臺灣中醫對於長期照顧患者的生活品質及心率變異之療效評估

Therapeutic efficacy of traditional Chinese medicine on quality of life and heart rate variability among patients in long-term care system in Taiwan

楊晉瑋(Ching-Wei Yang) ； 陳星諭(Hsing-Yu Chen) ； 陳俊良(Jiun-Liang Chen) ； 楊賢鴻(Sien-Hung Yang)

《中醫藥雜誌》 29卷1期 (2018/06) Pp. 42-59

https://doi.org/10.3966/241139642018062901004

摘要

目的：探討中醫治療對於臺灣長期照顧患者的生活品質及心率變異之影響。材料和方法：採前瞻性研究方法，分析32位桃園長庚護理之家病患，比較中醫治療前後的生活品質和心率變異，並對主要照顧者進行中醫治療的滿意度評估。使用統計軟體SPSS（version 19.0），採成對樣本t檢定分析，當P值＜0.05則達到統計意義。結果：（1）患者的慢性便秘、下背疼痛和情志抑鬱獲得改善。（2）心率變異分析發現心臟功能和負荷指數、總能量、低頻功率、低高頻功率比上升，達到統計學意義。（3）超過五成的主要照顧者滿意且認同中醫治療對患者有幫助。結論：本研究為臺灣首篇對於長照病患在接受西醫常規治療，同時配合中醫治療的療效評估之前驅研究。本文發現：患者的慢性便秘、關節疼痛、精神抑鬱獲得改善，心率變異分析呈現心臟功能、總能量、低高頻功率比上升，主要照顧者肯定中醫療效，且中醫治療期間無發生嚴重之併發症，未來仍需更多病患人數和嚴謹的臨床研究來證實中醫在長照的醫療價值。

關鍵字

長期照顧 ； 老年失能 ； 中醫治療 ； 生活品質 ； 心率變異分析

並列摘要

Objective: To investigate the therapeutic efficacy of traditional Chinese medicine (TCM) on quality of life and heart rate variability among patients in long-term care system in Taiwan. Materials and Methods: 32 patients in the nursing home of Taoyuan Chang Gung memorial hospital were included in this prospective study. To explore the role of TCM in long-term care system, quality of life, heart rate viability (HRV), and satisfaction of caregivers were used to evaluate the effectiveness of TCM. The results were analyzed by paired t-test statistic methods via SPSS (version 19.0) and P-value less than 0.05 was significant. Results: (1) The quality of life such as constipation (P=0.008), lower back pain (P=0.028), and depression (P=0.020) were improved. (2) HRV exam showed elevated levels of SDNN (P=0.012), RMSSD (P=0.011), TP (P=0.024), LF (P=0.015), LF/HF (P=0.012). (3) More than fifty percent of primary caregivers satisfied and agreed that TCM was helpful for patients in long-term care facility. Conclusion: This article was the first pilot study to explore the therapeutic efficacy of TCM combined with conventional western medicine among patients in long-term care system in Taiwan. We found the improvement of quality of life and HRV result. The efficacy of TCM for elderly disability was also agreed by caregivers. No severe adverse complications happened during TCM treatment. It will need more patients and more rigorous clinical studies to confirm the true adjuvant medical value in the future.

並列關鍵字

long-term care ； elderly disability ； traditional Chinese medicine ； quality of life ； heart rate viability

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