The Quality of Life Influences of Psycho-behavioral Interventions on Chinese Traditional Medicine Science

Mei Yun Yu^*

Clinical Instructor of Nursing, School of Nursing, Fooyin University, Taiwan

*Corresponding Author:

Mei Yun Yu
RN, BSN, Clinical Instructor of Nursing, School of Nursing
Fooyin University, Taiwan
Tel: + 886-2-8966-6514
E-mail: sv053@fy.edu.tw

Received date: September 05, 2017; Accepted date: September 12, 2017; Published date: September 15, 2017

Citation: Yu MY (2017) The Quality of Life Influences of Psycho-behavioral Interventions on Chinese Traditional Medicine Science. J Tradit Med Clin Natur 6:244.

Copyright: © 2017 Yu MY. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Journal of Traditional Medicine & Clinical Naturopathy

Introduction

Patients suffered from various of diseases or symptoms, including physical and psychological distress, such as fatigue, anxiety, depression, and pain, through the progression of the disease. Those psychological and physiological impairments lower their quality of life. The current trend that not only from pharmacological interventions but a more comprehensive approach to ease up symptoms and improving quality of life [1]. Psychobehavioral interventions (PBIs) developed to help and cope with the daily life of patients. The healthy body maintains a steady state of energy influx and expenditure needs to be able to fight against the invasion of microorganisms, and foreign substances rely on a series of dynamic biochemical reactions.

PBIs consists of psychosocial, behavioral and physical therapeutic methods, PBIs include a series of non-pharmacological approaches, mainly utilizing stress management, cognitive-behavioral therapy, and physical training. The early focus of PBIs aims at improving mental health [2] but has extended to relieve adverse side effects of cancer chemotherapy through relaxation, hypnosis, and distraction pathway [3-5]. With greater acceptance of PBIs in the medical community during the past decade become a very promising approach for quality improvement in cancer patients [6-9].

Life Influence Factors of TCM

A study noted that changes in lifestyle require participants to establish a comprehensive approach toward their cancer therapy. Changes in behavior include (1) a healthy diet; (2) movement; (3) use of complementary/alternative medicines; and (4) stress reduction [10]. Other researchers have shown similar results, especially regarding food intake, where a diet rich in fruit and vegetables and avoiding animal fats is important [11-13]. Likewise, another researcher showed sugar and animal proteins support the growth of cancer cells, such foods are called ‘cancer promoters’ while foods that reduce the proliferation of cancer cells are called ‘cancer suppressors [14-16]. Accordingly, people with cancer could benefit greatly by avoiding cancer-promoter and consuming cancer-suppressor food types. This behavior could delay cancer cell growth or even promote apoptosis of cancer cells. Thomas and Davies (2007) reported that a proper diet (increased dietary vitamins, selenium, all fish, and carotenoids) promoted cancer patient health. Additionally, some foods were considered harmful. They recommended reducing saturated fats, meat intake, and exposure to potential carcinogens, such as foods high in fat, salt, sugar, and food additives, which may harm for human tissue. Patients with cancer who under took healthy lifestyles improved their physical and psychological well-being, reduced risks from treatment, enhanced their self-esteem, and reduced the risk of recurrence. Their overall chances of survival improved [11].

The typical Chinese put family at the priority of life, feel completed to live with children. However, since suffering from cancer, they focus more on their health needs [9].

Taiwanese women who have cervical cancer highly valued the advice held within traditional Chinese medicine (T C M). For example, traditional Chinese medicine recommends the best sleeping hours are from 11:00 pm to 4:00 am. TCM thinks gall bladder channel restores from 11:00 pm to 1:00 am, and liver channel runs from 1:00 am to 3:00 am. Gallbladder channel and liver channel are cofactors to fulfill proper functions of other organs, both helpful in digestion and blood detoxification [14].

Women in Asia are influenced by the recommendations and norms of Chinese medicine. Payne, Chapman, and Holloway (2008) found Chinese people view food as: (1) having therapeutic value; (2) having aspects of risk; and (3) being supportive and comforting. Kimlin, Ashing-Giwa, Jung-Wonand, and Patricia (2010) found that the comfort and survival of cancer patients were significantly related to race, income, and education background [10]. Women eat more fiber, vitamin C, vitamin E, vitamin A, α-carotene, β-carotene, lutein, and folate that would reduce 40–60% the risk of cervical cancer. For victims of cervical cancer of a Chinese cultural background, diet, sleep, and exercise have all been nominated as important lifestyle considerations [8]. People believe that some foods cause the progression of cervical cancer while others guard against it. This is encapsulated in the Taiwanese expression: ‘Food is better for the body than [1]. Researchers found statistically significant correlations between lifestyle changes (including changes in diet and exercise) and improved mood and ability to cope with the discomfort of cancer. Further study found that healthy lifestyles reduce the side effects of treatment as well as cancer relapse rates [10]. They also result in increases in self-esteem, physical and mental status, better immunity, and reduced fatigue [10].

