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2013年10月30日星期三

Breeze徜徉:中西合璧,重燃病人希望(Rekindling a Patient’s Hope between East and West)

http://www.aia.com.hk/edm/ebook1309/tc/flash/index.html#10
 


Rekindling a Patient’s Hope between East and West
  
As a multicultural society, Hong Kong harbours its fair share of medical practitioners from every corner of the world.  Conventional medicine may still hold sway in the mainstream, but complementary approaches, such as Traditional Chinese Medicine (TCM) and naturalistic therapy, have met growing acceptance.  For patients in the oncology department, TCM promises stopgap relief in the midst of surgery, chemotherapy, or radiotherapy.  But more importantly, it offers an improved quality of life and kindles hope amongst patients.

Patients afflicted with various cases of neoplasm - tumours, in short-are flocking to TCM’s rescue in recent years.  Dr. Zhiguang Tao, Lecturer of Clinical Division, School of Chinese Medicine, Hong Kong Baptist University, notes that these patients largely fall under two categories.  ‘The first category opts for a two-pronged approach, with conventional medicine at the forefront and TCM on the side, and often comes under post-surgery cases when the body is recuperating and fending off relapses or metastases (i.e. cancer spreading to another part of the body); this approach helps relieve the side effects of chemotherapy.  The second category is older or weaker tumour patients who are too frail for surgery or chemotherapy, in which case treatment leans heavily on TCM.’



The etymology of cancer

Whereas conventional medicine simply takes cancer at face value - a malignant neoplasm involving unregulated cell growth - TCM traces the diagnosis all the way back to the Song Dynasty, with a gross description of anatomical pathology which emphasised its unyielding and obdurate nature.  Dr. Tao claims that a consensus exists amongst conventional medicine and TCM practitioners with regard to the causes of cancer, but whereas the former describes it as a localised pathology due to cell mutations, the latter posits it to be a systemic disorder.  Various causes from diets to fatigue and other external and internal factors may all come into play; TCM catalogues six climatic pathogens and seven emotional conditions that may cause internal impairments,leading to an accumulation of toxins and so on.
  

 ‘The six pathogens stem from the excess of normal climatic phenomena, namely the qualities of wind, cold, heat, dampness, dryness, and fire; the seven emotions refer to affective responses, such as joy, anger, anxiety, contemplation, grief, fear, and fright.  Fatigue could mean either overexertion or an excess of idleness: TCM stresses moderation, so both extremes are just as likely to take its toll on our bodies.’  Is there a way for us to target these causes?  ‘When it comes to pathogens or emotional trauma, we can keep our distance from toxins like tobacco and alcohol, and change our diet for the better - heavy on veggies, quit bingeing, and have regular meals that are moderately seasoned.  As for fatigue, apart from daily exercises, a well tempered sex life will go far stamping out anxiety, depression, or anger issues.’ 


A holistic change

The recognition that cancer stems from cell mutations necessitates a localised treatment regime in conventional medicine, and the focus on destroying cancerous cells through surgery, radiotherapy, chemotherapy or molecular targeted therapy affects healthy cells in the process, disrupting patients’ quality of life.  TCM approaches, with its blend of herbal medicine, acupuncture, and exercise (qigong), focus on overall conditioning and maintenance instead. 


‘TCM prescribes medicine in compound formula which reinforce insufficiencies and reduce excesses, striking a new homeostatic balance, encourageing the metabolism, and clearing a phlegmatic constitution.  This improves the patient’s overall health and shifts the balance from within, making conditions less favourable to malignant cell growth: tumours sometimes stabilise or even shrink in size, improving life expectancy as a result.  Acupuncture stimulates circulation; moxibustion gives the system a boost; qigong exercise helps manage the psychological as well as the physiological in that relaxation practice takes your mind off things.  This state of mind, together with a strengthened physical constitution, is sometimes seen as integral to the treatment of all diseases in general.’
  

The traditionalist’s broad strokes

Dr. Tao states that there is something to be said for both conventional and TCM approaches when it comes to treating tumours, and he believes that TCM’s strength lies within its focus on overall regulation and individuation. ‘TCM practitioners focus on regulating the patient’s body, and as a result is more focused on the ‘afflicted person’, taking care to preserve the patient’s spirits and strength in order to improve the quality of life and build up resistance.  Individuation (or personalisation) is another feature of TCM, and prescriptions are customised per the patient’s constitution and somatotype.’
  

Dr. Tao concludes by noting that medicines of various effects are combined in compound decoctions, complicating herbal therapy to such an extent that it remains poorly documented by modern pharmacological methodologies.  Whereas conventional targeted therapy interferes with a narrow range of specific molecules, TCM herbal therapy takes a broader approach and may be able to pinpoint a higher number of these specific targets, which may improve therapeutic outcomes.


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