摘要
中藥補脾健胃方劑乃為臨床中醫師常用之胃腸疾病調整治療藥物，本論文乃選擇八種 臨床上常用之中藥方劑：四君子湯、香砂六君子湯、芍藥甘草湯、安中散、人參養榮湯、 參苓白朮散、五積散、四逆湯應用 Fordtran 之"人工胃模式"建立定量方法測定制酸之作 用及時間。 本實驗以水為空白組,磷酸鋁乳膠液及碳酸氫鈉為正對照組，結果顯示：中和 胃酸能力其pH值分別為：磷酸鋁乳膠液(2.16*0.03)、碳酸氫鈉(1.83*0.03)、參苓白朮散 (1.76*0.03)、五積散(1.72*0.09)、人參養榮湯(1.65*0.10)、四逆湯(1.60*0.05)、香砂 六君子湯(1.58*0.06)、四君子湯(1.57*0.04)、安中散(1.53*0.03)、芍藥甘草湯(1.53*0 .02)、水(1.44*0.03)等。 持續中和胃酸的時間分別為：磷酸鋁乳膠液(172*3分)、香 砂六君子湯(137*3分)、安中散(130*5分)、參苓白朮散(127*5分)、人參養榮湯(124*6分) 、四君子湯(123*24分)、碳酸氫鈉(121*14分)、五積散(117*2分)、四逆湯(100*17分)、 芍藥甘草湯(92*8分)、水(87*6分)等。 綜合以上結果，說明補脾健胃之中藥方劑皆呈 現不同程度之制酸作用，且在胃的保護機制上佔有非常重要的角色。末期癌症病人，必然 承受自我身心及家庭社會的壓力。但是隨著各國社會文化背景的不同，病人所面臨的問題 也不儘相同。如何發展一套中國式的安寧照顧，則是此次實驗的目的。「生活品質」(qua lity of life,QOL)，是一個觀念或概念。在不同的族群有不同的內涵，曾被詮釋為對生 活的滿意度、自尊、生理及心理的安寧、健康、快樂、調適、生命價值、人際關係及社會 參與等功能的狀態。 本實驗利用問卷調查法，本研究將274個病人分成對照組(101人) 、補氣藥膳組(57人)及補氣止痛組(116人)，對照組則不給予藥膳，補氣藥膳組則給予補 氣之食膳，補氣止痛組則將補氣藥膳組之材料加入芍藥甘草湯。274個病人的問卷中，有1 73人的病人給予食膳，另外在給予食膳的173人其食後藥膳問卷中，149人(86.1%)的病人 食後願意繼續接受食膳，24人(13.9%)的病人因病情無法繼續接受食膳。統計結果發現： 病人原發癌的分布：前五位分別是肺癌(25.5%)、肝癌(12.4%)、大腸直腸癌(10.9%)、胃 腸癌(10.9%)、子宮頸癌(5.5%)。病人主訴症狀分布以疼痛(79.2%)所佔的比例高，其次為 全身倦怠(69.0%)、食慾不振(46.4%)、發燒(36.5%)、呼吸困難(31.0%)、水腫(31.0%)。 所以我們將利用傳統中藥的食膳由病人主訴症狀，調製成可口的食膳，每天選擇適當之藥 材，定時供予安寧病房之病人。 本實驗之食膳食譜以含有多醣類之白木耳和具有鎮痛 之芍藥甘草湯，再佐以含有維他命物質來調製。在每日下午供應食膳作為餐後甜點，經過 一個星期，收集問卷，研究結果以口述數字評分法（Verbal Numerical Scale）評估。統 計結果發現芍藥甘草為基礎調製之藥膳對病人疼痛症狀有明顯改善(P<0.01)。在生活品質 的改善也有正面意義(P<0.001)。 因此藉著傳統中國食療之推展，以期幫助病人支持 其精神生活，提高生活品質，並給其家人些許協助。
關鍵字
antacids並列摘要
Antacids are traditionally used for the treatment of peptic ulcer.In clinica l, Tonic Chinese Medicinal prescriptions are the drugs for invigorating the sp leen and stomach, usually used in the treatment of peptic ulcer by clinical Ch inese Medical doctor. In this study, We have utilized artificial stomach of Fo rdtran as a model system to quantitative analysis the water extracts of the in vigorating the spleen and stomach in the extracts of Traditional Chinese Medic ines, which include Si jun zi tang(四君子湯), Xiang sha liu jun zi tang(香砂六 君子湯), Shao-yao gan-cao tang(芍藥甘草湯), An zhong san(安中散), Ren shen yan g rong tang(人參養榮湯), Shen ling bai-zhu san(參苓白朮散), Wu ji san(五積散), and Si ni tang(四逆湯).The results are as following:1.The Antacid effect whic h was tested by Acid Neutralizing Capacity(ANC):Colloidal aluminum phosphate( 磷酸鋁乳漿) (2.16*0.03)、Sodium bicarbonate(碳酸氫鈉)(1.83*0.03)、Shen ling ba i-zhu san(參苓白朮散) (1.76*0.03)、Wu ji san(五積散)(1.72*0.09)、Ren shen yang rong tang(人參養榮湯)(1.65*0.10)、Si ni tang(四逆湯) (1.60*0.05)、Xiang sha