br Table br Demographic and clinical characteristics
Demographic and clinical characteristics of the study participants (N = 170).
All patients Patients with Patients with
BFI-T score BFI-T score ≥
BFI-T: Taiwanese version of the Brief Fatigue Inventory.
Comparisons of nine types of traditional Chinese medicine body constitution between patients with mild and moderate-to-severe cancer-related fatigue.
BFI-T: Taiwanese version of the Brief Fatigue Inventory; TCMBC: traditional Chinese medicine body constitution.
P-values obtained from Chi-square or Fisher’s exact test, as appropriate.
Table 2 shows the results comparing the proportions of patients with or without moderate-to-severe fatigue for each of the nine types of TCMBC. The proportion of patients with Gentleness TCMBC was sig-nificantly higher in those Ferrostatin1 without moderate-to-severe cancer-related fatigue (P < 0.001). Conversely, the proportions of patients with Qi-deficiency (P < 0.001), Yang-deficiency (P < 0.001), and Qi-depres-sion (P = 0.005) TCMBC were significantly higher in those with mod-erate-to-severe cancer-related fatigue. No significant diﬀerences were observed between the two groups in the remaining four types of TCMBC.
Of the 170 patients, 78 were classified as having only one type of TCMBC, whereas 87 and 5 were classified as having two or three types of TCMBC, respectively. Moreover, of those with two types of TCMBC, the most common combination was Qi-deficiency and Yang-deficiency (15, 8.8%), followed by Qi-deficiency and Qi-depression (8 patients, 4.7%) and Yang-deficiency and Qi-depression (6 patients, 3.5%).
Other independent variables included during the evaluation of the multiple logistic regression model included age, sex, body mass index, systolic blood pressure, diastolic blood pressure, cancer treatment, cancer stage, Qi-depression TCMBC, Yin-deficiency TCMBC, Phlegm-
Multiple logistic regression analysis of moderate-to-severe cancer-related fa-tigue.
Variable Odds ratio (95% confidence interval) P value
wetness TCMBC, Blood-stasis TCMBC, Wetness-heat TCMBC, and Special diathesis TCMBC.
This study is the first to show a significant association between TCMBC and moderate-to-severe cancer-related fatigue in cancer pa-tients. Specifically, patients with Qi-deficiency TCMBC and Yang-defi-ciency TCMBC were independently associated with a higher risk of moderate-to-severe cancer-related fatigue, whereas those with a Gentleness TCMBC were independently associated with a lower risk of moderate-to-severe cancer-related fatigue. The larger magnitude in the adjusted odds ratio for Yang-deficiency (aOR = 3.55) compared with that for Qi-deficiency (aOR = 2.84) was consistent with the TCM theory that Yang-deficiency generally represents a more severe condition than Qi-deficiency. Conversely, the significant inverse association between a Gentleness TCMBC was also in line with the TCM theory. Individuals with a Gentleness TCMBC mean that their bodily condition is in a state of relative balance of Yin and Yang. These individuals are therefore, less prone to suﬀer from moderate-to-severe cancer-related fatigue.
According to TCM theory, the TCMBC of individuals is formed by Yin and Yang, and an imbalance between Yin and Yang in the body can render them more prone to certain diseases.28–30 Several abnormalities underlie the pathogenesis of cancer-related fatigue, including the pro-motion of inflammatory cytokines imbalance, hypothalamus-pituitary-adrenal axis dysfunction, anemia, and cachexia have been postu-lated.31,32 In addition, Yang-deficiency may not only be related to hy-pothalamic-pituitary-adrenal axis and hypothalamic-pituitary-thyroid axis dysfunction, but also to functional disorders of the cyclic nucleo-tide and immune systems.33
The present study found that patients with Yang-deficiency TCMBC were strongly associated with a higher risk of moderate-to-severe cancer-related fatigue. Yang is the energy needed for maintaining proper body function, and Yang deficiency can be defined as the decline of energy level. Symptoms of Yang deficiency typically include cool extremities, weak pulse, and aversion to cold temperatures.15 It should be noted that the CCMQ should not be used as a diagnostic tool, but rather as a way to assist syndrome diﬀerentiation in TCM practice. The CCMQ is a well-validated instrument that can be used for guiding the treatment approach by Chinese medicine practitioners during disease consultation.