澳門地区某醫院中醫介入晚期癌症治療初步分析

Analysis of traditional Chinese medicine intervention on patients with advanced cancer in a hospital in Macao region

目的分析中醫介入晚期癌症治療的患者病情特點和中醫療法的作用。方法收集、分析鏡湖醫院中醫腫瘤專科門診晚期癌症患者和中醫會診的病房晚期癌症患者的臨床表現及中醫療法的應用。結果81例晚期癌症門診患者的病情表現主要為晚期癌症相關的症狀,常規治療的毒副作用,非直接由惡性腫瘤導致的其他疾病或症狀,分別是37例(45.68%),32例(39.51%)和24例(29.63%);主要使用內服中藥治療,佔80例(98.77%)。37例晚期癌症病房患者的病情表現主要為晚期癌症相關的症狀,晚期癌症導致的併發症,非直接由惡性腫瘤導致的其他疾病或症狀,分別是35例(94.59%),23例(62.16%)和6例(16.22%);主要使用內服中藥及針灸治療,分別佔33例(89.19%)和10例(27.03%)。顯示內服中藥為中藥介入晚期癌症治療的主要手段。28例病房死亡患者的治療後生存時間在2週之內及2週以上至1個月者,分別為7例(25%),和8例(28.57%),顯示病房晚期癌症病人多為終末期患者,中醫介入治療主要是針對晚期癌症相關的症狀及併發症的對症治療。中醫介入治療可改善晚期癌症門診病人疲乏、疼痛、食慾下降、便秘及放射性口腔炎或鼻腔炎的症狀。結論本研究顯示中醫介入晚期癌症患者的治療,主要是對晚期癌症相關症狀及併發症的對症治療,減輕常規治療的毒副作用,以及治療某些非直接由癌症導致的疾病或症狀,從而達到改善晚期癌症患者的症狀,減輕痛苦,提高生存品質。對於中醫療法的療效和機理,需要作進一步的循證醫學的研究。

Objective To analyze the clinical manifestations of patients with advanced cancer and evaluate the effect of the traditional Chinese medicine intervention.Methods To collect the manifestations of the patients with advanced cancer at out-patient and in-patient department respectively,analyze the differences of medical conditions between the in-patients and out-patients,and the application of traditional Chinese medicinal therapies.Results Among 81 patients with later stage cancer,incidence of symptoms caused by cancer,side effects of treatment and non-cancer related symptoms were 45.68%(N=37),39.51%(N=32)and 29.63%(N=24),respectively.The medical conditions of 37 in-patients were mainly cancer-related symptoms,complications of advanced cancers,and non-cancer-related conditions,they were 35 cases(94.59%),23 cases(62.16%),and 6 cases(16.22%)respectively.Chinese herbal medicine was major intervention solution for both out-patients and in-patients.Most of the in-patients involved in Chinese medicine intervention were at the end-of-life stage.Traditional Chinese medicine intervention could alleviate the clinical symptoms such as fatigue,pain,anorexia,constipation and radiotherapy induced mucositis in out-patients with advanced cancer.Conclusion This study showed that traditional Chinese medicine intervention on patients with advanced cancer mainly targeted cancer-related symptoms relieving,complications of advanced cancers,conventional therapies-related side-effects,and non-cancer-related conditions.Further study is needed to provide evidence to support Traditional Chinese medicine as the intervention for relieving advanced cancer patients’symptoms,improving quality of life and prolonging survival while minimizing the side effects of major conventional treatments.