Everyone needs to do a moderate activity and rest according to their physical condition. This is an integral part of the health. Physical activity is linked to increased functional capacity, improved mood, decreased nausea, increased immune function, decreased fatigue, improved health perceptions, and well-being [14]. Lack of sleep is associated with increased rates of infection and even mortality [13]. People who experience good quality sleep recover better physically and emotionally from stressful events. They have higher levels of energy and mental awareness. A study showed that negative thinking impairs the body’s immune system and accelerates the progression of the disease. Finally, while genetics play a role in the acquisition of cancer, the most prominent cause is a lifestyle, especially exercises and diet.

Dietary Factors of TCMs

Researchers found that significant levels of phenolics, flavonoids and trace metal contents in TCM herbal or food correlated well with antioxidant and anti-inflammatory activities. Some of the plants displayed high antioxidant and anti-inflammatory activities but contained low levels of phenolics and flavonoids. Interestingly, these plants contained significant levels of trace metals which are likely to be responsible for their activities [8].

Many natural products and their derivatives have been reported to have cancer chemopreventive effects in vitro and in vivo. Majority of these compounds also possess anti-oxidation and anti-inflammatory properties. On the other hand, several clinically used anti-inflammatory drugs like tumor necrosis factors (TNF) blockers have been associated with some reported cases of lymphoma and other cancers in children and young adults. These conflicting reports are because the immune system is an integral part of the body’s defense mechanism against cancer cells as well as pathogenic microorganisms. When the immune system is overwhelmed by anti-inflammatory drugs over an extended period, cancer cells can continue to grow. Therefore, the key to prevent cancer and have a good quality of life without debilitating diseases is to maintain a dynamic balance between anti-inflammatory and proinflammatory factors [2].

In this review, we have presented representative groups of plants and food with longevity-promoting potential. For example, chocolate and red wine have attracted a lot of attention lately. Chocolate with antioxidant flavonols has been reported to decrease blood pressure, LDL and cholesterol, increase insulin sensitivity and B cell function, and may even prevent heart disease. However, due to its sugar content in most commercial products, over consumption may contribute to obesity and diabetes. Resveratrol from red wine has been reported to have antioxidant and many beneficial effects in experimental models. Again over the use of either red wine or the phenolic resveratrol preparations may have significant side effects like alcoholism and redox imbalance, respectively. Therefore, the key to longevity and high quality of life is to maintain a delicate balance through healthy life style and proper intake of a wide variety of health food [8].

TCM dietary supplement (DS) assessed by research, entered into the meta-analysis. In this trial, 43 advanced ovarian cancer patients were assigned to receive chemotherapy plus two years of TCM DS and compared to patients given only chemotherapy. Quality of life was significantly improved in patients who underwent TCM DS compared with the pure chemotherapy group. The former group also displayed a significant increase in CD4+ lymphocytes and NK activity with a reduction in the number of CD8+ cells [7].

PBIs of TCM

Acupuncture

The result of eleven high-quality clinical trials with 968 cancer patients evaluated acupuncture and entered the meta-analysis showed that acupuncture improved the overall quality of life in cancer patients as assessed by the KPS remission rate scale. In particular, acupuncture relieved fatigue reduced diarrhea and shortened the time to first flatulence despite failing to relieve symptoms of depression [4].

Therapeutic Chinese Massage

The effect of Chinese massage of quality of life was assessed in 4 trials of 595 patients included. Chinese massage reduced time to first flatulence and intestinal peristaltic sound following surgery [4].

Tai chi

Researchers reported that a positive association between Tai Chi and quality of life in cancer patients. Indeed, in one study that scored four according to the Jadad Scale, 67 patients were assigned to receive a 6-month intervention of Tai Chi as compared to a control group. Patients who underwent Tai Chi had less postoperative upper limb lymphedema, Tai Chi increased circulating concentrations of IgA, IgG and IgM and improved lung function, sleep quality and limb muscle strength in cancer patients. Tai Chi also alleviated fatigue and reduced distress [4].

Qigong

There are limited clinical trials with Qigong; one is high-quality research in the meta-analysis. This clinical trial showed that the practice of Qigong in women with breast cancer resulted in less fatigue and improved quality of life as compared to the control group, but no significant differences were observed for sleep quality.

Discussion

TCMs originated and are mostly practiced in China, various growing acceptance of PBIs spread globally. Many TCM trials have reported on different aspects. The quality of life measurements includes pain, depression, insomnia, fatigue, diarrhea and intestinal dysfunction, relieved by TCM PBIs. Acupuncture, the common form of TCM PBIs, improved quality of life via reducing depression, fatigue, diarrhea and gastrointestinal distress. Therapeutic Chinese massage reduced symptoms, such as flatulence and intestinal paralysis postsurgery [4].

