title: Effects of symptoms and complementary and alternative medicine use on the yang deficiency pattern among breast cancer patients receiving chemotherapy.
abstract: BACKGROUND
  Based on traditional Chinese medicine (TCM) theory, yang deficiency pattern defined as an insufficiency of meridian energy (qi) is related to worsening disease symptoms. However, there is a lack of studies portraying the relationship among complementary and alternative medicine (CAM) use, symptoms, and meridian energy. Therefore, the primary purpose of this study was to describe the changes of CAM use, symptoms, and yang deficiency pattern among patients with breast cancer receiving chemotherapy. Additionally, the study explored factors predicting yang deficiency pattern.
  
  
  METHODS
  A longitudinal study was performed with 153 women with breast cancer at four teaching hospitals in northern Taiwan from June 1, 2009 to July 31, 2013. Researchers collected data before treatment and the 1st and 3rd months after chemotherapy. Yang deficiency pattern was examined using the Meridian Energy Analysis Device Me-Pro. Symptom severity and interference were assessed using the MD Anderson Symptom Inventory-Taiwan version. CAM use was evaluated using the US National Center for Complementary and Alternative Medicine (NCCAM) classification.
  
  
  RESULTS
  Meridian energy remained essentially the same over the 3-month period as the difference was not statistically significant. As time went by, patients developed worsening symptom severity and interference. More than 66% of the patients used CAM during chemotherapy. Older women had lower overall meridian energy. The more severe the symptoms were, the lower the overall meridian energy was. The patients who used tai chi or qi gong had higher overall meridian energy and those who used prayer or spirituality had lower overall meridian energy.
  
  
  CONCLUSIONS
  Symptom severity and interference among patients deteriorated during chemotherapy. Health providers should observe symptom changes and improve yang deficiency pattern. Whether or not use of CAM practices such as tai chi or qi gong improves the overall health of breast cancer patients on chemotherapy is worth further study.
authors.affiliation: Department of Nursing, Mackay Medical College, New Taipei City, Taiwan. Electronic address: r910862@yahoo.com.tw.
authors.forename: Sheng-Miauh
authors.initials: SM
authors.lastname: Huang
authors.affiliation: Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan. Electronic address: lychien@ym.edu.tw.
authors.forename: Li-Yin
authors.initials: LY
authors.lastname: Chien
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, Taipei Medical University Hospital, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address: cjtai@tmu.edu.tw.
authors.forename: Cheng-Jeng
authors.initials: CJ
authors.lastname: Tai
authors.affiliation: Department of Traditional Chinese Medicine, Taipei Medical University Hospital, Taiwan. Electronic address: hodazen@gmail.com.
authors.forename: Ping-Ho
authors.initials: PH
authors.lastname: Chen
authors.affiliation: Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan. Electronic address: prlain@vghtpe.gov.tw.
authors.forename: Pei-Ju
authors.initials: PJ
authors.lastname: Lien
authors.affiliation: Department of Traditional Chinese Medicine, Taipei Medical University Hospital, Taiwan; Department of OB/GYN, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address: chenjtai@tmu.edu.tw.
authors.forename: Chen-Jei
authors.initials: CJ
authors.lastname: Tai
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D016740:Meridians; D008875:Middle Aged; D013624:Taiwan; D016711:Yang Deficiency / Q000209:etiology* / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents
keywords: Breast cancer; Complementary and alternative medicine; Meridian energy; Qi; Symptom; Traditional Chinese medicine; Yang deficiency pattern