Journal of Traditional Chinese Medicine ›› 2026, Vol. 46 ›› Issue (2): 458-469.DOI: 10.19852/j.cnki.jtcm.2026.02.018
• Original Articles • Previous Articles Next Articles
Characterizing the distribution of Chinese medicine syndrome of cancer-related fatigue in childhood lymphoma based on latent structure model
DONG Ziqi1, HUANG Jing2(
), LU Lu3, CHEN Yuru4, GAN Guoling4, DUAN Yanlong5, JIN Ling5, HUANG Shuang5, ZHANG Meng5, LI Nan5, GAO Zhen4, LÜ Jiaxuan2
- 1
Department of Pediatrics ,Beijing Pinggu District Hospital of Traditional Chinese Medicine BeiJing 101200, China
2Department of Pediatrics ,Xiyuan Hospital, China Academy of Chinese Medical Sciences BeiJing 100091, China
3Department of pediatrics ,Beijing Mentougou Maternaland Child Care Hospital Beijing 102300, China
4Department of Pediatrics ,Dongzhimen Hospital, Beijing University of Chinese Medicine Beijing 100027, China
5Medical Oncology Department ,Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health Beijing 100045, China
-
Received:2024-12-16Accepted:2025-06-21Online:2026-04-15Published:2026-04-04 -
Contact:HUANG Jing, Department of Pediatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China 13522098586@163.com; Telephone: +86-13522098586 -
Supported by:Preliminary Study on Tiered Healthcare Based on a Pediatric Collaborative Development Model(XTGL201914);Establishment and Application of a Standardized Diagnosis and Treatment System for Pediatric Lymphoma(XTZD20180204)
Cite this article
DONG Ziqi, HUANG Jing, LU Lu, CHEN Yuru, GAN Guoling, DUAN Yanlong, JIN Ling, HUANG Shuang, ZHANG Meng, LI Nan, GAO Zhen, LÜ Jiaxuan. Characterizing the distribution of Chinese medicine syndrome of cancer-related fatigue in childhood lymphoma based on latent structure model[J]. Journal of Traditional Chinese Medicine, 2026, 46(2): 458-469.
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Table 1 Statistical tables of basic information on demographic characteristics
| Item | Frequency | Frequency distribution (%) | |
|---|---|---|---|
| Sex | Male | 107 | 69.93 |
| Female | 46 | 30.07 | |
| Age (years) | 8-9 | 58 | 37.91 |
| 10-12 | 60 | 39.22 | |
| 13-15 | 24 | 15.69 | |
| 16-17 | 11 | 7.19 | |
| Lymphoma immunophenotyping | Hodgkin's lymphoma | 14 | 9.15 |
| T-lymphoblastic lymphoma | 52 | 33.99 | |
| B-lymphoblastic lymphoma | 20 | 13.07 | |
| Burkitt's lymphoma | 22 | 14.38 | |
| Diffuse large B-cell lymphoma | 9 | 5.88 | |
| Anaplastic large cell lymphoma | 28 | 18.30 | |
| Others | 8 | 5.23 | |
| Lymphoma clinical staging | Ⅰ | 4 | 2.61 |
| Ⅱ | 17 | 11.11 | |
| Ⅲ | 57 | 37.25 | |
| Ⅳ | 75 | 49.02 | |
| Disease course (months) | 0-3 | 12 | 7.84 |
| 4-6 | 109 | 71.24 | |
| 7-12 | 25 | 16.34 | |
| over 12 | 7 | 4.58 | |
| Associated diseases/symptoms | bone marrow suppression | 58 | 37.91 |
| dyspepsia | 74 | 48.37 | |
| vomiting | 70 | 45.75 | |
| sleep disorders | 20 | 13.07 | |
| pain | 41 | 26.80 | |
| mood disorders | 81 | 52.94 | |
| mucositis of the anal orifice | 58 | 37.91 | |
Table 1 Statistical tables of basic information on demographic characteristics
| Item | Frequency | Frequency distribution (%) | |
|---|---|---|---|
| Sex | Male | 107 | 69.93 |
| Female | 46 | 30.07 | |
| Age (years) | 8-9 | 58 | 37.91 |
| 10-12 | 60 | 39.22 | |
| 13-15 | 24 | 15.69 | |
| 16-17 | 11 | 7.19 | |
| Lymphoma immunophenotyping | Hodgkin's lymphoma | 14 | 9.15 |
| T-lymphoblastic lymphoma | 52 | 33.99 | |
| B-lymphoblastic lymphoma | 20 | 13.07 | |
| Burkitt's lymphoma | 22 | 14.38 | |
| Diffuse large B-cell lymphoma | 9 | 5.88 | |
| Anaplastic large cell lymphoma | 28 | 18.30 | |
