初診斷肺癌病人接受手術期間經絡能量、生活品質變化與預後關聯性－縱貫性研究

Associations Among Changes in Meridian Energy, Quality of Life During Surgery, and Prognoses in Newly Diagnosed Lung Cancer Patients: A Longitudinal Study

10.6224/JN.202408_71(4).08

彭芸歆(Yun-Hsin PENG)；林麗美(Li-Mei LIN)；彭台珠(Tai-Chu PENG)；張比嵩(Bee-Song CHANG)；黃君后(Chun-Hou HUANG)

肺癌 ； 手術 ； 經絡能量 ； 生活品質 ； 預後 ； lung cancer ； surgery ； meridian energy ； quality of life ； prognosis

護理雜誌

71卷4期（2024 / 08 / 01）

57 - 68

繁體中文;英文

背景：肺癌早期主要治療方式為手術，約有30%的病人出現術後併發症。然而，目前仍缺少肺癌手術期間經絡能量與生活品質的變化趨勢與預後之關聯。目的：探討初診斷肺癌病人手術期間經絡能量、生活品質的變化與預後關聯性。方法：採縱貫性、重複測量研究設計，對初診斷肺癌病人進行術前、術後2週及12週的測量。研究工具為基本資料表、經絡能量、簡明12項健康狀況調查問卷，分析變化並探討術後預後風險關聯。結果：收錄48位病人，術後2週的經絡能量和生活品質顯著下降；經絡能量中的高／低比值、簡明12項健康狀況調查問卷中的生理健康層面、性別、癌症分期、身體質量指數分別與預後呈現顯著相關。結論／實務應用：肺癌病人術後2週的經絡能量和生活品質具有下降趨勢，且與不良預後有關。護理人員可依據本研究辨識高風險術後不良預後病人，提供制定相關的護理策略，達到更全面的照護。

Background: Approximately 30% of patients experience postoperative complications after surgery for early-stage lung cancer. However, the relationships among meridian energy during lung cancer surgery, changes in quality of life, and prognosis have not been investigated. Purpose: This study was designed to explore the associations among meridian energy, changes in quality of life, and prognosis in patients with newly diagnosed lung cancer undergoing surgery. Methods: A longitudinal, repeated-measures design was used. Basic data forms, meridian energy measurements, and a concise 12-item health status questionnaire were administered to the participants at the time of diagnosis, 2 weeks post-surgery, and 12 weeks post-surgery. During this period, changes were analyzed, and their association with postoperative risks was explored. Results: Forty-eight cases were investigated. Both meridian energy and quality of life were found to be significantly decreased 2 weeks after surgery. The high/low ratio of meridian energy, the physical component score of the Short Form 12-Item Health Survey Questionnaire, gender, cancer stage, and body mass index were identified as significantly associated with prognosis. Conclusion/Implications for Practice: The declining trends in meridian energy and quality of life during the 2 weeks after surgery in patients with lung cancer are associated with poor postoperative prognoses. Nurses may use the findings of this study to identify patients at high risk of postoperative complications and develop appropriate strategies to provide comprehensive care.

