增液湯含漱液配合針灸治療減緩頭頸癌患者於放化療期間之併發症與體重下降

Zeng Ye Decoction Mouthwashes With Acupuncture Can Decrease Complications and Body Weight Loss of Head And Neck Cancer Patient Under Radiotherapy With/without Chemotherapy

頭頸癌患者在接受放射線治療過程中，超過80% 的患者會出現放射線口腔黏膜炎、唾液減少、吞嚥困難、味覺異常等症狀，進而影響食慾與體重，目前尚無明確而有效的治療方法。本研究採用「清熱養陰」的增液湯含漱液搭配針灸的治療模式，藉此改善放射線口腔黏膜炎所造成的各項副作用。收案的患者以2015 年12 月初至2017 年3 月底被診斷出頭頸部腫瘤（20 到75 歲的患者），且初次接受放射線或合併同步化學治療，做為研究族群。實驗組於治療期間另外給予增液湯含漱液搭配針灸治療。治療前後測量體重、口腔黏膜 炎症狀與嚴重度。共58 位頭頸部腫瘤患者符合收案標準。治療前實驗組（n=26）與對照組（n=32）之基本資料無顯著差異，治療後實驗組體重下降程度明顯較對照組減少 （p=0.044），此外，在口腔黏膜炎症狀與嚴重度方面，實驗組相較於對照組有較緩解的趨勢，但無明顯統計差異。因此，頭頸癌患者在接受放射線治療或合併同步化學治療的同時，若合併增液湯含漱液搭配針灸治療，可有效減緩體重下降。

 

Over 80% of head and neck cancer patients had side effect of radiation-induced oral mucositis, leading to xerostomia, abnormal taste, dysphagia, poor intake and body weight loss under radiotherapy. No defined and effective golden treatment has been confirmed so far. Since these symptoms are classified into “fire/heat evil that damages yin” in Traditional Chinese Medicine (TCM), this research adopts the approach of “nourishing yin and clearing heat evil” by Zeng Ye Decoction mouthwashes with acupuncture to relieve the symptoms. The patients (aged 20-75) included in this research were diagnosed with head and neck cancer, taking the first-time radiotherapy with/without chemotherapy from Dec 2015 to Mar 2017. The Chinese medical group was additionally offered Zeng Ye Decoction mouthwashes four times per day and acupuncture three times a week. Body weight, PROMS (Patient-Reported Oral Mucositis Symptom Scale) and NCI-CTCAE (Common Terminology Criteria for Adverse Events, version 4.0) were collected before and after treatment for assessment. 58 patients with head and neck cancer are included in the research. No statistical difference of the baseline characteristics between TCM group (n=26) and the control group (n=32) was uncovered. Body weight loss improvement in TCM group has statistical significance (p=0.044) compared to the control group. Meanwhile, the severity of PROMS and NCI-CTCAE scores of the TCM group is milder than the control group. In conclusion, the combined therapies of Zeng Ye Decoction mouthwashes and acupuncture can effectively improve body weight loss for the patients with head and neck cancer, while they are taking radiotherapy with/without chemotherapy.