Increased Yin-Deficient Symptoms and Aggravated Autonomic Nervous System Function in Patients with Metastatic Cancer

Objectives: The objectives of this study were to investigate the differences in severity of yin-deficiency syndrome (YDS) and function of the autonomic nervous system (ANS) between patients with cancer with metastasis and those without metastasis. Setting: The setting was an outpatient clinic in a teaching hospital in central Taiwan. Subjects: The subjects were a total of 124 patients who had been diagnosed with cancer on the basis of pathologic and clinical findings. Among them, 61 had distant metastasis, and the other 63 had no evidence of metastasis. The two groups were similar in terms of age and gender. Interventions: The severity of YDS in each subject was evaluated using a questionnaire containing 12 items about symptoms and signs related to YDS. The severity of each symptom or sign was rated on a 4-point scale. Outcome measures: The total score on the questionnaire represented the severity of YDS. ANS function in each subject was evaluated by measuring heart rate variability (HRV), including time and frequency domains. The questionnaire data were coded, and statistical analysis was performed using SPSS version 12.0. Data were analyzed using the Student's t test or the chi(2) test. Results: The patients with metastasis had significantly higher average total YDS score and heart rate compared with the patients without metastasis. In contrast, they had significantly lower HRV, including standard deviation of the 5-minute average R-R interval, total power, very-low-frequency power, and low frequency (LF) power, but not high-frequency (HF) power and LF/HF ratio. Conclusions: The results of this study indicate that patients with metastatic cancer have more severe YDS and impaired ANS function than those without metastasis.