1. 李志剛（2012）．穴位和經絡探密說．北市中醫會刊，18（1），34–43。[Li, Z.-G. (2012). The theory about the secret of Xuewei and Jingluo. Taipei Journal of Chinese Medicine, 18(1), 34–43.] https://doi.org/10.6718/TJCMb.201203_18(1).0004
   連結：
2. 杜華福（2008）．亞健康人經絡能量的評估．臺灣中醫科學雜誌，3（1），11–19。[Toh, F.-F. (2008). The evaluation of sub-health through the meridian energy diagnostic equipment. Science Journal of Taiwan Traditional Chinese Medicine, 3(1), 11–19.] https://doi.org/10.29810/SJTTCM.200804.0004
   連結：
3. 徐金菊、陳孟君、曾月霞、黃曉峰、黃惠美（2009）．腹部經絡精油按摩改善末期病人便秘成效之先驅研究．護理暨健康照護研究，5（4），256–264。[Hsu, C.-C., Chen, M.-J., Tseng, Y.-H., Hwang, S.-F., & Huang, H.-M. (2009). Improving constipation in patients at terminal stage: A pilot study on the efficacy of using abdominal meridian massage with essential oil. Journal of Nursing and Healthcare Research, 5(4), 256–264.] https://doi.org/10.6225/JNHR.5.4.256
   連結：
4. 張志銘、李柏萱、盧廷峻、張世沛、陳妤瑄（2021）．探討職場疲勞、經絡按摩與睡眠品質之關係．運動與遊憩研究，16（1），77–92。[Chang, C.-M., Li, B.-S., Lu, T.-C., Chang, S.-P., & Chen, Y.-H. (2021). Relationship between workplace fatigue, meridian massage and sleep quality. Journal of Sport and Recreation Research, 16(1), 77–92.] https://doi.org/10.29423/JSRR.202109_16(1).06
   連結：
5. 黃君后、王淑芳、林麗美、彭台珠（2012）．探討足浴對經絡能量及自律神經變化之影響．中西醫結合護理雜誌，（2），32–43。[Huang, C.-H., Wang, S.-F., Lin, L.-M., & Peng, T.-C. (2009). Evaluation meridian energy and changes in autonomic nervous system by foot bath. Integrative Nursing, (2), 32–43.] https://doi.org/10.6211/TTCMNA.NO2-2012-03
   連結：
6. Bade, B. C., & Dela Cruz, C. S. (2020). Lung cancer 2020: Epidemiology, etiology, and prevention. Clinics in Chest Medicine, 41(1), 1–24. https://doi.org/10.1016/j.ccm.2019.10.001
   連結：
7. Bédat, B., Abdelnour-Berchtold, E., Krueger, T., Perentes, J. Y., Zellweger, M., Triponez, F., Karenovics, W., & Gonzalez, M. (2019). Impact of complex segmentectomies by video-assisted thoracic surgery on peri-operative outcomes. Journal of Thoracic Disease, 11(10), 4109–4118. https://doi.org/10.21037/jtd.2019.10.07
   連結：
8. Camino Willhuber, G., Slullitel, P., Taype Zamboni, D., Albergo, J., Terrasa, S., Piuzzi, N., & Boretto, J. (2020). Validation of a modified Clavien-Dindo classification for postoperative complications in orthopedic surgery. Revista de la Facultad de Ciencias Médicas de Córdoba, 77(3), 161–167. https://doi.org/10.31053/1853.0605.v77.n3.27931
   連結：
9. Casanova Barea, J., De la Gala, F., Piñeiro, P., Reyes, A., Simón, C., Rancan, L., Vara, E., Paredes, S., Bellón, J. M., & Garutti Martinez, I. (2021). Influence of postoperative complications on long-term outcome after oncologic lung resection surgery. Substudy of a randomized control trial. Journal of Clinical Monitoring and Computing, 35(5), 1183–1192. https://doi.org/10.1007/s10877-020-00580-1
   連結：
10. Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases, 40(5), 373–383. https://doi.org/10.1016/0021-9681(87)90171-8
    連結：
11. Chau, E. H. L., Lam, D., Wong, J., Mokhlesi, B., Chung, F., & Warner, D. S. (2012). Obesity hypoventilation syndrome: A review of epidemiology, pathophysiology, and perioperative considerations. Anesthesiology, 117(1), 188–205. https://doi.org/10.1097/ALN.0b013e31825add60
    連結：
12. Chung, M.-C., Tsai, P.-Y., Chen, C.-M., Yang, C.-K., & Chang, H.-H. (2023). Meridian energy analysis may predict the prognosis of patients with advanced cancers receiving palliative care. Journal of Traditional and Complementary Medicine, 13(4), 389–396. https://doi.org/10.1016/j.jtcme.2023.03.003
    連結：
13. Cohen, J. (1977). Statistical power analysis for the behavioral sciences (Rev. ed.). Academic Press. https://doi.org/10.1016/C2013-0-10517-X
