乳癌患者化療期間接受中醫輔助醫療之成效

乳癌是全球女性最常見的癌症，也是我國女性癌症發生率之首位。目前化學治療是治療乳癌常見的方式之一，但是化學治療將無可避免造成人體正常細胞的損傷。隨著全球醫學發展，我國醫療體系日漸著重西方正統醫學與非主流傳統醫學之整合，所以在延長患者生命及提高生活品質的醫療方式，中醫皆扮演著重要的角色。因此，本研究旨在探討乳癌病人在化療期間接受中醫輔助醫療之生理指標、營養狀況、生活品質及生活功能的變化，並探討乳癌病人在化療期間接受中醫輔助醫療之生理指標及營養狀況的變化，對於生活品質及生活功能的變化之影響。本研究採用回溯性研究設計，利用次級資料分析方法，於2016年4月至2017年12月之間，以高雄市某醫學中心的乳癌病人化療期間接受中醫輔助醫療為收案對象。研究對象在接受中醫輔助醫療前進行前測評估，而在接受3個月的中醫輔助醫療療程後進行後測測量。量表包括營養評估及癌症治療功能性評估的一般性量表(FACT-G)、生活功能狀態評分表(ECOG)，以及各項生理指標（BMI、白血球、血紅素、血小板）。本研究分析結果發現乳癌患者在化療期間，接受三個月的中醫輔助醫療介入，可以顯著提升乳癌患者之生活品質(t=8.10, p<0.001)，包括生理狀況、社交狀況、情緒狀況和功能狀況之面向，而且還有改善乳癌患者生活功能(t=-5.48, p<0.001)之成效。此外在中醫輔助醫療介入期間白血球狀況變差者，其生活品質(b=-7.14, p=0.002)和生活功能(b=0.50, p=0.007)會比其他病患變得更差。本研究結果了支持乳癌病患在化療期間接受中醫輔助醫療之成效，未來可研議推廣中醫輔助醫療介入，並須同時注意乳癌患者在化療期間之白血球變化狀況。

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並列摘要

Breast cancer is the most common cancer among women worldwide, and it is also the highest cancer incidence among women in Taiwan. At present, chemotherapy is one of the common ways to treat breast cancer, but chemotherapy will inevitably cause damage to normal cells in the human body. Along with the advancement of medicine, the health care system in Taiwan is increasingly focusing on the integration of Western medicine and non-mainstream traditional medicine. Traditional Chinese medicine (TCM) plays an important role in extending the patients’ lives and improving their quality of life. Therefore, the present study aimed to investigate the changes of physiological indicators, nutritional status, quality of life, and life function for breast cancer patients who received TCM during chemotherapy, and to examine the effect of the changes of physiological indicators and nutritional status on the changes of their quality of life and life functions. This study used a retrospective study design and conducted secondary data analysis. The study participants were the breast cancer patients in a medical center in Kaohsiung City who received supplementary TCM during their chemotherapy in the period of April 2016 to December 2017. The study participants conducted pre-test before supplementary TCM and conducted post-test after 3 months of TCM. The measurement scale includes the Functional Assessment of Cancer Therapy (FACT-G), the Eastern Cooperative Oncology Group scale (ECOG), and various physiological indicators (BMI, white blood cells, heme, and platelets). The results showed that the breast cancer patients who received three months of TCM intervention during chemotherapy significantly improved their quality of life (t=8.10, p<0.001), including the physiological, social, emotional, and functional dimension. The TCM can also improve the life function of breast cancer patients (t = -5.48, p<0.001). In addition, the breast cancer patients whose white blood cells became worse during the intervention of TCM, their quality of life (b=-7.14, p=0.002) and life function (b=0.50, p=0.007) were also worse than other patients. The results of this study support the effectiveness of TCM for breast cancer patients during chemotherapy. We can promote the TCM intervention for breast cancer patients, and we must pay attention to the changes in white blood cells for breast cancer patients during chemotherapy.