br Fatigue is a highly common
Fatigue is a highly common and often treatable problem that aﬀects a cancer patient’s quality of life. Therefore, all cancer patients should routinely be screened for fatigue using patient-reported outcome mea-sures.34 Patients with moderate or severe fatigue may benefit from pharmacologic and nonpharmacologic interventions.35 Increasing evi-dence showed that TCM can safely be used as a helpful adjunct to conventional care in the treatment of cancer-related fatigue.10,36 Clin-ical studies have also shown that Yang-deficiency TCMBC could be improved by acupuncture and moxibustion.37,38 Chen et al.39 reviewed the evidence for using TCM in the treatment of chronic fatigue syn-drome. The authors indicated that ginseng root has been the most widely studied herb for fatigue because of its eﬀect of invigorating Qi and Yang. A recent systematic review of Panax ginseng concluded that it is a viable and promising treatment for fatigue in people with chronic
illness.40 Moreover, Leong et al. proposed that Yang- and Qi-in-vigorating tonic herbs, such as Cistanches Herba and Schisandrae Fructus, might be beneficial in the treatment of chronic fatigue syndrome through their enhancement in mitochondrial function and regulation.41 It should be noted that while a question on “Do you get tired ea-sily?” was included in the calculation of both the Qi-deficiency TCMBC and Gentleness TCMBC, it measured a diﬀerent aspect of fatigue com-pared with the BFI-T. The former is an overall subjective feeling of fatigue over a long Fer1 of time (in the past year) whereas the BFI-T reflects the short-term (in the past 24 h) symptoms of fatigue. In other words, the one question on fatigue in the TCMBC and the BFI-T are not
merely overlapped items on fatigue-related issues.
Some limitations of the current study should be mentioned. First, the sample size is relatively small and thus precluded further subgroup analyses to examine the association of TCMBC with diﬀerent types of cancer. Second, the study participants were recruited based on con-venience sampling from one regional hospital and therefore, the pos-sibility of selection bias cannot be ruled out.
The findings of this study indicated that patients with Qi-deficiency TCMBC and Yang-deficiency TCMBC were more susceptible to mod-erate-to-severe cancer-related fatigue. The CCMQ could be served as a clinical tool to identify and cancer patients who are prone to experience moderate-to-severe cancer-related fatigue, and to provide Chinese medicine practitioners a basis for selecting an appropriate treatment approach based on TCMBC. Further studies on eﬀects of prescriptions for balancing Yang and Qi on alleviating moderate-to-severe cancer-related fatigue in cancer patients are warranted.
All authors made significant contributions to the study design, ac-quisition of data, drafting of the article, and final approval of the ar-ticle.
Conflicts of interest statement
The authors declare that there is no conflict of interests regarding the publication of Cytological hybridization paper.
We are indebted to all the participants who kindly participated in this study. This work was supported by Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation (grant no. DTCRD103-E-12).
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