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R2 10315 20042008 2004 CLINICAL RESEARCH OF TRADITIONAL CHINESE MEDICINE THEORY & TREATMENT TO RELIEVE PAIN OF BREAST CANCER PATIENTS 2007 5

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: : : 1960 10 8 : : 1983 1987 2000 2004 2007 Resume Name : Pang Fong Chin Sex : Female Date of Birth : 8 Oct 1960 Nationality : Singapore Educational and Professional Experience: 1983 1987 Diploma of TCM Singapore Traditional Chinese Medical College 2000 till now Pang Fong Chin TCM & Acupuncture Therapy Centre 2004 2007 Candidate of Master Nanjing University of TCM I

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ABSTRACT Objective: To explore the effective and safety of the prescription base on the theory of TCM this thesis which brought according to analysis of literature review clinical manifestation the etiology and pathogenesis of improve the quality of life to relieve pain of Breast Cancer Patients in Singapore. Methods: Clinical effect was observed to analyze the mechanism of theory of TCM which made of the therapy of improving the survival quality and relieve pain of Breast Cancer Patients. 30 patients in the self control group with Breast Cancer were randomly treated by TCM. Each patient was given one dosage per day with acupuncture and massage. 7 days per course of treatment. Clinical effect was observed for 2 courses. Results: Patient average age is 54.27±7.67. 30 patients after treatment showed that the survival quality of life (symptoms eg. Appetite pain sleep tiredness.. etc.) was improved. Z value was 4.7644.6974.7864.9144.9664.7654.5264.813 5.0704.8244.759 respectively. P<0.01. The clinical effective rate after treatment was 45.50±9.31which was higher than before treatment 17.97±1.45Z4.786P<0.01 significantly. Conclusion: The therapy of TCM & Acupuncture to improve the survival quality and relieve pain of Breast Cancer patient is effective and safety. Key word: Breast Cancer Traditional Chinese Medicine Acupuncture Classifications of treatment Clinical Research. III

90 Paget (1981 WHO ) 94 100 3 270 + + 70 IV

12 52 40 35 X A 1 2 3 B 1 2 1

3 ~ 12 3 4 2

. 3

( Sentinel node biopsy ) 1 1 2I 3II 4III IIIa IIIb 5IV 1982 WHO 1984 12 WHO 1990 11 WHO 1991 2000 WHO 2000 4

600 mg 2.55mg buprenophine Sheider 72 hrs 10 min 79.2%1 (Patient Controleel Analgesir PCA)PCA 1984 2 PCA 3 2 5

3.2.1 3.2.2 1400 6

[3] [4] [5] [6] [7] [8] [9] [10][11] [12] ( ) [13] [14] [15] [16] 407 (384 94.35%)(22 5.41%) 313 76.9% [17]( ) 71 29 ( 12 17 ) 40.8% 33 ( 3 30 ) 45% 9 ( 2 7 ) 12.6% 87.3% 7

[18] 61 [19] :1 2 1 2 3 4() 5 6[29] 1 2 3 8

4 5 6 7[30] 8[31] 9

a. 10 1 5~7 1 b. 5 1 5 1 c. 3 7 1 5 (1) (2) 1hr 35ml 1hr (3) (4) 20g 20g (5) (6) 20ml C0.1g 24 10

11

2004 1 2006 12 30 (1) (2) 2 (3) 18-80 (4) (5) (1) (2) (3) (4) (5) [20] (1) - 15g 9g 15g 9g 15g 6g 3g (2) 12

- 9g 9g 9g 15g 20g 15g 15g 9g (3) - 9g 6g 6g 9g 20g 15g - 30g 30g 15g 15g 15g (4) - 30g 15g 9g 9g 9g 9g 9g 6g : : : : : : : : : : 1 1 2 7 1 23 1 23 10 13

30 30 2 (1)NRS 0~10 0 10 0=1~3=4~6= 7~10= (2)WHO CR : PR : MR: NR : WHO (: 41 21~40 20 ) (1) 14

EpiData3.02SPSS 13.0 ± x ± s Wilcoxon Wilcoxon Signed Ranks Test 54.27±7.67397030 1136.7930.0 723.3310.0 <0.01 x s <0.01 15

WHO 23.3 10.0 3.3 13.3 13.3 3.3 6.7 10.0 6.7 3.3 6.7 46.7 40.0 6.7 6.7 P0.356>0.05 301446.71240.0 26.7P0.356>0.05 16

Z4.7644.6974.786 4.9144.9664.7654.5264.8135.0704.8244.759P0.01 45.50±9.3117.97±1.45Z4.786P<0.01 1 N x s Min Max x s Min Max Z* 30 2.00 0.00 2 2 4.20 0.81 2 5 4.764 30 1.40 0.50 1 2 4.20 1.06 1 5 4.697 30 1.87 0.35 1 2 4.30 1.02 1 5 4.786 30 1.10 0.31 1 2 3.80 0.85 1 5 4.914 30 1.97 0.32 1 3 3.90 0.71 2 5 4.966 30 1.30 0.47 1 2 4.17 1.02 1 5 4.765 28 2.00 0.38 1 3 4.29 1.15 1 5 4.526 30 2.00 0.00 2 2 4.43 0.90 2 5 4.813 30 1.00 0.00 1 1 3.70 0.79 1 4 5.070 30 1.97 0.18 1 2 4.47 0.82 2 5 4.824 30 1.53 0.51 1 2 4.30 1.06 1 5 4.759 30 17.97 1.45 14 20 45.50 9.31 15 53 4.786 * Wilcoxon Signed Ranks Test 30 30 26 86.72 6.72 6.7 70 17