| Others | 8 | 5.23 | |
| Lymphoma clinical staging | Ⅰ | 4 | 2.61 |
| Ⅱ | 17 | 11.11 | |
| Ⅲ | 57 | 37.25 | |
| Ⅳ | 75 | 49.02 | |
| Disease course (months) | 0-3 | 12 | 7.84 |
| 4-6 | 109 | 71.24 | |
| 7-12 | 25 | 16.34 | |
| over 12 | 7 | 4.58 | |
| Associated diseases/symptoms | bone marrow suppression | 58 | 37.91 |
| dyspepsia | 74 | 48.37 | |
| vomiting | 70 | 45.75 | |
| sleep disorders | 20 | 13.07 | |
| pain | 41 | 26.80 | |
| mood disorders | 81 | 52.94 | |
| mucositis of the anal orifice | 58 | 37.91 | |
Figure 1 Latent structural modeling of symptoms and signs in childhood lymphoma with cancer-related fatigue
Figure 1 Latent structural modeling of symptoms and signs in childhood lymphoma with cancer-related fatigue
Figure 2 Comprehensive clustering model diagram of children's CRF latent structure A: comprehensive clustering model diagram Z1; B: comprehensive clustering model diagram Z2; C: comprehensive clustering model diagram Z3; D: comprehensive clustering model diagram Z4; E: comprehensive clustering model diagram Z5; F: comprehensive clustering model diagram Z6. CRF: cancer-related fatigue.
Figure 2 Comprehensive clustering model diagram of children's CRF latent structure A: comprehensive clustering model diagram Z1; B: comprehensive clustering model diagram Z2; C: comprehensive clustering model diagram Z3; D: comprehensive clustering model diagram Z4; E: comprehensive clustering model diagram Z5; F: comprehensive clustering model diagram Z6. CRF: cancer-related fatigue.
Table 2 Comprehensive clustering model symptoms, signs and symptoms distribution
| CAT | Latent variable | Signs and symptoms | BIC | Pathogenetic syndrome elements | Pathological location syndrome elements |
|---|---|---|---|---|---|
| Z1 | Y0, Y3, Y10, Y13, Y15, Y17 | Greasy mouth without thirst, dry and uncomfortable eyes, loose stools, amnesia, skin oiliness, heavy body and drowsiness, dysuria, deep-colored urine, tastelessness without thirst, bitter taste in mouth, susceptibility, polydipsia, acne, abdominal bloating, hypersomnia, fear of cold | -2199.66 | Dampness, heat | Liver, spleen, kidneys |
| Z2 | Y4, Y8, Y11, Y16 | Spiritlessness, weakness, timidity, night sweating, hypothymic depression, spontaneous sweating, shortness of breath, feverishness in palms and soles, pale tongue | -1246.09 | Qi deficiency, Yin deficiency | Spleen, lungs |
| Z3 | Y9, Y10, Y11, Y12, | Squamous and dry skin, plump tongue, blue or purplish tongue, weak pulse, thready pulse, pale lip and nail colour, pink tongue, red tongue, slippery fur, greasy fur | -1259.01 | Blood stasis, blood deficiency | Heart, spleen |
| Z4 | Y15, Y16 | Night sweating, spontaneous sweating, dry and uncomfortable eyes, greasy mouth without thirst, dysuria, feverishness in palms and soles, amnesia | -866.83 | Yin deficiency, heat | Liver, kidney |
| Z5 | Y13, Y14 | Sensitization, anxiety, emaciation, sighing, irritability, obesity, skin dryness, stringy pulse | -688.25 | Qi stagnation, heat | Liver, heart |
| Z6 | Y1, Y2, Y5, Y6, Y7 | Poor appetite, nausea and vomiting, cold limbs, sore in mouth, light sleep, localized stabbing pain, sore throat, difficulty initiating sleep, difficulty with sleep consolidation, stink of excrement, halitosis | -2022.45 | Heat, food retention, blood stasis | Spleen, heart |
Table 2 Comprehensive clustering model symptoms, signs and symptoms distribution
| CAT | Latent variable | Signs and symptoms | BIC | Pathogenetic syndrome elements | Pathological location syndrome elements |
|---|---|---|---|---|---|
