| 摘要: | 背景及目的：癌症患者因疾病本身或接受相關治療過程中的不適，造成精神上的緊繃，引起許多不適而產生疲憊感，讓人主觀上有疲倦、苦惱、精疲力竭等持續性的感覺及許多負向的想法，並困擾日常生活作息及就醫意願等。本研究之目的在探討氣功與正念身體掃描介入對癌症患者疲憊、肺功能及體表穴位能量變化與的效益，作為輔助改善癌症患者癌因性疲憊問題的參考。 材料及方法：本研究以嘉義地區某教學醫院中醫部癌症患者為收案對象，實驗組30位進行為期10週的氣功與正念身體掃描介入，患者每週回診等侯看醫生前進行30分鐘的氣功暖身操及10分鐘的正念身體掃描靜坐，並自行於家中每天進行1-2次的氣功與正念身體掃描；對照組30位，只接受正規治療，無其他練習介入。研究工具包括台灣版簡明疲憊量表 (Brief Fatigue Inventory-Taiwan Form, BFI-T)、肺量計 (spirometer) 及皮膚穴道電能篩檢儀 (electrodermal screening device)。 結果：全部受試者BFI-T結果輕度疲憊者占58.2%，中度疲憊者占36.4%，重度疲憊者占5.4%。兩組BFI-T於前測無顯著差異，經10週介入練習後，實驗組疲憊程度下降並與對照組呈顯著差異(p=0.02)。肺功能部分，實驗組第一秒用力呼氣量(forced expiratory volume in one second, FEV1)、最大呼氣流率(peak expiratory flow rate, PEF)呈上升趨勢，肺齡估計值 (Lung age estimation) 值呈下降趨勢，但未達顯著差。24井穴測得初值 (Initial Reading, IR) 的統計結果，10週後對照組所有穴位IR平均值較前測時下降9.75% (從95.15 ± 6.08降為85.88 ± 6.76)，而實驗組所有穴位IR平均值較前測時下降3.68% (從93.85 ± 6.66降為90.39 ± 9.04)。實驗組IR值的標準化百分比改變量在LF1, LH2, LH3, RF1, RF2穴點呈增加趨勢並與對照組呈達顯著差異。百分落差值 (percentage differences, PD) 部分，對照組在LH3和RF2二個穴位點後測較前測增加，達顯著差異，實驗組所有穴位點之前後測PD值皆未呈現顯著差異，顯示實驗組在參與介入練習後身體的防衛力較對照與有明顯的改善。 結論: 綜合上述結果，氣功與正念身體掃描介入能使癌症患者之皮膚穴位能量下降程度趨緩，相應於疲憊狀況減緩的結果，可證明癌症患者的機體能量是可以透過氣功與正念身體掃描練習被改善的。
Background and Purpose: Patients with cancer often experience fatigue due to the cancer itself or the discomforts caused by the treatment process. The purpose of this study was to explore the effectiveness of qi-gong stretching and mindfulness body scan meditation techniques on cancer-related fatigue, respiratory functions and electrodermal activity in cancer survivors. The results of the study aim to serve as a reference on improving cancer-related fatigue. Materials and Methods: In this study, the subjects were recruited among cancer patients at an academic hospital of traditional Chinese medicine in Chiayi in Taiwan. The experiment group had 30 subjects with a 10-week intervention of qigong stretching and mindfulness body scan mediation. The patients in the experiment group carried out 30 minutes qigong stretching rehabilitation exercise and a 10-minute body scan mindfulness meditation during the waiting time to see the doctor during their weekly appointments. In addition, depending on patients’ circumstances they also practiced the qigong stretching rehabilitation exercise and mindfulness body scan meditation 1 to 2 times a day at home. The control group of 30 patients only received regular treatment without exercise intervention. The outcome measures included using the Brief Fatigue Inventory-Taiwan Form (BFI-T), a spirometer and an electrodermal screening device. Electrodermal impedance measures were obtained at all 24 Jing-Well points for each treatment visit. Results: Fifty-five participants completed the study, which consisted of 28 in the experimental group and 27 in the control group. 58.2% of all subjects’ BFI-T results were mild fatigue, moderate fatigue comprised 36.4%, and severe fatigue accounted for 5.4%. After 10 weeks intervention, the degree of fatigue in the experiment group decreased and a significant difference existed between the two groups (p = 0.02). The first second of the forced expiratory volume (FEV1) and the peak expiratory flow rate (PEF) increased and the lung age estimation decreased in the experiment group, but were not significantly different to the control group. The mean initial reading (IR) of all 24 Jing-Well points decreased 9.75% (from 95.15 ± 6.08 to 85.88 ± 6.76) in the control group and decreased 3.68% (from 93.85 ± 6.66 to 90.39 ± 9.04) in the experiment group. The increases in standardized percentage change of IR in LF1, LH2, LH3, RF1, RF2 were statistically significant in the experiment group compared to the control group. The percentage difference (PD) of the indicator drop (ID) value divided by the IR value is an indicator of the body's defense force. A larger percentage difference implies weaker self-defense function. The increases in the PD in LH3 and RF2 were statistically significant in the control group compared to the experiment group. Between-groups comparisons showed no significant differences in PD at all measured points. Conclusion: This study showed that cancer-related fatigue, respiratory function and EDA of cancer survivors had a deteriorating trend, while qi-gong stretching and mindfulness body scan exercise could be used to slow the degree of deterioration. The results of this study could be used as a reference for CAM therapy. |