l iu jun zi tang(香砂六君子湯) (1.58*0.06)、Si jun zi tang(四君子湯)(1.57*0.04) 、An zhong san(安中散)(1.53*0.03)、Shao-yao gan-cao tang(芍藥甘草湯)(1.53*0.02 )、water(水)(1.44*0.03).2.The duration of the acid neutralization(minutes): Co lloidal aluminum phosphate(磷酸鋁乳漿)(172*3)、Xiang sha liu jun zi tang(香砂 六君子湯)(137*3)、An zhong san(安中散)(130*5)、Shen ling bai-zhu san(參苓白朮 散) (127*5)、Ren shen yang rong tang(人參養榮湯)(124*6)、Si jun zi tang(四君子 湯)(123*24)、Sodium bicarbonate(碳酸氫鈉)(121*14)、Wu ji san(五積散)(117*2)、S i ni tang(四逆湯) (100*17)、Shao-yao gan-cao tang(芍藥甘草湯)(92*8)、water(水) (87*6). The results of these studies indicate that antacid effects play an important role in the gastric protective mechanisms of Traditional Chinese Med icines in invigorating the spleen and stomach. One of the end point of hospice movement is Taiwan in to create the Chinese model of hospice care for our peo ple. The trial of TCDT was our preliminary effort for this end point.274 sequ ential patients were included in this retrospective study. Questionnaire surve y for autonomy demonstrated that 173 out of 274 terminal cancer patients (63.1 %) were willing to take TCDT. The remaining 101 (36.9%) patients who did not take TDCT were assumed as the control group.The first five leading primary can cers include Lung CA (25.5%), Liver CA (12.4%),Colorectal CA(10.9%),Stomach CA (10.9%) and Cervical UT. CA (5.5%) comprised the major distribution of disease entity. TCDT is prescribed according to the priority of their problem lists w hich indicated pain (79.2%), weakness (69.0%), non-appetite(46.4%), fever(36.5 %), dyspnea (31.0%) and edema(31.0%). After admission, assessment and regular medication of palliative care were performed for 1 week. TCDT followed with ta ilored menu and served as dessert between meals for another 1 week. The result s were evaluated by Verbal Numerical Scale method. Main components of menu wer e composed of Tremella fuciformis, Paeonia Lactilora &Glycyrrhiza and other tr aditional medicine profounded with vital substance. As the results of evaluati on, 149(86.1%) patients shows their strong affinity to TCDT . Pain control was significantly favored in the test group. Those having Glycyrrhiza -Paeonia so up revealed pain relief(P<0.01). It is concluded that TCDT adjuvantly improves quality of life of the terminal cancer patients(P<0.001). In terms of practic al and clinical extension of TCDT , further prospective randomized study is ne cessary to be organized.