飲用氫水提高癌症患者生活品質

http://www.medicalgasresearch.com/content/1/1/11

Effects of drinking hydrogen-rich water on the quality of life of patients treated with radiotherapy for liver tumors

飲用氫水治療肝腫瘤放療患者的生活質量的影響

Ki-Mun Kang ¹ , Young-Nam Kang ¹ , Ihil-Bong Choi ^{1 , 2} , Yeunhwa Gu ^{3 , 2} , Tomohiro Kawamura ⁴ , Yoshiya Toyoda ⁴ and Atsunori Nakao ^{4 , 5 *} 文門康 ， 楊南康 ¹ ，Ihil奉財 ^{1 ， 2} ，Yeunhwa谷 ^{3 ， 2} ， 智博河村 ⁴ ， 快哉豐田 ⁴ Atsunori中尾 ^{4 ， 5 * 1}*通訊作者：Atsunori中尾anakao@imap.pitt.edu

Author Affiliations 作者背景

¹ Department of Therapeutic Radiology, Gyeongsang National University Hospital, Gyeongsang Institute of Health Sciences, Jinju, Korea ^1，韓國，晉州慶尚北道的健康科學研究所慶國立大學醫院，放射治療，

² Department of Radiation Oncology, Catholic University Medical College, Seoul, Korea ^2，韓國，首爾天主教大學醫學院放射腫瘤部

³ Graduate School of Health Science, Suzuka University of Medical Science, Suzuka, Japan鈴鹿賽道，日本鈴鹿大學醫學科學，健康科學研究生院

⁴ Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA ^4，美國匹茲堡大學，匹茲堡，賓夕法尼亞州，美國胸心外科

⁵ Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA ^5，美國匹茲堡大學，匹茲堡，賓夕法尼亞州，美國外科部

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Medical Gas Research 2011, 1 :11 doi:10.1186/2045-9912-1-11 醫用氣體研究 2011，1：11 作者：10.1186/2045-9912-1-11

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© 2011 Kang et al; licensee BioMed Central Ltd. © 2011康等;持牌BioMed Central的公司

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.這是一個開放訪問的文章分佈的條件下在Creative Commons Attribution許可（ http://creativecommons.org/licenses/by/2.0），它允許在任何媒體上無限制地使用，分發和複製，提供了原來的工作是正確引用。

Abstract摘要

Background背景

Cancer patients receiving radiotherapy often experience fatigue and impaired quality of life (QOL).接受放療的癌症患者常常出現疲勞和受損的生活質量（QOL）。 Many side effects of radiotherapy are believed to be associated with increased oxidative stress and inflammation due to the generation of reactive oxygen species during radiotherapy.許多副作用放療被認為是由於放療期間生成的活性氧增加氧化應激和炎症相關。 Hydrogen can be administered as a therapeutic medical gas, has antioxidant properties, and reduces inflammation in tissues.氫氣可以作為一種治療的醫療氣體管理，具有抗氧化性能，並減少組織炎症。 This study examined whether hydrogen treatment, in the form of hydrogen-supplemented water, improved QOL in patients receiving radiotherapy.這項研究是否治療氫，氫補充水的形式，在接受放療的患者提高生活質量。

Methods方法

A randomized, placebo-controlled study was performed to evaluate the effects of drinking hydrogen-rich water on 49 patients receiving radiotherapy for malignant liver tumors.一項隨機，安慰劑對照研究，評估 49接受放射治療惡性肝腫瘤的患者飲用富含氫的水影響。 Hydrogen-rich water was produced by placing a metallic magnesium stick into drinking water (final hydrogen concentration; 0.55~0.65 mM).富氫水生產飲用水（最後的氫濃度; 0.55〜0.65毫米）放入一個金屬鎂棒。 The Korean version of the European Organization for Research and Treatment of Cancer’s QLQ-C30 instrument was used to evaluate global health status and QOL.韓版的歐洲組織的研究和治療癌症的QLQ – C30儀器是用來評估全球健康狀況和生活質量。 The concentration of derivatives of reactive oxidative metabolites and biological antioxidant power in the peripheral blood were assessed.衍生物的活性氧化代謝產物和生物抗氧化能力，在外周血中的濃度進行了評估。

