中医肿瘤综合康复治疗的尝试与初探

Clinical research of combined rehabilitation therapy with traditional Chinese medicine

目的尝试中医药、心理干预、营养指导及运动为一体的综合治疗方法在肿瘤康复中的应用并评价其疗效,探讨有效且适合肿瘤患者的康复方法。方法纳入卡氏评分≥60分的术后或放、化疗后各期各病种肿瘤患者56例,采用中医药治疗、心理调护、营养指导和运动疗法,并于治疗后2个月随访,通过中医症状变化、卡氏评分、SCL90项症状量表、HAD医院焦虑抑郁量表、营养状况评价、体重变化和生活质量评价(FACT 4.0)对肿瘤患者综合康复治疗前后的情况进行比较和疗效评价。结果对54例临床资料完整的患者分析结果显示,中医综合康复治疗可明显改善肿瘤患者的临床症状(P<0.001)和体能(P<0.001),改善患者的焦虑抑郁心理状态(P<0.05)及营养状况(P<0.05),提高肿瘤患者的生存质量(P<0.05)。结论中医肿瘤综合康复治疗可显著改善患者生存质量,值得进一步研究探索切实可行的康复方法和随访机制,引导肿瘤患者进行科学康复。

Objective To attempt to apply integrated cancer rehabilitation methods in clinical use,combining traditional Chinese medicine（TCM）,psychological intervention,nutritional guidance and physical exercise,and to estimate their curative effects in order to search for the effective and suitable rehabilitation methods for cancer patients.Methods We brought 56 different kinds and stages of cancer patients with KPS≥60 who have completed operations,chemotherapy or radiation therapy into our research.All the patients were in hospital and accepted 10 to 14 days combined rehabilitation therapy with traditional Chinese medicine,which included Chinese herbs,tonic herbal paste,medicated bath,acupuncture and moxibustion.We coordinated with psychological intervention,which involved counseling,aromatherapy,art therapy and film and video,etc.,along with nutritional guidance and Chinese traditional physical exercise,and paid follow-up visits two months later.Results 54 patients were analyzed.The results indicate that the combined cancer rehabilitation therapy with TCM can obviously improve the clinical symptoms（P﹤0.001）,the condition of physical strength（P﹤0.001）,the mental state of anxiety-depression（P﹤0.05）and also improve the patients＇ nutritional state（P﹤0.05）.The combined cancer rehabilitation therapy with TCM can obviously improve the patients＇ quality of life（P﹤0.05）.Conclusions The combined cancer rehabilitation therapies with TCM have the effect of improving QOL of cancer patients.It is worth further investigation to explore practicable rehabilitation and follow-up methods and lead cancer patients to recover through the most advanced scientific methods.