Please use this identifier to cite or link to this item: http://hdl.handle.net/11455/23179
標題: 以三黃瀉心湯治療癌症患者經放射線治療前後,體內微量元素濃度之變化
The fluctuation of trace elements among caner patients in pre- and post-treatment of San-Huang-Hsien Tang and radiation
作者: 邱明珠
Chiu, Ming-Chu
關鍵字: Cancer patient;癌症患者;Quality of life (QOL);trace elements;urine;serum;Cu/Zn;Cu/Se;生活品質;尿液與血液;微量元素;Cu/Zn;Cu/Se比值
出版社: 生命科學院碩士在職專班
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摘要: 
由於人體中微量元素對癌症作用機轉之影響,至今仍未十分明確、尤其癌症患者治療過程體內微量元素之變化是否會影響其療效,值得進一步來探討。因此,本研究是探討三黃瀉心湯治療癌症病人前、中、後其尿液與血液微量元素之變化,對各種療效指標與其生活品質(EORTC: QLQ-C30)之影響。研究對象主要來自中部某醫院癌症治療中心癌症患者,總共有64位。平均每位患者共服用11週之500mg三黃瀉心湯錠劑。同時患者依不同照射部位及癌症種類,給予不同放射線照射劑量,每週照射5天,平均每位患者療程共6-8週。
結果顯示患者尿液中除汞金屬在治療中與治療前與血液中鎳金屬在治療後與治療前有統計上差異。在臨床療效指標之比較,治療後在白血球與血色素濃度皆較治療前為低,而腎功能指標 (BUN、肌肝酸)卻較治療前為高。在平均生活品質分數,三個階段未有明顯變化。癌症患者在尿液與血液中Cu/Zn比值,在三個治療之差異期間皆有顯著性之差異。癌症病人當Cu/Zn比值愈高時其「症狀項目」生活品質則愈差,至於血液Cu/Zn比在治療、中與後與「症狀項目」生活品質皆有統計之相關性。在「功能項目」之生活品質與尿中Cu/Se比值,在治療前 (r=0.541)及治療後(r=0.433),在治療中 (r=0.544及r=0.599) 均有統計上相關性,在血液中Cu/Se比值在治療中與「功能項目」之生活品質呈統計之相關性(r=0.518)。利用多變相回歸分析尿液及血液中Cu/Zn及Cu/Se比值對治療癌症患者生活品質得分之影響,在調整年齡、性別、治療方式及治療分期後,在尿中Cu/Zn及Cu/Se比值皆有顯著性影響癌症患者生活品質得分,當尿中Cu/Zn及Cu/Se越高時整體生活品質得分亦越差。因此,建立Cu、Se與Zn之比值與其變化,可作為未來癌症臨床療效參考之指標。

The mechanism of carcinogenesis caused by trace elements is still unclear. It is necessary to explode the fluctuation of trace elements in cancer patients during the treatment process in order to understand the efficacy using the Chinese medicine. This objective of this study is to measure the concentration of elements in urine and serum during treatment process using the San-Huang-Hsien-Hsin Tang, and to assess the effects of efficacy indictors and quality of life (QOL, EORTC: QLQ-C30). 65 cancer patients, enrolled from a cancer center of hospital, were treated using a standardized protocol including 500 mg San-Huang-Hsien-Hsin Tang for 11 weeks and irradiated for 6-8 weeks which dose based on the locations and types of cancer.
Results indicated there are significant differences in mercury levels in urine and nickel levels in serum during treatment process. White blood cell and hemoglobin levels were lower in the post-treatment, but levels of renal indicators (BUN and creatinine) in post-treatment were higher than pre-treatment. There is no significant difference in measuring the QOL in patients during treatment processes of cancer. However, the ratios between copper (Cu) and zinc (Zn) (Cu/Zn) in serum and urine were significant difference in three stages of treatment process. While the Cu/Zn ratio was increase, the symptom items of QOL were worse. Cu/Zn ratio in serum was significantly correlated with the symptom items of QOL in three stages of treatment processes. The ratios of Cu and selenium (Se) ratio (Cu/Se) in urine were significantly correlated with the functional items of QOL in pre-treatment (r=0.541), med-processes (r=0.544) and post-treatment (r=0.433). There is a significant correlation between the Cu/Se ratio in serum and the functional items of QOL (r=0.518). The QOL scores in cancer patients during treatment process were affected by the Cu/Zn and Cu/Se ratios in urine using multiple linear regression models after adjusted for age gender, treatment types and cancer stages. The higher of Cu/Zn and Cu/Se ratios are, the worse scores of QOL in treatment process are. In conclusion, establishment of ratios of Cu/Zn and Cu/Se are use as indictors to assess the efficacy of cancer treatment.
URI: http://hdl.handle.net/11455/23179
其他識別: U0005-0202200710283500
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