    連結：
14. Dindo, D., Demartines, N., & Clavien, P.-A. (2014). Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Annals of Surgery, 240(2), 205–213. https://doi.org/10.1097/01.sla.0000133083.54934.ae
    連結：
15. Ettinger, D. S., Aisner, D. L., Wood, D. E., Akerley, W., Bauman, J., Chang, J. Y., Chirieac, L. R., D’Amico, T. A., Dilling, T. J., Dobelbower, M., Govindan, R., Gubens, M. A., Hennon, M., Horn, L., Lackner, R. P., Lanuti, M., Leal, T. A., Lilenbaum, R., Lin, J., ... Hughes, M. (2018). NCCN guidelines insights: Non-small cell lung cancer, version 5.2018. Journal of the National Comprehensive Cancer Network: JNCCN, 16(7), 807–821. https://doi.org/10.6004/jnccn.2018.0062
    連結：
16. Fernandez, F. G., Falcoz, P. E., Kozower, B. D., Salati, M., Wright, C. D., & Brunelli, A. (2015). The Society of Thoracic Surgeons and the European Society of Thoracic Surgeons general thoracic surgery databases: Joint standardization of variable definitions and terminology. The Annals of Thoracic Surgery, 99(1), 368–376. https://doi.org/10.1016/j.athoracsur.2014.05.104.
    連結：
17. Ferreira, V., Lawson, C., Ekmekjian, T., Carli, F., Scheede-Bergdahl, C., & Chevalier, S. (2021). Effects of preoperative nutrition and multimodal prehabilitation on functional capacity and postoperative complications in surgical lung cancer patients: A systematic review. Supportive Care in Cancer, 29(10), 5597–5610. https://doi.org/10.1007/s00520-021-06161-5
    連結：
18. Guerrera, F., Lyberis, P., Lausi, P. O., Cristofori, R. C., Giobbe, R., Molinatti, M., Filosso, P. L., Curcio, C., Crisci, R., Ruffini, E., & on the behalf of the Italian VATS Group. (2022). Does morbid obesity influence perioperative outcomes after video-assisted thoracic surgery (VATS) lobectomy for non-small cell lung cancer? Analysis of the Italian VATS group registry. Surgical Endoscopy, 36(5), 3567–3573. https://doi.org/10.1007/s00464-021-08680-y
    連結：
19. Gupta, S., Padhan, P., Subhankar, S., & Singh, P. (2021). Cardiovascular complications in patients with interstitial lung disease and their correlation with 6-minute walk test and spirometry: A single-center study. Journal of Family Medicine and Primary Care, 10(9), 3330–3335. https://doi.org/10.4103/jfmpc.jfmpc_350_21
    連結：
20. Hamann, H. A., Williamson, T. J., Studts, J. L., & Ostroff, J. S. (2021). Lung cancer stigma then and now: Continued challenges amid a landscape of progress. Journal of Thoracic Oncology, 16(1), 17–20. https://doi.org/10.1016/j.jtho.2020.10.017
    連結：
21. Hino, H., Hagihira, S., Maru, N., Utsumi, T., Matsui, H., Taniguchi, Y., Saito, T., & Murakawa, T. (2023). The surgical Apgar score predicts postoperative complications and the survival in lung cancer patients. Surgery Today, 53(9), 1019–1027. https://doi.org/10.1007/s00595-023-02677-x
    連結：
22. Iddi, S., & Donohue, M. C. (2022). Power and sample size for Longitudinal models in R-The longpower package and shiny app. The R Journal, 14(1), 264–282. https://doi.org/10.32614/RJ-2022-022
    連結：
23. Iijima, Y., Ishikawa, M., Iwai, S., Yamagata, A., Motono, N., & Uramoto, H. (2022). Is overweight related to the prognosis of octogenarians with lung cancer? Obesity Surgery, 32(4), 1279–1288. https://doi.org/10.1007/s11695-022-05948-7
    連結：
24. Kasprzyk, A., Bilmin, K., Chmielewska-Ignatowicz, T., Pawlikowski, J., Religioni, U., & Merks, P. (2021). The role of nutritional support in malnourished patients with lung cancer. In Vivo, 35(1), 53–60. https://doi.org/10.21873/invivo.12231
    連結：
