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| 題 名 | SMD-2合併放射線及化學治療頭頸部癌病患對尿中微量元素Cu/Zn及Cu/Se之比值與生活品質及中醫證型變化之評估=Evaluation of the Effect of SMD-2 on the Human Urine Trace Elements (Cu/Zn and Cu/Se), Quality of Life and TCM Differentiation of Syndrome in Head and Neck Cancer patients Receiving the Radiotherapy and chemotherapy |
|---|---|
| 作 者 | 賴東淵; | 書刊名 | 中醫藥年報 |
| 卷 期 | 28:3 2010.09[民99.09] |
| 頁 次 | 頁111-140 |
| 專 輯 | 中醫醫療品質之研究(二) |
| 分類號 | 413.39 |
| 關鍵詞 | 癌症患者; 生活品質; 尿液; 微量元素; Cu/Zn及Cu/Se比值; Cancer patients; Quality of life; Urine; Trace element; Cu/Zn and Cu/Se ratios; |
| 語 文 | 中文(Chinese);中文(Chinese) |
| 中文摘要 | 研究目的:評估SMD-2對放射線及化學治療中頭頸部癌與肺癌病患的尿中微量元素 Cu/Zn & Cu/Se比值、生活品質及中醫證型變化之臨床試驗。 研究方法:自民國98年1月21日至12月31日止,共收錄80例,已完成全部療程並可 分析者52例,分別為頭頸部癌42例、肺癌10例,男與女35:17,年齡27-81 歲,平均年齡55.2歲,中位年齡54歲;服用SMD-2平均週數為8週,放射線照 射平均劑量為5440 cGy,化學治療平均週數為4週。 結果:1. 在生活品質方面,頭頸部癌患者由1.73±0.39減少至1.48±0.32 (p < 0.001);肺癌患者由1.76±0.29減少至1.39±0.23 (p < 0.001)。進一步分析生活品質核心指標,發現頭頸部癌之身體功能、角色功能、情緒功能、認知功能、社會功能以及疲勞、疼痛、呼吸困難、食慾不振等症狀均有明顯的進步。另 發現肺癌之角色功能、認知功能、疲倦、呼吸困難、食慾不振等症狀均有明 顯的進步。2. 在尿中微量元素方面,頭頸部癌患者之Cu由33.95±52.00減少至8.33 ±6.81 (p < 0.001),Zn由212.21±274.1提高至790.78±862.99 (p < 0.001),Se 由37.44±35.74提高至115.83±862.99 (p < 0.001),Zn/Cu由11.01±15.30提高至 122.14±114.37 (p < 0.001),Se/Cu由2.08±2.20提高至20.80±16.46 (p < 0.001)。而肺癌患者之Cu由25.93±30.64減少至8.55±7.44 (p=0.003),Zn由50.90±38.23 提高至164.73±96.65 (p=0.003),Se由29.45±24.58提高至69.75±31.88 (p= 0.003),Zn/Cu由4.89±7.90提高至30.82±21.78 (p=0.003),Se/Cu由1.80±1.20提高至13.97±8.99 (p=0.003)。頭頸部癌與肺癌患者尿液中微量元素濃度前、中、後測之相關性:前-中比值Zn/Cu p=0.001,Se/Cu無統計意義;前-後比 值Zn/Cu p < 0.001,Se/Cu無統計意義。3. 頭頸部癌與肺癌患者治療前、中、後中醫證型之百分比變化:「氣陰 兩虛」由57.7%減少至15.4%,「氣血兩虛」由5.8%減少至0%,「氣虛」 由13.4%提高至40.4%,「陰虛」由17.3%提高至42.3%。頭頸部癌患者治療 前、中、後中醫證型之百分比變化:「氣陰兩虛」由64.2%減少至16.7%,「氣血兩虛」由4.8%減少至0%,「氣虛」由14.2%提高至42.8%,「陰虛」 由12%提高至40.5%。肺癌患者治療前、中、後中醫證型之百分比變化:「氣陰兩虛」由30%減少至10%,「氣虛」由10%提高至30%,「陰虛」由40%提高至50%。 討論:SMD-2對接受放射線及化學治療的頭頸部癌與肺癌病人,可提高尿中 Zn/Cu及Se/Cu之比值,明顯改善生活品質如身體功能、角色功能、情緒功 能、認知功能、社會功能以及疲勞、疼痛、呼吸困難、食慾不振、整體生活品質,並與中醫證型變化的轉歸呈正相關性 (p < 0.05)。 |
| 英文摘要 | Aim: This study assessed the effectiveness of SMD-2 on the human urine trace elements (Cu/Zn and Cu/Se), quality of life and TCM differentiation of syndrome in cancer patients (head & neck cancer and lung cancer) receiving the radiotherapy and / or chemotherapy. Method: From 21st January 2009 through 31st December 2009, there were eighty patients entered to our clinical trial. Fivty-two cases have completed course and were analyzed included forty-two cases of head & neck cancer and ten cases of lung cancer. The male to female ratio was 35:17. The mean age was 55.2. The median age was 54. The average treatment-duration of SMD-2 was 8 weeks. The average radiation-dose was 5440 cGy. The average treatment-cycle of chemotherapy was 4 weeks. Results: The EORTC QLQ showed 1.73±0.39 fell to 1.48±0.32 (p < 0.001) in head & neck cancer patients, and 1.76±0.29 down to 1.39±0.23 (p < 0.001) in lung cancer patients, respectively. Further analysis, health function, emotion, recognition, social capability, fatigue, soreness, dyspnea, poor appetite and global outcome in head & neck cancer patients were much improved in quality of life. While in lung cancer patients, recognition, fatigue, dyspnea, poor appetite and global outcome were also much improved. On the other hand, the analysis of trace elements in head & neck cancer patients, Cu showed 33.95±52.00 fell to 8.33±6.81 (p < 0.001), Zn showed 212.21±274.1 increased to 790.78±862.99 (p < 0.001), Se showed 37.44±35.74 increased to 115.83±862.99 (p < 0.001), Zn/Cu showed 11.01±15.30 increased to 122.14±114.37 (p < 0.001), Se/Cu showed 2.08±2.20 increased to 20.80±16.46 (p < 0.001). Whereas in lung cancer patients, Cu showed 25.93±30.64 down to 8.55 ±7.44 (p = 0.003) Zn showed 50.90±38.23 elevated to 164.73±96.65 (p = 0.003), Se showed 29.45±24.58 elevated to 69.75±31.88 (p = 0.003), Zn/Cu showed 4.89 ±7.90 elevated to 30.82±21.78 (p = 0.003), Se/Cu showed 1.80±1.20 elevated to 13.97±8.99 (p = 0.003). In changes of traditional Chinese medical systems in both head & neck cancer and lung cancer patients, “deficiency of Qi and Yin” showed 57.7% fell to 15.4%, "deficiency of Qi and Blood" showed 5.8% fell to 0%, “Qi deficiency" showed 13.4% increased to 40.4%, "Yin deficiency" showed 17.3% increased to 42.3%. Discussion: The SMD-2 significantly elevated the Cu/Zn & Cu/Se ratios of human urine trace elements and improved the quality of life in cancer patients during the treatment of radiotherapy and / or chemotherapy (p < 0.05). The corelationship among trace elements, quality of life and changes of traditional Chinese medical systems in cancer patients showed positive relationship. |
本系統中英文摘要資訊取自各篇刊載內容。