Chung Hsueh-Wen, Chien Li-Yin, Huang Sheng-Miauh, Tai Chen-Jeng, Tai Chen-Jei
J Tradit Chin Med. 2016 Jun;36(3):326-31. doi: 10.1016/s0254-6272(16)30045-0.
Symptom patterns are an important diagnostic concept in terms of Traditional Chinese Medicine. Although symptom patterns and health related quality of life (HRQOL) are common diagnostic measures for cancer patients, the association between them has not been studied. This study aimed to describe the changes in the pattern of symptoms of Yang-deficiency, Yin-deficiency, blood stasis, and HRQOL before and after chemotherapy, and to examine the association between the patterns and the cancer patients' HRQOL.
A panel study was undertaken with 123 cancer patients who were about to begin their first course of chemotherapy at four teaching hospitals in Taiwan. A structured questionnaire was used before and after chemotherapy. HRQOL was assessed using the Medical Outcomes Survey Short-Form 36. The Traditional Chinese Medical Constitutional Scale was used to measure Yang-deficiency, Yin-deficiency, and blood stasis patterns, with higher scores indicating a larger deficiency.
The patients had significantly worse scores for Yang-deficient pattern, Yin-deficiency pattern, blood stasis pattern, and the physical components of HRQOL after chemotherapy compared with before chemotherapy. The HRQOL scores correlated significantly with Yang-deficiency, Yin-deficiency, and the blood stasis pattern scores. A generalized estimating equation model showed that the HRQOL scores were significantly worse after chemotherapy compared with before chemotherapy for the physical component, but not for the mental component. Blood stasis pattern was significantly associated with a decreased HRQOL in both the physical and mental components. A hemoglobin level < 12 g/dL was associated with a worse physical component of HRQOL.
The Yang-deficiency, Yin-deficiency, and blood stasis patterns were all associated with lower HRQOL in cancer patients after chemotherapy.
症状模式是中医诊断的一个重要概念。虽然症状模式和健康相关生活质量（HRQOL）是癌症患者常用的诊断指标，但它们之间的关联尚未得到研究。本研究旨在描述化疗前后阳虚、阴虚、血瘀症状模式及HRQOL的变化，并探讨这些症状模式与癌症患者HRQOL之间的关联。
对台湾四所教学医院即将开始首个化疗疗程的123例癌症患者进行了一项队列研究。化疗前后使用结构化问卷。采用医学结局研究简表36评估HRQOL。采用中医体质量表测量阳虚、阴虚和血瘀模式，得分越高表明亏虚越严重。
与化疗前相比，患者化疗后阳虚模式、阴虚模式、血瘀模式及HRQOL的身体维度得分显著更差。HRQOL得分与阳虚、阴虚及血瘀模式得分显著相关。广义估计方程模型显示，化疗后身体维度的HRQOL得分显著低于化疗前，但心理维度并非如此。血瘀模式与身体和心理维度的HRQOL降低显著相关。血红蛋白水平<12 g/dL与HRQOL的身体维度较差有关。
阳虚、阴虚和血瘀模式均与化疗后癌症患者较低的HRQOL相关。
