探討中醫會診在癌症化療後的利用率與處方用藥──回溯性觀察研究

Exploring the Utilization and Prescription of TCM Consultation for Post-Chemotherapy Care-A Hospital-Based Retrospective Observational Study

癌症造成人類生命威脅和高死亡率，世界衛生組織統計，癌症造成全球死亡第二大原因，2015年全球因癌症死亡880萬人。在台灣癌症已蟬聯台灣十大死因之首，許多人在癌症治療之外（化療、放療、標靶），尋求中醫輔助治療，中醫會診可以提供病患第一時間協同中醫治療的照護方式，緩解化療、放療、標靶副作用或加強效果。本研究搜尋2013-2017五年內在某中部醫學中心中醫會診的資料，共有3115人次，因癌症化療後尋求中醫會診555（17.81％）人次，出院一個月內再回診率高達7成7，癌症種類依序卵巢癌（28.47％）、肺癌（17.48％）、大腸癌（10.09％），最常使用中藥依序白朮、黃芩、牡丹皮、厚朴、炮附子。本研究了解到化療族群會診中醫利用率明顯較其他族群要高，未來希望藉由這次計畫結果進行臨床試驗，來評估中醫在癌症化療後的輔助效果。

Cancer poses a serious threat to human well-beings and lead to significant mortality. According to the World Health Organization statistics, cancer is the second leading cause of death globally, and was responsible for 8.8 million deaths in 2015. In Taiwan, cancer is always the most common cause of death. People suffering from cancer turn to traditional Chinese medicine as combined treatment along with chemotherapy, radiotherapy and target therapy. TCM consultation provides hospitalized patients with an efficient access to collaborative care of traditional Chinese medical treatment as combined treatment to relieve side effects after chemotherapy, radiotherapy, target therapy or enhance the efficacy of current treatment. We built the study population with the data of TCM consultation in a medical center in central Taiwan during 2013 to 2017. The total utilization of TCM consultation during the five years was 3115 person-times. Among the 3115 person-times, the utilization of TCM consultation for post-chemotherapy was 555 (17.81%), which accounted for the largest proportion. The return rate of chemotherapy population within one month was up to 77.70%. The most common cancer types of TCM consultation for post-chemotherapy care was listed as sequence as ovarian cancer (28.47%), lung cancer (17.48%) and colorectal cancer (10.09%). The most frequently used single herbs was Baizhu (Atractylodes Macrocephala), followed by Huangqin (Scutellaria baicalensis) and Moutan cortex (Paeoniasuffruticosa Andrews). Through this study, the utilization of TCM consultation for chemotherapy population was higher than non- chemotherapy population. In the near future, we hope to design a randomized, double-blinded, and placebo-controlled clinical trial based on the results of this study to evaluate the efficacy of TCM treatment as a role of collaborative post-chemotherapy care.