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題 名 | 針刺治療急性癌病相關疼痛之臨床試驗=Clinical Trial of Acupuncture Analgesia for Acute Cancer-related Pain |
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作 者 | 賴易成; | 書刊名 | 中醫藥年報 |
卷 期 | 16:1 1998.05[民87.05] |
頁 次 | 頁303-323 |
分類號 | 413.91 |
關鍵詞 | 急性癌病相關疼痛; 針刺止痛; 生活品質; Acute cancer-related pain; Acupuncture analgesia; Quality of life; |
語 文 | 中文(Chinese) |
中文摘要 | 疼痛是癌症患者最主要的症狀之一,臨床治療多採用世界衛生組織之 藥物三階段止痛階梯(WHO 3-step analgesic ladder)準則,然而長期 使用非嗎啡性止痛藥物,有表淺性胃炎、消化道出血、消化不良、噁 心、嘔吐甚至凝血機轉障礙等副作用發生,使用嗎啡性止痛藥物,亦 有頭暈、睏倦、噁心、嘔吐、便秘、排尿困難及呼吸抑制等副作用, 甚至有耐藥性及依藥性之產生。本研交採前瞻性隨機取樣方法,從85 年8月至86年6月共收集50位接受頭頸部放射治療之癌病患者,放 射治療每天照射180cGy,每週5天總劑量為5000cGy-7700cGy。所有 患者在臨床上出現口腔潰瘍、咽喉腫痛、吞嚥困難等症狀,才進入分組 臨床試驗組,止痛藥物組(對照組)有24位,針刺合併止痛藥物組(實 驗組)有26位,藥物止痛遵循WHO三階段止痛階梯。針刺穴位依循「遠 端循經取穴及近端局部取穴」原則,選定小海、偏歷、溫溜、合谷、 地蒼等穴位,同時電針刺激左右二側穴位,以疏密波2Hz×3秒及15Hz ×3秒交替使用,每個穴位刺激15分鐘。對照組之BPI(Wisconsin Brief Pain Inventory)疼痛指數治療前5.71±0.99;治療後3.75± 1.75(P<0.001),實驗組之BPI治療前5.31±1.09;治療後2.77± 2.61(P<0.001),但二組互相比較,無統計上差異。PMI(Pain Management Index)疼痛處理指標方面,治療前PMI<0;治療後PMI≧0者,在對照 組有11例,佔45.8%,實驗組有15例,佔57.7%。FLIC(Functional Living Index:Cancer)功能性生活指標方面,對照組在治療前1.17 ±3.28;治療後4.5±4.75(P<0.001),實驗組在治療前0.76±4.53; 治療後7.0±13.48(P<0.001),生活品質的提升,實驗組優於對照組。 |
英文摘要 | Pain is a majority of symptoms in cancer patients. In clinically, pain control by pharmacological approach has been applied in guidance with WHO 3-step analgesics ladder. Long-term application of non-narcotic drugs for cancer patients may result in some side effects, such as superficial gastritis, upper gastrointestinal bleeding, dyspepsia, nausea, vomiting and coagulopathy. In similarly, narcotic drugs may also induce dizziness, somnolence, nausea, vomiting, constipation, dysuria, respiratory suppression and drug-dependence. This clinical trial is a prospective randomized study. Fifty-five patients treated with irradiation in head and neck regions have enrolled August 1996 through June 1997. All patients were given 5000 cGy to 7700 cGy, 180 cGy per fraction, 5 times a week. Patients with occurrence of oral ulcer, dysphasia and odynophagia clinically, entered our study. An experiment group (acupuncture plus drugs) has 26 cases and a control group (durg only )has another 24 cases. The acupuncture points were selected in accordance with the meridian theory. We choose 5 points of Xiaohai (L.I.8), Pianli (L.I.6) Wenliu (L.I.7), Hegu (L.I.4), and Dicang (St. 4) for being stimulated by electoacunpucture in both sides, 5 times a week. The dosage of acupuncture is sparse-densed stimulation with frequency 2 Hz for 3 seconds and 15 Hz for 3 seconds alternatively. Each point was stimulated for 15 minutes. The score of Wisconsin Brief Pain Inventory showed pre-treatment 5.31±1.09 down to post-treatment 2.77±2.61 (P<0.001) in experiment group and pre-treatment 5.71±0.99 down to post-treatment 3.75± 1.75(P<0.001) in control group. In comparison of 2 groups, there is no statistical difference. The score of Pain Management Index from minus level risen positive level has 15 cases (57.7%)in experiment group and 11 cases (45.8%)in control group. The score of Functional Living Index: Cancer disclosed pre-treatment 0.76 ±4.53 up to post-treatment 7.0±13.48(P<0.001)in experiment group and pre-treatment 1.17±3.28up to post-treatment 4.5± 4.75 in control group. It implied the quality of life in experiment group superior to that in control group. |
本系統中英文摘要資訊取自各篇刊載內容。