The integration of Traditional Chinese Medicine (TCM) and Western Medicine in a multidisciplinary approach is the future direction for the diagnosis and treatment of Cancer-Related Fatigue (CRF). However, the lack of standard criteria for syndrome differentiation and treatment selection limits the application of TCM in Western and international contexts. Patients with CRF often experience fatigue associated with metabolic and energy balance abnormalities, with thyroid function playing a critical role in the body's energy metabolism and regulation.

To analyze the TCM syndrome characteristics of CRF and explore their correlation with thyroid function levels, providing a reference for the integrated diagnosis and treatment of CRF and mechanism research in both TCM and western medicine.

The study included cancer patients who visited the oncology outpatient and inpatient departments of the China Academy of Chinese Medical Sciences Xiyuan Hospital in 2021. General information of the patients was collected. The Chinese version of the Revised Piper Fatigue Scale (RPFS-CV) was used to assess patients' fatigue. Thyroid function tests, including triiodothyronine (T₃), thyroxine (T₄), free triiodothyronine (FT₃), free thyroxine (FT₄), thyroid-stimulating hormone, anti-thyroid peroxidase antibody (TPO-Ab), and thyroglobulin antibody, were collected on the day of or the day after enrollment. TCM syndrome characteristics of CRF patients were collected through a self-designed CRF TCM Four-Diagnostic Information Form. Spearman's rank correlation analysis was used to explore the correlation between RPFS-CV fatigue scores and thyroid function indicators. Point biserial correlation analysis was used to investigate the correlation between RPFS-CV fatigue scores, thyroid function indicators, and TCM syndrome characteristics of CRF.

A total of 159 CRF patients were included. The most common types of cancer were lung cancer (50 cases, 31.4%), breast cancer (23 cases, 14.5%), head and neck tumors (21 cases, 13.2%), rectal cancer (21 cases, 13.2%), and colon cancer (18 cases, 11.3%). The median diagnosis duration was 2.15 (3.16) years; 88 patients (55.3%) experienced recurrence or metastasis, with 40 patients (45.5%) having local recurrence and 38 patients (43.2%) having oligometastasis. The median duration of metastasis was 1.50 (2.83) years; 91 patients (57.2%) were in advanced stages, 101 patients (63.5%) had received antitumor treatment, and 57 patients (35.8%) had undergone chemotherapy. In TCM syndromes, deficiency syndromes with a frequency over 10% were Qi deficiency, heart deficiency, and spleen deficiency; among excess syndromes, those occurring more than 20 times were Qi stagnation and damp-cold. Syndromes with a median RPFS-CV fatigue score over 4 were, in descending order, damp-cold, Qi stagnation, spleen deficiency, heart deficiency, liver deficiency, damp-heat, and Qi deficiency. RPFS-CV fatigue scores were positively correlated with Qi deficiency, spleen deficiency, heart deficiency, liver deficiency, damp-cold, and Qi stagnation (P<0.05). RPFS-CV fatigue scores were negatively correlated with FT₃ and T₃ (P<0.05). Qi deficiency was positively correlated with T₄, Kidney deficiency with TPO-Ab, and Qi stagnation with FT₄ (P<0.05) ; Damp-heat was negatively correlated with T₃ and T₄ (P<0.05) .

The fatigue condition of CRF patients is closely related to TCM syndrome characteristics and thyroid function levels. Further research will help deepen the understanding of these correlations and promote the collaborative development of TCM and western medicine in the management of CRF disease.

中西医结合下的多学科参与是癌因性疲乏（CRF）未来诊疗模式的发展方向。然而，缺乏辨证选方的标准和依据限制了中医药在西医和国际范围内的应用。CRF患者的疲乏感常伴随着代谢和能量平衡的异常，甲状腺功能在机体能量代谢和调节方面扮演着重要角色。

分析CRF的中医证候特征并探讨其与甲状腺功能水平之间的相关性，为CRF的中西医结合诊疗和机制研究提供参考。

纳入2021年就诊于中国中医科学院西苑医院肿瘤科门诊及病房的肿瘤患者为研究对象，收集患者一般资料。采用中文版Piper疲乏修订量表（RPFS-CV）评估患者疲乏情况。收集入组患者当日或次日的甲状腺功能检测结果，包括三碘甲状腺原氨酸（T₃）、甲状腺素（T₄）、游离三碘甲状腺原氨酸（FT₃）、游离甲状腺素（FT₄）、促甲状腺激素、抗甲状腺过氧化物酶抗体（TPO-Ab）、甲状腺球蛋白抗体。由自拟CRF中医四诊信息表收集CRF患者中医证候特征。采用Spearman秩相关分析探讨RPFS-CV疲乏评分与甲状腺功能指标的相关性，采用点二列相关分析探讨RPFS-CV疲乏评分和甲状腺功能指标与CRF中医证候的相关性。

纳入159例CRF患者，常见的肿瘤种类依次为肺癌（50例，31.4%）、乳腺癌（23例，14.5%）、头颈部肿瘤（21例，13.2%）、直肠癌（21例，13.2%）、结肠癌（18例，11.3%）；中位确诊年限为2.15（3.16）年；88例（55.3%）患者发生了复发转移，40例（45.5%）患者为局部复发，38例（43.2%）患者为寡转移，中位转移年限为1.50（2.83）年；91例（57.2%）为晚期患者，101例（63.5%）患者接受过抗肿瘤治疗，57例（35.8%）患者接受化疗。中医证候中，虚证频率超过10%从高到低分别为气虚证、心虚证、脾虚证；实证中出现频次超过20次的从高到低分别为气滞证、寒湿证。RPFS-CV疲乏评分中位数超过4分的证候从高到低分别为寒湿证、气滞证、脾虚证、心虚证、肝虚证、湿热证、气虚证。RPFS-CV疲乏评分与气虚证、脾虚证、心虚证、肝虚证、寒湿证、气滞证呈正相关（P<0.05）。RPFS-CV疲乏评分与FT₃、T₃呈负相关（P<0.05）。气虚证与T₄、肾虚证与TPO-Ab、气滞证与FT₄呈正相关（P<0.05），湿热证与T₃、T₄呈负相关（P<0.05）。

CRF患者疲乏情况与中医证候及甲状腺功能水平密切相关，进一步的研究将有助于深入理解这些关联，并促进中医和西医在CRF疾病管理中的协同发展。