25. Lee, L.-Y., Huang, B.-S., Lin, C.-Y., Su, Y.-H., Chung, C.-F., Chang, Y.-L., & Chen, S.-C. (2023). Effects of a nurse-led survivorship care program on the health and resilience of primary caregivers of patients with advanced head and neck cancer: A randomized controlled trial. Seminars in Oncology Nursing, 39(4), Article 151425. https://doi.org/10.1016/j.soncn.2023.151425
    連結：
26. Lee, Y.-C., Ng, H.-P., Chang, Y.-H., & Ho, W.-C. (2018). The development and application evaluation of meridian energy detection system in traditional oriental medicine: A preliminary study. Evidence-Based Complementary and Alternative Medicine, 2018(1), Article 9469703. https://doi.org/10.1155/2018/9469703
    連結：
27. Li, R., Wang, K., Qu, C., Qi, W., Fang, T., Yue, W., & Tian, H. (2021). The effect of the enhanced recovery after surgery program on lung cancer surgery: A systematic review and meta-analysis. Journal of Thoracic Disease, 13(6), 3566–3586. https://doi.org/10.21037/jtd-21-433
    連結：
28. Liu, J., Yang, X., Liu, X., Xu, Y., & Huang, H. (2022). Predictors of readmission after pulmonary resection in patients with lung cancer: A systematic review and meta-analysis. Technology in Cancer Research & Treatment, 21. https://doi.org/10.1177/15330338221144512
    連結：
29. Liu, Y., Tao, T., Li, W., & Bo, Y. (2017). Regulating autonomic nervous system homeostasis improves pulmonary function in rabbits with acute lung injury. BMC Pulmonary Medicine, 17(1), Article 98. https://doi.org/10.1186/s12890-017-0436-0
    連結：
30. Pompili, C., McLennan Battleday, F., Chia, W. L., Chaudhuri, N., Kefaloyannis, E., Milton, R., Papagiannopoulos, K., Tcherveniakov, P., & Brunelli, A. (2021). Poor preoperative quality of life predicts prolonged hospital stay after VATS lobectomy for lung cancer. European Journal of Cardio-Thoracic Surgery, 59(1), 116–121. https://doi.org/10.1093/ejcts/ezaa245
    連結：
31. Pu, Q., Zhou, J., Zheng, Q., Hao, J., Wu, D., Zhang, R., Wang, H., Wang, T., & Liu, L. (2022). Free of choice on anterior and posterior chest tube position after lung cancer resection. Interactive Cardiovascular and Thoracic Surgery, 35(1), Article ivac069. https://doi.org/10.1093/icvts/ivac069
    連結：
32. Raman, V., Jawitz, O. K., Voigt, S. L., Rhodin, K. E., D’Amico, T. A., Harpole, D. H., Yang, C.-F. J., & Tong, B. C. (2021). The effect of tumor size and histologic findings on outcomes after segmentectomy vs lobectomy for clinically node-negative non-small cell lung cancer. Chest, 159(1), 390–400. https://doi.org/10.1016/j.chest.2020.06.066
    連結：
33. Siegel, R. L., Miller, K. D., Wangle, N. S., & Jemal, A. (2023). Cancer statistics, 2023. CA: A Cancer Journal for Clinicians, 73(1), 17–48. https://doi.org/10.3322/caac.21763
    連結：
34. Soh, S.-E., Morello, R., Ayton, D., Ahern, S., Scarborough, R., Zammit, C., Brand, M., Stirling, R. G., & Zalcberg, J. (2021). Measurement properties of the 12-item short form health survey version 2 in Australians with lung cancer: A Rasch analysis. Health and Quality of Life Outcomes, 19(1), Article 157. https://doi.org/10.1186/s12955-021-01794-w
    連結：
35. Sommer, M. S., Vibe-Petersen, J., Stærkind, M. B., Langer, S. W., Larsen, K. R., Trier, K., Christensen, M., Clementsen, P. F., Missel, M., Christensen, K. B., Lillelund, C., Langberg, H., Pedersen, J. H., & Quist, M. (2020). Early initiated postoperative rehabilitation enhances quality of life in patients with operable lung cancer: Secondary outcomes from a randomized trial. Lung Cancer, 146, 285–289. https://doi.org/10.1016/j.lungcan.2020.06.023
    連結：
36. Sun, D., Hu, J., Li, X., He, J., Xu, L., Fu, X., Liu, Y., Liu, D., Chen, P., Zhang, X., & Liu, L. (2023). Real-world surgical treatment patterns and clinical outcomes in patients with stages IA-IIIA non-small cell lung cancer: A retrospective multicentric observational study involving 11,958 patients. Journal of Cancer Research and Clinical Oncology, 149(11), 8213–8223. https://doi.org/10.1007/s00432-023-04729-8
