癌症患者抑鬱症中醫藥治療文獻回顧

Literature Review of Chinese Medicine Treatment for Depression in Patients With Cancer

抑鬱在患有惡性腫瘤的患者中具有高發病率和復發率。這是非常有害的，因為抑鬱的情緒很大程度上影響了患者的生活品質，降低患者對治療的順從性。此外，它影響預後和增加死亡率。隨著癌症治療和手術方法的發展，癌症死亡率逐年下降。然而，抑鬱症的發病率仍然很高。Massie 的研究表明，癌症患者抑鬱的發生率為1%-50%；嚴重抑鬱0-38%；抑鬱症併發症發生率為0-58%(1)。本文提出針對現代人抑鬱症以中醫辨證論治分型，最常見的證型可分為：肝氣鬱結、肝鬱脾虛、心脾兩虛。根據中醫典籍提出情緒與癌症的相關性，治則可採用疏肝健脾、補益心脾的方劑(2) 此外，許多研究都提出針灸治療抑鬱症效果如同抗憂鬱劑(3)(4)(5)(6)，針灸配合抗憂鬱劑比單純服用藥物更有效。且癌症患者因已接受過化療、放療等對於腫瘤抑制的治療，選擇能治療抑鬱症，又低化學毒性及副作用的療法，中藥和針灸能減輕病患身體的負荷，也能提高治療癌症的成效。

Depression has high morbidity and recurrence rates in patients with cancer. Furthermore, depression may contribute to shortened survival in those diagnosed with cancer, as well as increasing the risk of developing cancer in some people. With the development of cancer treatment and surgical methods, cancer mortality decreased year by year. However, the incidence of depression remains high. Massie's study showed that prevalence of major depression in individuals with cancer was 1%-50%; severe depression 0-38%; depression with complications was 0-58%. The objectives of this paper were to summarize the commonly diagnosed Traditional Chinese Medicine (TCM) patterns in patients with depression .We only analyzed the top four commonly studied TCM patterns: liver qi depression, liver depression and spleen deficiency, dual deficiency of the heart, and spleen and liver depression and qi stagnation. To find out the current practice of pattern-based CHM treatment for depression. Furthermore, using the treatment of depression as an example, accumulating evidence has indicated that acupuncture combined with antidepressant medications is more effective than antidepressants alone. Pharmacological treatment of depression, can contribute to the high chemical burden already carried by cancer patients, creating additional side effects. As a result, patients are interested in evidence-based low pharmacologic alternatives like acupuncture or TCM for these symptoms.