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  • 學位論文

癌症住院患者中醫輔助醫療之成效分析

Efficacy of Traditional Chinese Supplementary Treatment for Inpatients with Carcinoma

指導教授 : 應純哲
共同指導教授 : 蔡金川(Chin-Chuan Tsai)

摘要


研究目的:本研究旨在瞭解癌症住院患者經中醫輔助醫療介入後,自覺健康狀況差異,並評估中醫體質、生活功能、生命質量之成效分析。 研究方法:本研究為回溯性研究,以民國100年1月至民國101年12月間,接受中醫會診之腫瘤患者,扣除未做前測、後測個案後65例為研究對象。於會診後即給予中醫體質量表 (BCQ)、生活功能狀態評分表 (ECOG)、癌症患者生命質量表 (EORTC) 進行前測評估;在病患接受約14天的療程之後,進行後測測量。在前、後測結束之後,將中醫體質量表 (BCQ)、癌症患者生命質量表 (EORTC) 進行獨立樣本t檢定,生活功能狀態評分表 (ECOG) 進行卡方檢定,並探討中醫輔助醫療之成效分析。 研究結果:(一) 患者中醫體質中,陰虛、熱、血瘀體質有效改善,而其中以中醫輔助治療方式分類中,藥物、藥物與推拿、單一體質陰虛、熱均有顯著性;西醫治療方式中,以放療、化療的治療方式、陰虛、熱、血瘀的體質改善均有顯著性成效;癌症期別T0、T1、T2,T3與血瘀T3、T4期的患者對於中醫體質改善有顯著性成效;癌症種類則以其他癌症有顯著性改善。(二) EORTC癌症患者生命質量中,分為功能性與症狀型題型,其中功能性題型,在中醫輔助治療方式中複合性的治療與癌症種類肝癌與肺癌有顯著性成效,症狀型則以西醫治療方式放療與化療及期別T0、T1、T2初期患者有顯著性成效。(三) 以ECOG評分表則可得知生活功能狀態無顯著差異。 結論:根據本研究結果探討,中醫輔助醫療介入可增加西醫療效並減輕其所帶來的副作用,且對病患本身體質與生命質量的改善俱有顯著成效。而中醫輔助醫療介入西醫化放療患者後,對於生命質量能有效的提升。本研究結果發現,中西醫結合治療癌症患者對於副作用的改善有實證的成效,可提供醫療單位對於臨床治療的參考依據。

並列摘要


Objective: This study aimed to evaluate the efficacy of intervention of supplementary Chinese medical treatment for hospitalized patients with cancer, in terms of body constitution status, life function, and quality of life. Method: This was a retrospective study, which included 65 cancer inpatients referred to Department of Traditional Chinese Medicine of the case hospital by oncology department from January 2011 to December 2012. The questionnaires of Body Constitution Questionnaire (BCQ), Life Function State Rating Scale (ECOG) and Cancer Patients Life Quality Scale (EORTC) were administered to the subjects before the supplementary Chinese medical treatments. The subjects were asked to complete the same questionnaires after the 14-day treatment course. The pre- and post-tests of Body Constitution Questionnaire (BCQ) and Cancer Patients Life Quality Scale (EORTC) were analyzed by independent t-test, and Life Function State Rating Scale (ECOG) was evaluated by Chi-square analysis. Results: Yin deficiency, heat, and blood stasis physique of the subjects were improved significantly, for those with radiotherapy and chemotherapy in particular. Chinese herbal medicine and massage were efficacious significantly for all subjects and subjects with yin deficiency and heat physique. Subjects in all stages and cases with blood stasis in T3/T4 stages responded to the Chinese medicine therapy significantly. EORTC scale included functional and symptomatic questions. In functional questions, the Chinese medical treatment was efficacious significantly to the subjects with liver or lung cancer, as well as subjects in early T0~T2 stages For symptomatic questions, the Chinese medical treatment was efficacious significantly to subjects in early T0~T2 stages and cases with radiotherapy and chemotherapy. However, no significant differences were found in terms of ECOG. Conclusions: Based on the findings, the intervention of supplementary Chinese medical treatments to cancer patients was efficacious and relieved the side effects due to oncology treatment, in terms of body constitution and quality of life. This study illustrated the efficacy of the integration of traditional Chinese medicine and western medicine, and be able to provide an evidence-based medical reference to clinical treatment for cancer patients.

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