    連結：
37. Ulibarri-Ochoa, A., Ruiz-de-Alegría, B., López-Vivanco, G., García-Vivar, C., & Iraurgi, I. (2023). Differences in quality of life and emotional well-being in breast, colon, and lung cancer patients during outpatient adjuvant chemotherapy: A longitudinal study. Cancer Nursing, 46(2), E99–E109. https://doi.org/10.1097/NCC.0000000000001070
    連結：
38. Voorn, M. J. J., Franssen, R. F. W., Hoogeboom, T. J., van Kampen-van den Boogaart, V. E. M., Bootsma, G. P., Bongers, B. C., & Janssen-Heijnen, M. L. G. (2023). Evidence base for exercise prehabilitation suggests favourable outcomes for patients undergoing surgery for non-small cell lung cancer despite being of low therapeutic quality: A systematic review and meta-analysis. European Journal of Surgical Oncology, 49(5), 879–894. https://doi.org/10.1016/j.ejso.2023.01.024
    連結：
39. Ware, J., Jr., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233. https://doi.org/10.1097/00005650-199603000-00003
    連結：
40. Yamamichi, T., Ichinose, J., Omura, K., Hashimoto, K., Matsuura, Y., Nakao, M., Okumura, S., Ikeda, N., & Mun, M. (2022). Impact of postoperative complications on the long-term outcome in lung cancer surgery. Surgery Today, 52(9), 1254–1261. https://doi.org/10.1007/s00595-022-02452-4
    連結：
41. Yoshiyasu, N., Kojima, F., Takahashi, O., Ishikawa, Y., & Bando, T. (2020). The impact of surgical chest wall damage caused by classic thoracotomy on pulmonary function and morphology. General Thoracic and Cardiovascular Surgery, 68(5), 508–515. https://doi.org/10.1007/s11748-019-01250-z
    連結：
42. Yu, X. Q., Yap, M. L., Cheng, E. S., Ngo, P. J., Vaneckova, P., Karikios, D., Canfell, K., & Weber, M. F. (2022). Evaluating prognostic factors for sex differences in lung cancer survival: Findings from a large Australian cohort. Journal of Thoracic Oncology, 17(5), 688–699. https://doi.org/10.1016/j.jtho.2022.01.016
    連結：
43. Zhang, W., Cong, X., Zhang, L., Sun, M., Li, B., Geng, H., Gu, J., & Zhang, J. (2020). Effects of thoracic nerve block on perioperative lung injury, immune function, and recovery after thoracic surgery. Clinical and Translational Medicine, 10(3), Article e38. https://doi.org/10.1002/ctm2.38
    連結：
44. Zhang, J., Yip, R., Taioli, E., Flores, R. M., Henschke, C. I., Yankelevitz, D. F., Schwartz, R. M., & IELCART Investigators. (2024). Change in quality of life of stage IA non-small cell lung cancer after surgery or radiation therapy. Journal of Thoracic Disease, 16(1), 147–160. https://doi.org/10.21037/jtd-23-1201
    連結：
45. Zuomei, H., Huiyong, H., Wenhui, G., Yun, X., Liang, L., Feng, S., & Puhua, Z. (2019). Comparative study on distribution of pattern elements and results of different methods of pattern differentiation in cases of non-small cell lung cancer. Journal of Beijing University of Traditional Chinese Medicine, 42(9), 787–792. https://doi.org/10.3969/j.issn.1006-2157.2019.09.014
    連結：
46. 林珈慶（2019，7月）．短時間視聽刺激與靜坐對身心經絡能量影響之研究〔碩士論文，佛光大學〕．臺灣博碩士論文知識加值系統。[Li, C.-C. (2019). Study on influence of short time audio-visual stimulation and mediation on physical, mental and meridian energy [Master’s thesis, Fo Guang University]. National Digital Library of Theses and Dissertations in Taiwan.] https://hdl.handle.net/11296/2taemy
47. 衛生福利部（2023，6月12日）．111年國人死因統計結果。[Ministry of Health and Welfare, Taiwan, ROC. (2023, June 12). Cause of death statistics in Taiwan, 2022.] https://www.mohw.gov.tw/cp-16-74869-1.html