針刺治療食道癌患者慢性失眠與藥物所致之譫妄：一病例報告

Acupuncture Treatment for Insomnia Accompanied with Drug-related Delirium in a Patient with Esophageal Cancer: a Case Report

王婕(Chieh Wang) ； 黃明正(Ming-Cheng Huang)

《中華針灸醫學會雜誌》 22卷1-2期 (2019/06) Pp. 1-10

摘要

本病例為一位54歲食道癌第四期，慢性失眠之男性患者，此次因懷疑肺炎入院，並於住院期間接受化學與免疫藥物治療。入院化療後患者失眠加重，甚則發生譫妄，因有肝硬化之病史，又此次入院施打抗癌藥物，血液腫瘤科醫師欲減少患者肝腎負擔，且減少藥物間交互作用，故會診中醫針灸協助治療。患者之睡眠與譫妄情形於針灸治療介入一次後即明顯得到改善，包括睡眠遲滯期縮短以及睡眠總時數上升，譫妄於往後住院期間不曾復見。根據此患者於三次針灸治療療程之臨床症狀變化，發現針灸能有效輔助治療癌症患者失眠以及譫妄之情形，改善睡眠品質，提高睡眠效率，有助於患者獲得更良好的生活品質。

關鍵字

針灸 ； 食道癌 ； 失眠 ； 譫妄

並列摘要

This 54-year-old man diagnosed as esophageal cancer had suffered from insomnia and relied on the sleeping pills for a long time. After receiving chemotherapy and immunotherapy, insomnia exacerbated with less than 10 minutes sleep and thereby an episode of delirium occurred. Due to the impaired liver function and elevated ammonia in serum, the physician avoided the prescription of hypnotics and suggested him receiving the acupuncture intervention. After once acupuncture intervention, his sleep latency significantly reduced and the sleep duration prominently lengthened. Moreover, no more delirium was seen. In this case report, we demonstrated acupuncture could improve the sleep efficiency. Our report implies that acupuncture maybe be beneficial for improving insomnia and quality of life in cancer patients.

並列關鍵字

acupuncture ； delirium ； esophageal cancer ； insomnia

參考文獻

Eriksen, Whitney T., et al. "Understanding the Use of Acupuncture for Insomnia Among Cancer Survivors: A Qualitative Study." The Journal of Alternative and Complementary Medicine 24.9-10 (2018): 962-967

Induru, Raghava R., and Declan Walsh. "Cancer-related insomnia." American Journal of Hospice and Palliative Medicine® 31.7 (2014): 777-785.

Savard, Josée, and Charles M. Morin. "Insomnia in the context of cancer: a review of a neglected problem." Journal of clinical oncology 19.3 (2001): 895-908.

Weckmann, Michelle T., et al. "Incidence and Cause of Delirium in Hospitalized Patients between the Ages of 18 and 56: A Retrospective Chart Review." International Journal of Palliative Care 2014 (2014)

Simeit, Rainer, Ruth Deck, and Beate Conta-Marx. "Sleep management training for cancer patients with insomnia." Supportive care in Cancer 12.3 (2004): 176-183.