Characterizing the distribution of Chinese medicine syndrome of cancer-related fatigue in childhood lymphoma based on latent structure model.
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OBJECTIVE: To explore the distribution patterns of Traditional Chinese Medicine (TCM) syndromes in children with lymphoma-related cancer-related fatigue (CRF) using latent structure model analysis. METHODS: This was a single-center cross-sectional study in which Chinese medicine diagnostic information was collected from 153 children diagnosed with childhood lymphoma CRF from July 2022 to December 2023. The latent structure model of the CRF for childhood lymphoma was constructed using the latent tree model-extension adjustment simplification until termination algorithm, and the population was classified using comprehensive clustering. Combined with the existing guidelines, we explored the distribution characteristics and dynamic progression of syndrome types in patients with childhood lymphoma CRF. RESULTS: Initially, a latent structural model incorporating 72 manifest variables was constructed. Through comprehensive clustering, 6 distinct TCM syndrome types were identified, and corresponding quantitative identification rules were formulated. The 153 pediatric cases were then reclassified according to these rules, with the syndromes ranked in descending order of percentage as follows: blood deficiency and stasis, vigorous fire due to Yindeficiency, deficiency of both the lung and spleen, liver constraint and Qi stagnation, dampness-heat retention, and heart-spleen heat accumulation. Preliminary findings suggest that the shifting patterns of TCM syndromes in childhood lymphoma CRF may exhibit clinically meaningful relationships with tumor staging and treatment time courses. CONCLUSION: Using latent structure analysis, 6 TCM syndromes and their quantitative identification rules were identified. A comparison with existing guidelines revealed that CRF in patients with childhood lymphoma is characterized primarily by a syndrome of mixed deficiency and excess. Therefore, in the treatment of pediatric CRF, it is recommended not only that deficiency patterns be addressed but also that the clinical stage and treatment phase of the tumor be considered. Additionally, therapeutic strategies should emphasize promoting digestion, resolving food stagnation, regulating Qi, and clearing heat to formulate a tailored treatment plan.