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一所人智学医院中的姑息性癌症住院治疗:I. 治疗模式及对人智学医学的依从性

Palliative in-patient cancer treatment in an anthroposophic hospital: I. Treatment patterns and compliance with anthroposophic medicine.

作者信息

Heusser Peter, Braun Sarah Berger, Ziegler Renatus, Bertschy Manuel, Helwig Silke, van Wegberg Brigitte, Cerny Thomas

机构信息

Institute for Complementary Medicine KIKOM, University of Bern, Switzerland.

出版信息

Forsch Komplementmed. 2006 Apr;13(2):94-100. doi: 10.1159/000091694. Epub 2006 Apr 19.

Abstract

BACKGROUND

Complementary and alternative medicine (CAM) and most of all anthroposophic medicine (AM) are important features of cancer treatment in Switzerland. While the number of epidemiological investigations into the use of such therapies is increasing, there is a distinct lack of reports regarding the combination of conventional and CAM methods.

PATIENTS AND METHODS

144 in-patients with advanced epithelial cancers were enrolled in a prospective quality-of-life (QoL) study at the Lukas Klinik (LK), Arlesheim, Switzerland. Tumor-related treatment was assessed 4 months prior to admission, during hospitalization and 4 months after baseline.

OBJECTIVE

We aimed at giving a detailed account of conventional, AM and CAM treatment patterns in palliative care, before, during and after hospitalization, with emphasis on compliance with AM after discharge.

RESULTS

Certain conventional treatments featured less during hospitalization than before but were resumed after discharge (chemotherapy, radiotherapy, sleeping pills, psychoactive drugs). Hormone therapy, corticosteroids, analgesics WHO III and antidepressants remained constant. AM treatment consisted of Iscador? (mistletoe), other plant- or mineral-derived medication, baths, massage, eurythmy, art therapy, counseling and lactovegetarian diet. Compliance after discharge was highest with Iscador (90%) and lowest with art therapy (14%). Many patients remained in the care of AM physicians. Other CAM and psychological methods were initially used by 39.9% of patients. After 4 months, the use had decreased with few exceptions.

CONCLUSION

During holistic palliative treatment in an anthroposophic hospital, certain conventional treatments featured less whereas others remained constant. After discharge, chemotherapy returned to previous levels, AM compliance remained high, the use of other CAM therapies low.

摘要

背景

补充和替代医学(CAM),尤其是人智医学(AM)是瑞士癌症治疗的重要特色。虽然对这类疗法使用情况的流行病学调查数量在增加,但关于传统疗法与补充和替代医学方法相结合的报告却明显不足。

患者与方法

144例晚期上皮癌住院患者参加了瑞士阿尔勒斯海姆卢卡斯诊所(LK)的一项前瞻性生活质量(QoL)研究。在入院前4个月、住院期间以及基线后4个月对肿瘤相关治疗进行评估。

目的

我们旨在详细描述姑息治疗中住院前、住院期间和出院后的传统治疗、人智医学治疗和补充与替代医学治疗模式,重点是出院后对人智医学的依从性。

结果

某些传统治疗在住院期间的使用频率低于住院前,但出院后恢复使用(化疗、放疗、安眠药、精神活性药物)。激素治疗、皮质类固醇、WHO三级镇痛药和抗抑郁药的使用保持不变。人智医学治疗包括伊沙卡多(槲寄生)、其他植物或矿物衍生药物、 baths、按摩、韵律操、艺术治疗、咨询和素食饮食。出院后对伊沙卡多的依从性最高(90%),对艺术治疗的依从性最低(14%)。许多患者仍由人智医学医生护理。其他补充与替代医学和心理方法最初有39.9%的患者使用。4个月后,除少数例外,使用量有所下降。

结论

在人智医学医院进行整体姑息治疗期间,某些传统治疗的使用频率降低,而其他治疗保持不变。出院后,化疗恢复到以前的水平,对人智医学的依从性仍然很高,其他补充与替代医学疗法的使用量较低。

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