+ + 302 <0.01 30 1446.71240.026.7 P0.356>0.05 1 Z 4.7644.6974.7864.9144.966 4.7654.5264.8135.0704.8244.759P 0.01 45.50±9.3117.97±1.45Z4.786P<0.0130 26 (86.7%)2 (6.7%)2 (6.7%) 18

21 Cy T B DTH 22 2324 camp 25 B 26 2728 19921997 400 23 30 10 30 19

20

1 : : : : (1) (A) (B) (C) 1( ) 1( ) 1( ) 2( ) < 1/2 2( ) 2( ) 3( ) 1/2 3( ) 3( ) 4( ) 4( ) 4( ) 5( ) 5( ) 5( ) (D) (E) (F) 1( ) 1( ) IV 1( ) 2( ) 2( ) III 2( ) 3( ) 3( ) II 3( ) 4( ) 4( ) I 4( ) 5( ) 5( ) 0 5( ) (G) (H) (I) 1( ) 1( ) 1( ) 2( ) 2( ) 2( ) 3( ) 3( ) 3( ) 4( ) 4( ) 4( ) 5( ) 5( ) 5( ) (J) (K) (L) 1( ) 1( ) 2( ) 2( ) 3( ) 3( ) 4( ) 4( ) 5( ) 5( ) 1( ) 2( ) 3( ) 4( ) 5( ) 21

: : : : (1) (A) (B) (C) 1( ) 1( ) 1( ) 2( ) < 1/2 2( ) 2( ) 3( ) 1/2 3( ) 3( ) 4( ) 4( ) 4( ) 5( ) 5( ) 5( ) (D) (E) (F) 1( ) 1( ) IV 1( ) 2( ) 2( ) III 2( ) 3( ) 3( ) II 3( ) 4( ) 4( ) I 4( ) 5( ) 5( ) 0 5( ) (G) (H) (I) 1( ) 1( ) 1( ) 2( ) 2( ) 2( ) 3( ) 3( ) 3( ) 4( ) 4( ) 4( ) 5( ) 5( ) 5( ) (J) (K) (L) 1( ) 1( ) 2( ) 2( ) 3( ) 3( ) 4( ) 4( ) 5( ) 5( ) 1( ) 2( ) 3( ) 4( ) 5( ) 22

: () WHO CR : PR : MR: NR : () : : 41 21~40 20 : : :14 : : CR-( ) PR-( ) MR-( ) NR-( ) 2006 23

(2) 0 1 2 3 4 - - 11.0 9.5-10.9 8.0-9.4 6.5-7.9 <6.5-4.0 3.0-3.9 2.0-2.9 1.0-1.9 <1.0-2.0 1.5-1.9 1.0-1.4 0.5-0.9 <0.5-1.0 7.5-9.9 5.0-7.4 2.5-4.9 <2.5 1.25xN 1.26-2.50xN 2.6-5.0xN 5.1-10.0xN >10xN 1.25xN 1.26-2.50xN 2.6-50xN 5.1-10.0xN >10xN 1.25xN 1.26-2.50xN 2.6-50xN 5.1-10.0xN >10xN (<2 ) (>2 ), 1.25xN 1.26-2.50xN 2.6-50xN 5.1-10.0xN >10xN 1.25xN 1.26-2.50xN 2.6-50xN 5.1-10.0xN >10xN +,<0.3 /100 ++,+++,0.3-1.0 ++++,>1 () <38 38-40 >40,,, (), PVC PVC >100 /,,,,, 50 50 / / / () () N = 24

[1].J.199530(10) 613. [2].J.199227(7)291. [3]..200031(1)24-25 [4]. 36.199710(5)38 [5]..200110(32)44-45 [6].. 200326(4)11-12 [7]..200428(2)44 [8].200428(6)36-37 [9].2003 26(3)18-19 [10]...1999276-282 290-294 [11].2005 [12]..200525(3)218-221 [13]. 1993 10 1 38 [14]. 1992 11 1 323 [15].. 1992(3):21 [16]. 407 199926(9): 387 [17]. 1992 (6): 9 [18] II 2000 27 (7) : 534536 [19]..1997 [20] 2003 4 148 [21]. 2003 22 (14):1 [22] 1996 12 (6):16-18 25

[23]. 2000 21(10): 51-57 [24]. 2000 8 (3): 6-8 [25] 43. 2003 9(11): 12-14 [26] 1984 46368 [27] 1999 72: 156-157 [28] 410006 [29]. 1991 3 290 [30]. 1989 1 398 [31].. 1987 1 18 26

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