| 摘要: | 沙參麥門冬湯對癌症放射線治療中病人的免疫調節與生活品質之臨床評估 研究生：鄭文裕 指導教授：賴東淵副教授 中國醫藥大學中醫研究所 研究目的：評估「沙參麥門冬湯」對放射線治療中癌症病患免疫功能、生活品質的影響以及癌症患者中醫證型的變化。 材料與方法：本研究依雙盲試驗隨機分組共收錄54例，完成全部療程且可分析者有42例；男：女比為15：27；中位年齡57.5歲，實驗組平均服用「沙參麥門冬湯」共11週，對照組服用之安慰劑為乳糖；平均放射線劑量為5440 cGy；平均化學治療為4週。 評估項目包括1.免疫功能：lymphocyte、 CD3-/CD19+ (B cell marker)、CD3+/CD45+ (T cell marker)、 CD3-/CD56+ (NK cell marker)、CD4 ∕ CD8。2.癌症放療病人生活品質及健康評估。 主要成果：1.在免疫功能評估的變項中，計有實驗組Lymphocyte count (p=0.001)、B cell count (p=0.004)的改變有統計上的顯著差異。實驗組之NK cell count(p=0.051)的p值介於0.05-0.10之間，為統計顯著性邊緣。2.在生活品質方面：本研究根據 EORTC QLQ - C30作生活品質評估，實驗組優於對照組（p = 0.043）。在核心問卷中發現社會功能（p = 0.00）、疲倦（p = 0.006）、噁心嘔吐（p = 0.008）、失眠（p = 0.029）、食慾不振（p = 0.004）、財務功能（p = 0.017）、整體生活評估（p = 0.000）等指標，有明顯統計意義，而以上這些症狀是放化療常見的副作用。3. 放射線治療中癌症患者免疫功能指標、生活品質與「氣陰兩虛」中醫證型的轉歸呈正相關。 沙參麥門冬湯對癌症放射線治療之病人能明顯提高淋巴細胞數目、B 細胞數目；改善生活品質如社會功能、疲倦、噁心嘔吐、失眠、食慾不振、財務困難、整體生活。 關鍵字：中藥、免疫調節、沙參麥門冬湯、放射線治療; Clinical Evaluation of the Effect of Sha-Sheng-Mai- Dong-Tang on the Immune Modulation and Quality of life in Cancer Patients Receiving the Radiotherapy Wen-Yu Cheng Major Professor: Tung-Yuan Lai Institute of Chinese Medical Science, China Medical University The main purpose of this study is to evaluate the effect of Sha-Shen-Mai-Dong-Tang on immune modulation and the quality of patients’ life as well as to see how the treatment of traditional Chinese medical systems effects on the cancer patients who receive the radiotherapy. There were 54 patients participated in our trial, while only 42 subjects completed all the processes, 15 of them were male and 27, female. They were grouped randomly and underwent double-blind experiment, 22 of them in experimental group, 20 in control group. Their mean age was 60, Median age, 57.5. Average duration of treatment with “Sha-Shen-Mai-Dong-Tang” lasted 11 weeks. Mean while, the average radiation-dose was 5440 cGy, average treatment- cycle of chemotherapy, 4 weeks. Comparing between before and after treatments, we found the count of lymphocyte (p=0.001) and the count of B cell (p=0.004) in experimental group showed significant difference. The account ofNK cell (p=0.099) in experimental group showed borderline significant difference in the evaluation of immune modulation. On the other hand, the EORTC QLQ-30 questionnaire showed that the experimental group was better than control group significantly (p=0.043) in the evaluation of quality of life. The items in EORTC QLQ-30 included emotion, fatigue, nausea, vomiting, insomnia, andanorexia, social functions and recognition. All the results of these items were improved significantly after the treatment with “She-Shen-Mai-Dong-Tang”. The corelationship among immune modulation, quality of life and changes of tranditional Chinese medical systems in cancer patients showed positive relationship. The “She-Shen-Mai-Dong-Tang” is an immunopotentiator in cancer patients treated with radiotherapy and it can improve the quality of life of cancer patients significantly. Keywords：herbs, immune modulation, She-Shen-Mai-Dong-Tong, radiotherapy |
