| Objective To observe the improvement of fatigue,TCM syndromes,body function and quality of life in patients with cancer-related fatigue of lung-spleen deficiency type treated by invigorating spleen and benefiting lung method,and to evaluate the safety of taking traditional Chinese medicine.Methods 90 subjects who met the inclusion criteria were collected from the inpatient department of the second department of oncology of shaoxing second hospital and professor luo xuexin's oncologist outpatient department.They were followed up and divided into Chinese medicine group and control group according to whether the patients took Shenling Baizhu Decoction or not.The control group was only given symptomatic basic treatment of Western medicine,while the Chinese medicine group was given oral Decoction based on Shenling Baizhu Decoction,one dose a day,warm in the morning and evening,and 8 weeks of intervention.Questionnaires were collected in a cycle of 4 weeks.The changes of Piper fatigue scale score,TCM syndrome score,quality of life score and functional state score before and after intervention were compared between the two groups,and the clinical efficacy of Jianpi Yifei method in treating cancer-related fatigue of lung-spleen-qi deficiency type was evaluated.Blood routine,urine routine,stool routine,liver and kidney function and electrocardiogram were used as safety indicators to evaluate the safety of traditional Chinese medicine.All the data were processed by SPSS24.0 statistical software.If the measurement data conformed to the normal,homogeneous and independent variance,t-test was used for statistics.If not,rank-sum test was used for statistics.Max-2 test or rank-sum test was used for counting data.Results(1)General data Comparison: Demographic data showed that the number of patients over 50 years old accounted for 95% of the total number,with no obvious characteristics of gender,occupation,education level,marital status and home address.Disease data showed that there were 73 patients with lung cancer,colorectal cancer and gastric cancer,accounting for 87% of the total number of effective intervention,of which lung cancer accounted for 50% of the total effective intervention.Among the treatment methods,the proportion of surgery combined with chemotherapy(29%)was the highest,followed by surgery alone(19%),followed by chemotherapy alone(11%),surgery combined with radiotherapy chemotherapy(10%),chemotherapy combined with radiotherapy(6%),untreated chemotherapy(6%),and chemotherapy combined with targeted therapy(5%),which may be related to the distribution of cancer species.(2)Comparison of Cancer-related fatigue: Compared with fatigue score,the scores of sensory dimension in Chinese medicine group decreased most obviously after 4 weeks of intervention and before intervention,and the scores of emotional fatigue and sensory fatigue decreased most obviously after 8 weeks of intervention compared with before intervention;the scores of emotional dimension in control group decreased most obviously after 4 weeks of intervention compared with before intervention,and the scores of emotional dimension decreased most obviously after 8 weeks of intervention compared with before intervention.The two groups were in moderate and severe fatigue before intervention.After 4 weeks of intervention,the Chinese medicine group and the control group were mainly moderate fatigue,with 81% in the Chinese medicine group and 83% in the control group.After 8 weeks of intervention,the Chinese medicine group had the most mild fatigue,accounting for 60% of the total number of the Chinese medicine group and the remain 40% was moderate fatigue,while the control group was still dominated by moderate fatigue,accounting for 88% of the total number of patients in the control group.(3)Comparison of quality of life: Before intervention,cognitive and physical functions of CRF patients with lung-qi deficiency were relatively better,and the worst was role function.The clinical symptoms were fatigue,shortness of breath,insomnia and loss of appetite.After 4 weeks of intervention,the improvement of role function,body function,shortness of breath,insomnia,pain,tolerance and constipation on the quality of life of patients in TCM group was the most obvious(P < 0.01),but the improvement of social function,fatigue and diarrhea was not significant(P > 0.05).Simple symptomatic treatment of Western medicine could improve the functional dimension and overall health score of patients(P < 0.01),except for fatigue(P < 0.05),there was no obvious therapeutic effect on the other clinical symptoms(P > 0.05).After 8 weeks of intervention,the functional dimensions of quality of life in the TCM group showed the most significant improvement in role function,body function and emotional function(P<0.01),but no significant improvement in cognitive function and social function(P>0.05).In the symptom dimension,insomnia,shortness of breath,fatigue,poor appetite,pain,constipation,economic difficulties,diarrhea,nausea and vomiting were significantly improved(P<0.01).In the functional dimension of quality of life of the control group,the improvement of emotional function and social function was the most obvious(P<0.01),followed by cognition,role,and physical function(P< 0.05).There was no significant improvement in symptom dimension(P>0.05),and economic difficulties showed an aggravating trend(P<0.01).