of symptoms is a regular activity(49.06%),followed by relationships with others(46.23%),joy of life(46.23%),emotional(40.57%),walking(38.68%)and working(29.25%)(3)Four symptom cluster were extracted.Symptom cluster 1(general symptom cluster):fatigue,shortness of breath,forgetfulness,drowsiness,dry mouth,numbness;Symptoms cluster 2(antiangiogenic inhibitors related symptoms cluster):hand and foot pain,joint pain,rash,easy bruising and even bleeding,hands,legs,feet,abdomen or around the eyes edema;Symptom cluster 3(affective symptom cluster):sadness,headache,distress,restless sleep;Symptoms of 4(digestive tract symptoms group):disgusting vomiting,poor appetite.(4)The functional scores of the patients were higher,however,the symptom scale scores were low except for fatigue and loss of appetite,(5)Correlation analysis between quality of life and symptom cluster:Symptom clusters were negatively correlated with quality of life.2.Preliminary study on TCM syndromes of intermediate and advanced lung cancer patients during Anlotinib treatment(1)Analysis of TCM symptoms of lung cancer patients during the treatment with Anlotinib:the top 10 symptoms according to the frequency of symptoms were:fatigue(93.33%),less qi and lazy speech(80.00%),anorexia(75.00%),spontaneous sweating(70.00%),insomnia(60.00%),shortness of breath(53.33%),chest pain(46.67%),dry mouth and throat(46.67%),dry cough(41.67%),chills,cold limbs(40.00%).(2)Analysis of TCM tongue and pulse signs in lung cancer patients during Anlotinib treatment:tongue signs were mainly thin and fat tongue(53.33%),thin and white tongue(50.00%)and tongue edge tooth marks(43.33%).Pulse signs were mainly thin and weak pulse(40.00%)and heavy and thin pulse(30.00%).(3)Analysis of TCM syndromes in lung cancer patients during Anlotinib treatment:in included cases,Qi deficiency syndrome(38.33%)and Yin deficiency syndrome(21.67%)were the main symptoms.Conclusions1.In this study,the symptoms with the highest incidence and the most serious were fatigue,appetite,drowsiness and distress,suggesting that these symptoms must be actively intervened in clinical practice to minimize the symptoms and troubles of patients.2.During antiangiogenic inhibitors therapy,cancer patients had four symptom cluster,which were general symptom cluster,anti-antiangiogenic inhibitors treatment-related symptom cluster,affective symptom cluster and digestive tract symptom cluster.3.The quality of life of cancer patients was not optimistic during antiangiogenic inhibitors therapy.The symptom cluster was negatively correlated with the overall health score of quality of life,moderately negatively correlated with the general symptom group and the affective symptom group,and weakly negatively correlated with the symptom cluster related to antiangiogenic inhibitors therapy.4.During the treatment of antiangiogenic inhibitors,cancer patients’ symptom cluster had a high correlation with physical function,emotional function and cognitive function,suggesting that the symptom cluster had a serious impact on the role change of physical and mental health and cognitive function of patients.Affective symptom cluster is an important factor affecting quality of life.5.In this preliminary study of TCM syndrome analysis,Qi deficiency and Yin deficiency were the most common symptoms in lung cancer patients during the treatment with Anlotinib:fatigue,less energy and less qi,lazy speech,less spontaneous sweating,insomnia,shortness of breath,chest pain,dry mouth,dry throat,less phlegm,fear of cold limbs,cold tongue,light and fat,thin coating,white tongue edge,tooth marks,thin pulse,thin pulse... |
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