| Summary: | Background Constipation is the third common in advanced cancer patients, only superseded by pain and anorexia. According to the clinical practice guidelines, a combination of a stimulant (e.g. senna or sodium picosulphate) and an osmotic laxative (e.g. polyethylene glycol or lactulose) is generally recommended. However, over 60% of patients prescribed laxatives reported certain degrees of constipation (e.g. inadequate pushing force, sense of incomplete defecation or difficult defecation) according to our previous cross-sectional study. Therefore, a revisit to existing guidelines is recommended. Traditional Chinese medicine (TCM) originated from Chinese philosophy is a different medical system with conventional western medicine. It focuses on health maintenance and emphasizes on harmonizing the imbalance of body. Zheng (pattern), as the essential concept in TCM theory, is a diagnostic conclusion of the pathological changes at a certain stage of a disease, including the location, cause, nature, and the trend of development. From our previous study, advanced cancer patients were subject to be in deficient pattern, and many of them were complicated by excessive pattern. Qi deficiency and its combination of Qi stagnation and blood (Yin) deficiency were the most common syndromes for patients with constipation. Objective For better making use of TCM into the palliative care, further support with scientific proof is essential. In the present collaborative studies, our research team, including palliative medicine specialists and traditional Chinese medicine professionals, plans to 1) identify the responsiveness of laxatives for patients in different Zheng (patterns), and 2) carry out a pilot clinical trial on TCM intervention for advanced cancer patients with constipation. We believe that the results from these two research projects can provide robust clinical evidences to implement a large scale randomized controlled trial, and shed light on integrated treatment on palliative care in future.
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| Keywords: | Chinese and Western Medicine Collaborative Studies, Palliative Cancer Patients, Constipation, Human 中西醫協作研究; 癌症舒緩; 便秘; 治療; 人類; 晚期腫瘤 |