Li-Yin Chien

Effectiveness of Traditional Chinese Medicine for Liver Protection and Chemotherapy Completion among Cancer Patients.

While traditional Chinese medicine (TCM) is widely used among Chinese patients with cancer, studies evaluating the effectiveness of TCM using objective indicators are rare. We examined the effectiveness of TCM for liver protection and completion of chemotherapy among patients with cancer receiving chemotherapy. We used a case-control design to examine the medical records of patients with cancer who received chemotherapy in a teaching hospital in Taipei in 2004. A total of 184 courses of chemotherapy among 89 patients were studied. Of the 184 courses, 42 used TCM jointly with chemotherapy served as cases, while the remaining 142 courses served as controls. Outcome variables included counts of cancelled or delayed chemotherapies and liver function (aspartate aminotransferase, AST and alanine aminotransferase, ALT) 1 week before, during and 2 weeks after chemotherapy. Generalized estimating equations were used to analyze the data. Patients who had concomitant TCM with chemotherapy had lower serum ALT and AST during chemotherapy than the controls given that the age, sex, cancer stage, radiotherapy sites, cancer diagnosis and potential hepatotoxicity of the chemotherapeutic drugs were controlled for in the model [β  = −3.48, 95% confidence interval (CI) −10.08 to 3.11 for AST; β  = −5.95, 95% CI: −11.47 to −0.44 for ALT]. There was no significant difference between the case and control groups for odds of completing one course of chemotherapy. Use of TCM with chemotherapy resulted in protection of the liver during chemotherapy, as manifested by lower serum AST and ALT levels.

Effectiveness of 3-Week Intervention of Shi Quan Da Bu Tang for Alleviating Hematotoxicity Among Patients With Breast Carcinoma Receiving Chemotherapy

Purpose. Although Shi Quan Da Bu Tang (SQDBT) has been used to treat cancer patients clinically, very few studies evaluating the effectiveness of SQDBT using objective indicators have been published. The study objectives were to examine the effectiveness of SQDBT for alleviating hematotoxicity, as indicated by white blood cell (WBC) counts and hemoglobin (Hb) levels, among patients with breast carcinoma receiving chemotherapy. Methods. The authors identified patients with breast carcinoma who received chemotherapy in a teaching hospital in Taipei in 2008 through a chart review process. Only patients with initial WBC counts of <4000/µL were included. The case group was composed of 47 chemotherapy courses treated with SQDBT, whereas the comparison group included 257 courses without SQDBT. The complete blood count test was done before start of a chemotherapy course and 1 week after chemotherapeutic drugs were given. Results. Age, cancer stage, cancer status, use of granulocyte colony-stimulating factor, and chemotherapy drugs were controlled in the model. Patients who took SQDBT had significantly increased WBC counts, especially neutrophils, and Hb after chemotherapy (adjusted β = 1202.51, 95% confidence interval [CI] 440.45-1964.57 for WBC; β = 834.83, 95% CI = 197.35-1472.31 for neutrophils; β = 0.34, 95% CI = 0.05-0.63 for Hb). There were no significant differences in tumor markers CEA and CA153 between patients given SQDBT or not after chemotherapy. Conclusion. SQDBT is effective in alleviating hematotoxicity among patients with breast carcinoma receiving chemotherapy, without affecting the presentation of tumor markers in the short term. More study is needed to determine long-term outcomes such as recurrence and survival.

Abnormal gastroscopy findings were related to lower meridian energy.

According to the theories of Traditional Chinese Medicine (TCM), energy runs through 12 meridians longitudinally up and down the body. The study objectives were to compare the meridian energy between subjects with and without abnormal gastroscopy findings. We applied a cross-sectional and correlational research design. The study included 1,223 participants who had their health examinations at a university hospital in Taipei from 1st August 2005 through 31st August 2007. Meridian energy was examined using a meridian energy analysis device. The gastroscopy was operated by certified gastroenterologists. Participants with abnormal stomach and esophageal findings using gastroscopy had significantly lower mean meridian energy. There were no significant differences in meridian energy between participants with and without abnormal duodenum findings. When all of the meridians were examined individually, participants with abnormal findings in esophagus and stomach had significantly lower meridian energy in each of the meridians. The results of this study demonstrated that structural abnormality in the gastric area was related to lower meridian energy. Whether enhancing meridian energy could improve gastric and esophageal health merits further studies.

Effects of symptoms and complementary and alternative medicine use on the yang deficiency pattern among breast cancer patients receiving chemotherapy

BACKGROUND Based on traditional Chinese medicine (TCM) theory, yang deficiency pattern defined as an insufficiency of meridian energy (qi) is related to worsening disease symptoms. However, there is a lack of studies portraying the relationship among complementary and alternative medicine (CAM) use, symptoms, and meridian energy. Therefore, the primary purpose of this study was to describe the changes of CAM use, symptoms, and yang deficiency pattern among patients with breast cancer receiving chemotherapy. Additionally, the study explored factors predicting yang deficiency pattern. METHOD A longitudinal study was performed with 153 women with breast cancer at four teaching hospitals in northern Taiwan from June 1, 2009 to July 31, 2013. Researchers collected data before treatment and the 1st and 3rd months after chemotherapy. Yang deficiency pattern was examined using the Meridian Energy Analysis Device Me-Pro. Symptom severity and interference were assessed using the MD Anderson Symptom Inventory-Taiwan version. CAM use was evaluated using the US National Center for Complementary and Alternative Medicine (NCCAM) classification. RESULTS Meridian energy remained essentially the same over the 3-month period as the difference was not statistically significant. As time went by, patients developed worsening symptom severity and interference. More than 66% of the patients used CAM during chemotherapy. Older women had lower overall meridian energy. The more severe the symptoms were, the lower the overall meridian energy was. The patients who used tai chi or qi gong had higher overall meridian energy and those who used prayer or spirituality had lower overall meridian energy. CONCLUSION AND IMPLICATIONS Symptom severity and interference among patients deteriorated during chemotherapy. Health providers should observe symptom changes and improve yang deficiency pattern. Whether or not use of CAM practices such as tai chi or qi gong improves the overall health of breast cancer patients on chemotherapy is worth further study.

Increases in Xu Zheng and Yu Zheng among Patients with Breast Cancer Receiving Different Anticancer Drug Therapies

Aim. The objectives of this study were to compare yang-xu, yin-xu, and yu among patients with breast cancer right before, one month after, and three months after receiving target, chemo, or combined therapy. Method. After recruiting 126 patients from 4 hospitals in northern Taiwan, a longitudinal study was carried out with 61 patients receiving chemotherapy, 30 receiving target therapy, and 35 receiving combined therapy. Yang-xu, yin-xu, and yu were assessed using the Traditional Chinese Medical Constitutional Scale (TCMCS), with higher scores indicating more xu and yu. Results. There were significant increases in yang-xu, yin-xu, and yu at 1 month and 3 months after than before the start of the chemotherapy, target, or combined therapy. Patients receiving combined therapy had significantly higher scores in yang-xu and yin-xu than patients receiving chemo or target therapy. A history of coronary heart disease was associated with more yin-xu. Those patients who had undergone a mastectomy were associated with less yu zheng than those patients who had not. Conclusion and Implications. TCM doctors should focus their treatment on dealing with xu and yu in order to support their patients, as they complete their modern anticancer treatments.