| Z1 | Y0, Y3, Y10, Y13, Y15, Y17 | Greasy mouth without thirst, dry and uncomfortable eyes, loose stools, amnesia, skin oiliness, heavy body and drowsiness, dysuria, deep-colored urine, tastelessness without thirst, bitter taste in mouth, susceptibility, polydipsia, acne, abdominal bloating, hypersomnia, fear of cold | -2199.66 | Dampness, heat | Liver, spleen, kidneys |
| Z2 | Y4, Y8, Y11, Y16 | Spiritlessness, weakness, timidity, night sweating, hypothymic depression, spontaneous sweating, shortness of breath, feverishness in palms and soles, pale tongue | -1246.09 | Qi deficiency, Yin deficiency | Spleen, lungs |
| Z3 | Y9, Y10, Y11, Y12, | Squamous and dry skin, plump tongue, blue or purplish tongue, weak pulse, thready pulse, pale lip and nail colour, pink tongue, red tongue, slippery fur, greasy fur | -1259.01 | Blood stasis, blood deficiency | Heart, spleen |
| Z4 | Y15, Y16 | Night sweating, spontaneous sweating, dry and uncomfortable eyes, greasy mouth without thirst, dysuria, feverishness in palms and soles, amnesia | -866.83 | Yin deficiency, heat | Liver, kidney |
| Z5 | Y13, Y14 | Sensitization, anxiety, emaciation, sighing, irritability, obesity, skin dryness, stringy pulse | -688.25 | Qi stagnation, heat | Liver, heart |
| Z6 | Y1, Y2, Y5, Y6, Y7 | Poor appetite, nausea and vomiting, cold limbs, sore in mouth, light sleep, localized stabbing pain, sore throat, difficulty initiating sleep, difficulty with sleep consolidation, stink of excrement, halitosis | -2022.45 | Heat, food retention, blood stasis | Spleen, heart |
Table 3 Rules for recognizing damp-heat condensation syndrome
| No. | Symptom | Score | No. | Symptom | Score |
|---|---|---|---|---|---|
| 1 | Greasy mouth without thirst | 3.6 | 9 | Tastelessness without thirst | 2.2 |
| 2 | Dry and uncomfortable eyes | 3.6 | 10 | Bitter taste in mouth | 2.1 |
| 3 | Loose stools | 3.1 | 11 | Susceptibility | 1.8 |
| 4 | Amnesia | 3.2 | 12 | Polydipsia | 1.8 |
| 5 | Skin oiliness | 2.9 | 13 | Acne | 1.7 |
| 6 | Heavy body and drowsiness | 2.8 | 14 | Abdominal bloating | 1.5 |
| 7 | Dysuria | 2.8 | 15 | Hypersomnia | 1.5 |
| 8 | Deep-colored urine | 3.4 | 16 | Fear of cold | 1.5 |
Table 3 Rules for recognizing damp-heat condensation syndrome
| No. | Symptom | Score | No. | Symptom | Score |
|---|---|---|---|---|---|
| 1 | Greasy mouth without thirst | 3.6 | 9 | Tastelessness without thirst | 2.2 |
| 2 | Dry and uncomfortable eyes | 3.6 | 10 | Bitter taste in mouth | 2.1 |
| 3 | Loose stools | 3.1 | 11 | Susceptibility | 1.8 |
| 4 | Amnesia | 3.2 | 12 | Polydipsia | 1.8 |
| 5 | Skin oiliness | 2.9 | 13 | Acne | 1.7 |
| 6 | Heavy body and drowsiness | 2.8 | 14 | Abdominal bloating | 1.5 |
| 7 | Dysuria | 2.8 | 15 | Hypersomnia | 1.5 |
| 8 | Deep-colored urine | 3.4 | 16 | Fear of cold | 1.5 |
Table 4 Rules for recognizing deficiency of both the lung and spleen syndrome
| No. | Symptom | Score | No. | Symptom | Score |
|---|---|---|---|---|---|
| 1 | Spiritlessness | 5.5 | 6 | Spontaneous sweating | 2.2 |
| 2 | Weakness | 5.7 | 7 | Shortness of breath | 1.9 |
| 3 | Timidity | 2.9 | 8 | Feverishness in palms and soles | 1.5 |
| 4 | Night sweating | 2.4 | 9 | Pale tongue | 1 |
| 5 | Hypothymic depression | 2.1 |
Table 4 Rules for recognizing deficiency of both the lung and spleen syndrome
| No. | Symptom | Score | No. | Symptom | Score |
|---|---|---|---|---|---|
| 1 | Spiritlessness | 5.5 | 6 | Spontaneous sweating | 2.2 |
| 2 | Weakness | 5.7 | 7 | Shortness of breath | 1.9 |
| 3 | Timidity | 2.9 | 8 | Feverishness in palms and soles | 1.5 |
| 4 | Night sweating | 2.4 | 9 | Pale tongue | 1 |
| 5 | Hypothymic depression | 2.1 |
