針刺治療急性癌病相關疼痛之臨床試驗

賴易成 
光田綜合醫
疼痛是癌症患者最主要的症狀之一，臨床治療多採用世界衛生組織三階段疼痛控制(WHO 3-step analgesic ladder)，然而長期使用止痛藥物，有表淺性胃炎、消化道出血（非嗎啡性藥物），以及頭暈、睏倦、嘔心、便秘、呼吸抑制（嗎啡性藥物）等副作用發生。針刺止痛在學理上有很好的神經生理學理論基礎，在臨床上亦是世界衛生組織認可的適應症之一。中國大陸文獻報告，以生理食鹽水做耳根環形注射或耳神門穴注射，對40例晚期癌症患者，能即時止痛。

選擇60位急性癌病相關疼痛患者，例如化學治療或頭頸部放射治療引起口腔炎、食道炎、以及皮膚潰瘍等疼痛，在WHO三階段止痛療法控制下，隨機取樣分為針刺實驗組和儰針 (placebo)對照組，每組每週各治療五天，連續二週。以Pain Management Index (PMI), Wisconisin Brief Pain Inventory (BPI) 及 Functional Living Index : Cancer (FLIC)等評估方法，比較實驗組和對照組止痛效果、WHO三階段止痛藥用量減少的情形以及病患生活品質(quality of life)狀況有無改善等。

關鍵字：針刺，癌病疼痛，生活品質

Clinical Trial of Acupuncture Analgesia for acute Cancer-related pain
Cancer pain is the most symptom of cancer patients. The management of pain-control is used to medications according to WHO 3-step analgesic ladder. The long-term use of non-narcotic analagesia always results in superficial gastritis and upper GI bleeding. Narcontic analgesia also induces side-effests of dizziness, lethargy, vomiting, constipation and respiratory depression. The mechanizm of acupuncture analgesia is well established on the basis of neurophysiology. In clinical application, acupuncture analgesia is recognized by WHO in 1980.

We choose 60 patients with acute cancer-related pain sufferred from mucositis, esophagitis, skin ulceration caused by chemotherapy or head & neck irradiation. All of them are treated with pain-killer under the guidance of WHO 3-step ladder. This trial is randomized to two group:acupuncture and placebo. Needle electroacupuncture (experimental group) and placebo (control group) will be done five times a week individually. Each patient is going t
關鍵字：Acupunture, Cancer pain, Quality of life