(4)Comparison of Physical State: before the intervention,the average score of physical status of patients in the two groups was between 60 and 70 points,and their physical status was average,requiring the care of others;after 4 weeks of intervention,the average physical strength score of the two groups was between 70 and 80 points,and life was still self-care,but it was difficult to carry out normal activities;after 8 weeks of intervention,the average physical strength score of the traditional Chinese medicine group was between 80 and 90 points,and most patients were able to normal activities.In the control group,the mean physical strength score was still between 70 and 80.According to the statistical analysis,there were significant differences between the two groups after 4 weeks of intervention and 8 weeks of intervention(P<0.01).There were significant differences between the two groups before intervention,4 weeks after intervention,and 8 weeks after intervention(P<0.01).There were significant differences between the control group 4 weeks after intervention and before intervention,and between the control group 8 weeks after intervention and before intervention(P<0.01),while no significant differences were found between the control group 8 weeks after intervention and 4 weeks after intervention(P>0.05).(5)Comparison of TCM Syndromes: the most obvious improvement in the TCM group after 4 weeks of intervention was,in order,tiredness,fatigue,sputum spitting and pulse condition(P < 0.01);After 8 weeks of intervention,the most obvious improvement was followed by eating less and eating less,being exhausted and languorous,pulse condition,tiredness and fatigue,spitting,chronic cough,and sallow complexion(P < 0.01).In the control group,the intervention for 4 weeks could alleviate the patients' mental fatigue,eating less,sweating and sallow complexion(P < 0.05),but had no significant effect on other symptoms(P > 0.05).After 8 weeks of intervention and 4 weeks of intervention,except for sputum and abdominal distension,there was no significant improvement in the remaining symptoms(P < 0.05),and compared with before intervention,loose stools,intestinal rumble and shortness of breath were worse after 8 weeks of intervention than before treatment.After 4 weeks of intervention,the total effective rate was 77% in the TCM group and 34% in the control group.After 8 weeks of intervention,the total effective rate was 98% in the TCM group and 51% in the control group.(6)Safety assessment: There was no significant difference in blood routine,urine routine,fecal routine,liver function,renal function and electrocardiogram before,4 weeks and 8 weeks after intervention in the control group(P > 0.05).Similarly,there was no significant difference in fecal routine,liver function,renal function,electrocardiogram(ECG)before,4 weeks and 8 weeks after intervention(P > 0.05),but there was significant difference in blood routine and urine routine(P < 0.01).Conclusion The occurrence of cancer-related fatigue of lung-spleen Qi deficiency type is correlated with patient's age,distribution of cancer species and treatment methods.Before intervention,the fatigue of patients is mainly moderate to severe,with general physical condition,poor quality of life,and obvious manifestations of fatigue,shortness of breath,insomnia and loss of appetite.Traditional Chinese and Western medicine can alleviate the fatigue of patients with lung and spleen qi deficiency cancer-related fatigue,reduce the fatigue degree of patients,improve the life quality of patients,improve the patient's physical condition,reduce TCM syndromes in patients with clinical manifestations and reduce the degree of TCM syndromes of patients,but the combination of Spleen-strengthening and lungbenefiting TCM treatment is more effective,and the longer the treatment time,the more obvious the effect is.Western medicine treatment has a timeliness.After 4 weeks of treatment,fatigue,quality of life,physical strength and clinical symptoms have obvious effect.However,the treatment after 8 weeks compared with after 4 weeks,fatigue,quality of life,physical condition,TCM syndromes all of them did not improve much.With the advancement of treatment,patients will feel more and more economic difficulties,so their compliance is poor.The method of invigorating the spleen and benefiting the lung is safe and reliable in the treatment of cancer-related fatigue of lung-spleen deficiency type,without obvious adverse reactions,and can reduce the abnormalities of blood routine and urine routine,with good patient compliance,which is worthy of promotion and application. |
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