Comparing TCM and non-TCM PBIs, both benefit to the quality of life in Chinese cancer patients. Importantly, TCM PBIs relieved fatigue, eased diarrhea, and improved gastrointestinal function followed surgery significantly. Several individual clinical studies have consistently established that acupuncture relieves fatigue and reduces diarrhea. The influences of acupuncture on depression symptom, different researchers had various outcomes; some researchers showed improvement, some researchers didn’t get consistent results. Tai Chi improves quality of life both of mental and physical, including fatigue, distress, and sleep quality [3].

The other highly effective influence factor improving patients’ health knowledge, health-care-management skills to make the change of health behavior is the role of care manager. The strong partnership between the patient, care manager, and physician attributes positive impact of health behavior changes [16].

Conclusion

TCM dietary, Qigong, and Tai chi are pathways to improve quality of life for cancer patients. Qigong and Tai chi improve the symptoms of fatigue and immune function via increasing cortisol level. TCM dietary encourages to intake natural food or supplement to absorb antioxidation and anti-inflammatory properties to enhance the function of the immune system [12].

Quality of life affected prognosis and survival rates of cancer patients strongly. Researchers showed that TCM dietary and PBIs significantly improve their quality of life. Occurs because TCM is associated with relieving pain, depression, sleep loss, fatigue, diarrhea and gastrointestinal dysfunction [11]. TCM PBIs represent beneficial adjunctive therapy for cancer patients. The current evidenced-based researchers are still limited, expect more evidenced-based researches in the future.

References

1. Chen YQ (2011) People clean cell of cancer every day. Taipei, Taiwan, ROC: China Times Publishing Co, Ltd. (Original work published in Chinese).
2. Ravipati AS, Zhang L, Koyyalamudi SR, Jeong SC, Reddy N, et al. (2012) Antioxidant and anti-inflammatory activities of selected Chinese medicinal plants and their relation with antioxidant content. Complement Altern Med 12: 1-14.
3. Chang M L (2011) Introduction to Traditional Chinese Medicine in Nursing. Taipei, Taiwan, ROC: New Wun Ching Developmental Publishing Co, Ltd. (Original work published in Chinese)
4. Tao WW, Luo X, Cui B, Liang D, Wang C, et al. (2015) The practice of traditional Chinese medicine for psycho-behavioral intervention improves quality of life in cancer patients: A systematic review and meta-analysis. Oncotarget6: 39275-39739.
5. Lien JC, Lien LM, Wang J (2010) Longevity Depends on a Balance between Proinflammatory and Anti-Inflammatory Factors: Use of Tcms and Natural Products.Curr Drug Discov Technol 7: 13-21.
6. Clemmens DA, Knafl K, Lev EL, McCorkle R (2008) Cervical Cancer: Patterns of Long-Term Survival. Oncol Nurs Forum 35: 897-903.
7. Doyle C, Kushi LH, Byers T, Courney AS, Demark-Wahnefried D, et al. (2006) Nutrition and physical activity during and after cancer treatment: an American cancer society guide for informed choices. CA Cancer J Clin 56: 323-353.
8. Ghosh C, Baker J, Moysich K, Rivera R, Brasure JR, et al. (2008) Dietary intakes of selected nutrients and food groups and risk of cervical cancer. Nutr Cancer 60: 331-341.
9. Hewitt M, Rowland JH, Yancik R (2003) Cancer survivors in the United States: Health and disability.Psycho-Oncology 58: 82-91.
10. Ashing-Giwa KT, Lim JW, Gonzalez P (2010) Exploring the Relationship between physical well-being and healthy lifestyle changes among. European- and Latina-American breast and cervical cancer survivor. Psychooncology 19: 1161-1170.
11. Thomas R, Davies N (2007) Lifestyle during and after cancer treatment. Clin Oncol 19: 16-627.
12. Steven D, Fitch M, Dhaliwal H, Kirk-Gardner R, Sevean P, et al. (2004) Knowledge, attitudes, beliefs, and practices regarding Breast and cervical cancer screening in selected ethnic, cultural groups in Northwestern Ontario. Oncol Nurs Forum 31: 305-311.
13. Korfage IJ, Essink-Bot ML, Mols F, van de Poll-Franse L, Kruitwagen R, et al. (2009) Health-related quality of life in cervical cancer survivors: a population-based survey. Int J Radiat Oncol Biol Phys 73: 1501-1509.
14. Payne JE, Alice Chapman S, Holloway M (2008) Older Chinese people's views on food: Implications for supportive, Ethnicity & Health 13: 728-733.
15. Wang C, Lin J, Chen L (2010) Personal health maintenance: the perspective of traditional Chinese medicine [Chinese]. J Nursing 57: 10-15.
16. Ciccone MM, Aquilino A, Cortese F, Scicchitano P, Sassara M, et al. (2010) Feasibility and effectiveness of a disease and care management model in the primary health care system for patients with heart failure and diabetes(Project Leonardo). Vasc Health Risk Manag 6: 297-305.