| 摘要: | 背景及目的：癌症患者的生活品質雖越來越受到重視，但患者仍然常被疾病本身和治療副作用所帶來的症狀困擾著，其中最常見的就是失眠，並且發生在癌症治療期間與康復過程中的每個階段，已嚴重影響患者的生活品質，研究顯示癌症病人失眠困擾發生率佔30～50%，有48%的癌症病人敘述失眠常出現於癌症診斷前6個月及癌症診斷後18個月。而癌症患者失眠的原因複雜，包括患者體質、情志、勞倦、年齡、放化療、手術等，目前除了藥物之外並無積極的治療措施。過去的研究發現失眠與中醫體質具有相關性，治療策略以體質調理為先。本研究探討癌症患者失眠的中醫體質分型，並利用穴檢儀量測癌症患者之穴位導電性，藉由時間與電流的向量變化，來探討癌症患者人體電勢能反應與體質及失眠的相關性，作為臨床改善癌症患者失眠問題的參考。 材料及方法：受測者使用匹茲堡睡眠品質量表(Pittsburgh Sleep Quality Index；PSQI)、中醫體質量表(The Constitution in Chinese Medicine Questionnaire；CCMQ)及穴檢儀(Electro-Acupuncture according to Voll；EAV) 測量；受測者須移除身上可能之干擾物，然後手握一銅把，逐一量測左右手共20個穴位點，並記錄每一穴位電流數值。將測得的穴位導電度、失眠症狀分數、中醫體質分類三個參考數值，連同患者性別、年齡、癌症種類等因素輸入建檔，並進行統計分析。 結果:研究結果顯示，癌症患者經CCMQ做體質分型後不分單複型統計，比例最高者為氣虛質佔34.2%。以PSQI評估結果顯示64.6%的癌症患者有失眠情形。癌症患者失眠與平和質、氣虛質及痰濕質呈顯著相關，進一步以逐步迴歸分析顯示氣虛質仍有顯著相關性。在癌症患者穴位導電度EAV量測結果部分，第2點的肺系統在初值(Initial Reading；IR)與能量值中皆顯示低弱。癌症患者失眠與穴位導電度，達顯著差異的是在第4點神經系統的能量值。在癌症患者的中醫體質與穴位導電度的相關性探討部分，與初值 (IR) 呈現顯著負相關的有氣虛質與氣鬱質；特稟質者則呈現顯著正相關。氣虛質、陰虛質、痰濕質、濕熱質、血瘀質及氣鬱質與偏墜值 (Indicator Drop；ID)達顯著正相關；氣虛質、痰濕質、濕熱質、血瘀質、氣鬱質及特稟質則與EAV能量值達顯著負相關。 結論: 本研究首次探討癌症患者的穴位導電度與中醫體質之相關性，發現因疾病導致體內「生命勢」的改變確實與中醫體質關聯密切，研究結果可作為未來相關研究及臨床上癌症治療之參考。
Background and Purpose: The quality of life among cancer patients have caught much attention, but the patients still keep drawn disturbed by cancer and treatment side effect, among them. The most common disturbance is insomnia, which occurs during cancer treatment and rehabilitation among for each stage, some seriously influenced the quality of life among cancer patients. The study indicates that the incidence of insomnia in cancer patients is 30% to 50%,48% of cancer patients often describe insomnia appeared six months before cancer diagnosis, and 18 months after the diagnosis of cancer. The complex causes of insomnia in cancer patients include constitution, emotion, weariness, age, chemotherapy and surgery. There is no active treatment except for drugs. Some researches have been found that insomnia and body constitution in TCM is relevant, and therapeutic strategies in TCM is to adjust body conditioning study, was to study TCM body constitution type of insomnia for cancer patients, and measure Electrical Conductance on the acupoint of cancer patients with EAV (Electro-Acupuncture according to Voll). By means of time and the vector change of the electric current, the correlation among the electric potential reaction of human, constitution and insomnia for cancer patients were investigated for the future reference to improve insomnia in cancer patients. Materials and Methods: The subjects were measured with of Pittsburgh Sleep Quality Index (PSQI), and Constitution in Chinese Medicine Questionnaire (CCMQ) and EAV; the subjects were requested to remove any interference, and then hold a copper. The researcher held the probe and put on the gloves for insulation, pressed in 20 acupuncture points, left and right hands of the subject, and recorded the current value of each point. All data including with gender, age, cancer type were input for statistic software. Results: The results showed that the 34.2% Qi-deficiency which is the majority. After evaluating by PSQI, it was found that 64.6% of the cancer patients suffered insomnia. In cancer patients of significant value are on the association between body constitution and insomnia only Gentleness type, Qi-deficiency and Phlegm-wetness type, significance more. While using Regression Analysis Qi-deficiency significant cause relationships still show relevant. In the relationship between cancer patients and acupoint electrical conductance, the second pulmonary system in the initial value IR and energy values showed significantly slow. Insomnia and acupoint electrical conductance in the cancer patients, reached significant difference in the energy value of point 4 of the nervous system. In the cancer patients, the CCMQ and acupoint electrical conductance reach a significantly negative correlation with Qi-deficiency type and Qi-depression type. A significant positive correlation was reached at Special-diathesis type, in the ID; Significantly positive correlation were reached at Qi-deficiency type, Yin-deficiency type, Phlegm-wetness type, Wet-heat type, Blood-stasis type, Qi-depression type. In the energy value; a significantly negative correlation were reached at Qi-deficiency type, Phlegm-wetness type, Wet-heat type, Blood-stasis type, Qi-depression constitution, Special-diathesis type. Conclusion: This study is the first investigation for relationships among electrical conductance on the acupoint, and Traditional Chinese medicine constitution in cancer patients. The finding that the illnesses cause the changes of the life potential is closely related to TCM constitution. The results can be applied to further research and clinical treatment of cancer. |
