非藥物方法緩解老年人慢性疼痛的實證醫學

Evidence-based Medicine Regarding the Nonpharmacological Approaches for the Alleviation of Chronic Pain in Older Adults

辜美安(Malcolm Koo) ； 蔡坤維(Kun-Wei Tsai) ； 林詩淳(Shih-Chun Lin)

《台灣老年醫學暨老年學雜誌》 10卷2期 (2015/05) Pp. 63-72

https://doi.org/10.29461/TGG.201505_10(2).0001

摘要

慢性疼痛是老年人常見的症狀，除了常規的藥物治療外，其它非藥物介入方法或輔助療法近年亦有新發展。但是現有文獻仍缺乏近年相關實證研究和文獻回顧之整理。因此，本文探討較為常見的非藥物及侵襲性較少之介入性治療，包括針灸、按摩、太極拳、心理療法等用以緩解老年人慢性疼痛的文獻。整體上，目前證據大部分是從個案報告或小型研究匯集所得。不論是任何一個輔助療法皆出現相同的問題，例如統計力不足、缺乏適當的對照組和客觀臨床結果評量等，此等輔助療法在提供老年人使用前，醫護人員必須衡量非藥物療法的風險和效益。

關鍵字

非藥物治療 ； 輔助療法 ； 老年人 ； 慢性疼痛 ； 持續性疼痛

並列摘要

Chronic pain is a common symptom encountered by elderly people. In addition to usual pharmacological treatment, nonpharmacological therapies or complementary therapies have become popular recently. However, the current literature still lacks a synthesis of the existing evidence-based studies and systematic reviews. Therefore, the present review aimed to examine the literature on chronic pain in the elderly with common nonpharmacological and minimally-invasive therapies including acupuncture, massage, Tai Chi Chuan, and psychological therapies. Overall, the existing evidence was generated mostly from case reports or small studies. Similar weaknesses, such as low statistical power, lack of adequate control groups, and lack of objective outcome measures, prevail in most studies regardless of the type of complementary therapies. Before providing advice to elderly patients, healthcare professionals must consider the risks and benefits of those nonpharmacological therapy.

並列關鍵字

nonpharmacological therapy ； complementary medicine ； elderly ； chronic pain ； persistent pain