Satija Aanchal, Bhatnagar Sushma
Department of Onco-Anaesthesia and Palliative Medicine, Dr. BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Indian J Palliat Care. 2017 Oct-Dec;23(4):468-479. doi: 10.4103/IJPC.IJPC_100_17.
Cancer patients are often poly-symptomatic which distressingly affects their quality of lives (QOLs). Alhough, conventional management provides adequate symptom control, yet is coupled with some limitations. Complementary therapies (CTs) have shown beneficial effects in cancer patients for symptomatic relief. The aim of this article is to provide evidence-based review of commonly used CTs for symptom management in cancer care. Hypnosis has promising evidence to be used for managing symptoms such as pain, chemotherapy-induced nausea/vomiting, distress, fatigue, and hot flashes. Guided imagery increases comfort and can be used as a psycho-supportive therapy. Meditation substantially improves psychological function, mental health, and QOL. Cognitive behavioral therapies effectively reduce pain, distress, fatigue, anxiety, and depression; and improve subjective sleep outcomes along with mood and QOL. Yoga has short term beneficial effects for anxiety, depression, fatigue, perceived stress, QOL, and well-being. T'ai Chi and qigong are beneficial adjunctive therapies for supportive cancer care, but their role in reducing cancer pain is not well proven. Acupuncture is effective for reducing treatment related side-effects, pain and fatigue. Other therapies such as massage techniques, energy therapies, and spiritual interventions have also demonstrated positive role in managing cancer-related symptoms and improve overall well-being. However, the clinical effectiveness of these therapies for symptom management in cancer patients cannot be concluded due to poor strength of evidence. Nonetheless, these are relatively free from risks and hence can be given along with conventional treatments. Only by tailoring these therapies as per patient's beliefs and preferences, optimal patient-centered holistic care can be provided.
癌症患者通常有多种症状，这令人苦恼地影响了他们的生活质量（QOL）。虽然传统治疗能提供充分的症状控制，但也存在一些局限性。补充疗法（CTs）已显示出对癌症患者症状缓解有有益效果。本文旨在对癌症护理中用于症状管理的常用补充疗法进行循证综述。催眠有充分证据可用于管理疼痛、化疗引起的恶心/呕吐、痛苦、疲劳和潮热等症状。引导式意象能增加舒适度，可作为一种心理支持疗法。冥想能显著改善心理功能、心理健康和生活质量。认知行为疗法能有效减轻疼痛、痛苦、疲劳、焦虑和抑郁；并改善主观睡眠结果以及情绪和生活质量。瑜伽对焦虑、抑郁、疲劳、感知压力、生活质量和幸福感有短期有益影响。太极拳和气功是支持性癌症护理的有益辅助疗法，但它们在减轻癌症疼痛方面的作用尚未得到充分证实。针灸对减轻治疗相关的副作用、疼痛和疲劳有效。其他疗法，如按摩技术、能量疗法和精神干预，在管理癌症相关症状和改善整体幸福感方面也显示出积极作用。然而，由于证据力度不足，无法得出这些疗法对癌症患者症状管理的临床有效性结论。尽管如此，这些疗法相对风险较低，因此可与传统治疗一起使用。只有根据患者的信仰和偏好量身定制这些疗法，才能提供以患者为中心的最佳整体护理。