Table 5 Rules for recognizing blood deficiency and stasis syndrome
| No. | Symptom | Score | No. | Symptom | Score |
|---|---|---|---|---|---|
| 1 | Squamous and dry skin | 4 | 6 | Pale lip and nail colour | 2 |
| 2 | Plump tongue | 3.6 | 7 | Pink tongue | 2 |
| 3 | Blue or purplish tongue | 4.3 | 8 | Red tongue | 1.6 |
| 4 | Weak pulse | 3.3 | 9 | Slippery fur | 1.7 |
| 5 | Thready pulse | 2.8 | 10 | Greasy fur | 1.1 |
Table 5 Rules for recognizing blood deficiency and stasis syndrome
| No. | Symptom | Score | No. | Symptom | Score |
|---|---|---|---|---|---|
| 1 | Squamous and dry skin | 4 | 6 | Pale lip and nail colour | 2 |
| 2 | Plump tongue | 3.6 | 7 | Pink tongue | 2 |
| 3 | Blue or purplish tongue | 4.3 | 8 | Red tongue | 1.6 |
| 4 | Weak pulse | 3.3 | 9 | Slippery fur | 1.7 |
| 5 | Thready pulse | 2.8 | 10 | Greasy fur | 1.1 |
Table 6 Rules for recognizing vigorous fire due to Yin deficiency syndrome
| No. | Symptom | Score | No. | Symptom | Score |
|---|---|---|---|---|---|
| 1 | Night sweating | 4 | 5 | Dysuria | 2.6 |
| 2 | Spontaneous sweating | 3.4 | 6 | Feverishness in palms and soles | 2.5 |
| 3 | Dry and uncomfortable eyes | 2.9 | 7 | Amnesia | 2.5 |
| 4 | Greasy mouth without thirst | 2.6 |
Table 6 Rules for recognizing vigorous fire due to Yin deficiency syndrome
| No. | Symptom | Score | No. | Symptom | Score |
|---|---|---|---|---|---|
| 1 | Night sweating | 4 | 5 | Dysuria | 2.6 |
| 2 | Spontaneous sweating | 3.4 | 6 | Feverishness in palms and soles | 2.5 |
| 3 | Dry and uncomfortable eyes | 2.9 | 7 | Amnesia | 2.5 |
| 4 | Greasy mouth without thirst | 2.6 |
Table 7 Rules for recognizing liver constraint and Qi stagnation syndrome
| No. | Symptom | Score | No. | Symptom | Score |
|---|---|---|---|---|---|
| 1 | Sensitization | 5.2 | 5 | Irritability | 2 |
| 2 | Anxiety | 4.2 | 6 | Obesity | 1.1 |
| 3 | Emaciation | 3.3 | 7 | Skin dryness | 1.1 |
| 4 | Sighing | 2.7 | 8 | Stringy pulse | 1 |
Table 7 Rules for recognizing liver constraint and Qi stagnation syndrome
| No. | Symptom | Score | No. | Symptom | Score |
|---|---|---|---|---|---|
| 1 | Sensitization | 5.2 | 5 | Irritability | 2 |
| 2 | Anxiety | 4.2 | 6 | Obesity | 1.1 |
| 3 | Emaciation | 3.3 | 7 | Skin dryness | 1.1 |
| 4 | Sighing | 2.7 | 8 | Stringy pulse | 1 |
Table 8 Rules for recognizing heart-spleen heat accumulation syndrome
| No. | Symptom | Score | No. | Symptom | Score |
|---|---|---|---|---|---|
| 1 | Poor appetite | 4 | 7 | Stink of excrement | 2 |
| 2 | Light sleep | 3 | 8 | Difficulty with sleep consolidation | 2 |
| 3 | Nausea and vomiting | 3 | 9 | Halitosis | 2 |
| 4 | Localized stabbing pain | 2 | 10 | Cold limbs | 2 |
| 5 | Difficulty initiating sleep | 2 | 11 | Sore in mouth | 2 |
| 6 | Sore throat | 3 |
Table 8 Rules for recognizing heart-spleen heat accumulation syndrome
| No. | Symptom | Score | No. | Symptom | Score |
|---|---|---|---|---|---|
| 1 | Poor appetite | 4 | 7 | Stink of excrement | 2 |
| 2 | Light sleep | 3 | 8 | Difficulty with sleep consolidation | 2 |
| 3 | Nausea and vomiting | 3 | 9 | Halitosis | 2 |
| 4 | Localized stabbing pain | 2 | 10 | Cold limbs | 2 |
| 5 | Difficulty initiating sleep | 2 | 11 | Sore in mouth | 2 |
| 6 | Sore throat | 3 |
Figure 3 Sankey diagram analysis of TCM syndrome-clinical stage-treatment duration correlations in children's CRF TCM: Traditional Chinese Medicine; CRF: cancer-related fatigue.
Figure 3 Sankey diagram analysis of TCM syndrome-clinical stage-treatment duration correlations in children's CRF TCM: Traditional Chinese Medicine; CRF: cancer-related fatigue.
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