Results結果

The consumption of hydrogen-rich water for 6 weeks reduced reactive oxygen metabolites in the blood and maintained blood oxidation potential. 6週富氫水的消耗降低活性氧代謝物在血液和保持血液氧化電位。 QOL scores during radiotherapy were significantly improved in patients treated with hydrogen-rich water compared to patients receiving placebo water.放療期間的生活質量評分均顯著改善，在治療的患者相比，患者接受安慰劑水及氫水。 There was no difference in tumor response to radiotherapy between the two groups.腫瘤放療兩組間無差異。

Conclusions結論

Daily consumption of hydrogen-rich water is a potentially novel, therapeutic strategy for improving QOL after radiation exposure.富氫水的日常消費，輻射照射後，生活質量改善的一個潛在的新的治療策略。 Consumption of hydrogen-rich water reduces the biological reaction to radiation-induced oxidative stress without compromising anti-tumor effects.富氫水的消費量減少而不影響抗腫瘤作用的生物輻射誘導的氧化應激反應。

Background背景

Radiotherapy is one of the major treatment options for malignant neoplasms.放射治療是惡性腫瘤的主要治療方案之一。 Nearly half of all newly diagnosed cancer patients will receive radiotherapy at some point during treatment and up to 25% may receive radiotherapy a second time所有新診斷的癌症患者中，有將近一半在某些時候會接受放療在治療過程中，高達 25％，可能會收到第二次放療 [ 1 ]. [ 1 ]。 While radiotherapy destroys malignant cells, it adversely affects the surrounding normal cells雖然放療破壞惡性細胞，產生不利影響周圍正常的細胞 [ 2 ]. [ 2 ]。 Acute radiation-associated side effects include fatigue, nausea, diarrhea, dry mouth, loss of appetite, hair loss, sore skin, and depression.急性輻射相關的副作用包括疲勞，噁心，腹瀉，口乾，食慾不振，脫髮，皮膚疼痛，和抑鬱症。 Radiation increases the long-term risk of cancer, central nervous system disorders, cardiovascular disease, and cataracts.輻射增加癌症，中樞神經系統疾病，心血管疾病和白內障的長期風險。 The likelihood of radiation-induced complications is related to the volume of the irradiated organ, the radiation dose delivered, the fractionation of the delivered dose, the delivery of radiation modifiers, and individual radiosensitivity輻射引起的並發症的可能性是與量照射的器官，輻射劑量，劑量的分餾，輻射改性劑的交付，以及個人的放射敏感性 [ 3 ]. [ 3 ]。 Most radiation-induced symptoms are believed to be associated with increased oxidative stress and inflammation, due to the generation of reactive oxygen species (ROS) during radiotherapy, and may significantly affect the patient’s quality of life (QOL)大多數輻射誘發的症狀被認為是增加氧化應激和炎症，由於放療期間生成的活性氧（ROS），並有可能顯著影響病人的生活質量（QOL） [ 2 ]. [ 2 ]。

Hydrogen, a therapeutic medical gas, has antioxidant properties and reduces inflammatory events in tissues治療的醫療氣體，氫氣，有抗氧化性能，並降低組織的炎症事件 [ 4 – 6 ]. [ 4 – 6 ]。 Drinking liquids supplemented with hydrogen represents a novel method of hydrogen gas delivery that is easily translatable into clinical practice, with beneficial effects for several medical conditions, including atherosclerosis, type 2 diabetes, metabolic syndrome, and cognitive impairment during aging and in Parkinson’s disease喝氫補充液體，代表了氫的氣體輸送到臨床實踐中，很容易翻譯的新方法，有益的影響，一些醫療條件，包括動脈粥樣硬化，2型糖尿病，代謝綜合徵，並在老齡化和帕金森氏病認知功能障礙 [ 7 – 11 ]. [ 7 – 11 ]。 Currently, there is no definitive therapy to improve the QOL of patients receiving radiotherapy.目前，還沒有確切的治療，接受放療的患者提高生活質量。 Drinking solubilized hydrogen on a daily basis may be beneficial and would be quite easy to administer without complicating or changing a patient’s lifestyle.每天飲用溶解氫可能是有益的，將很容易管理，而無需複雜或改變病人的生活方式。 We hypothesized that oral intake of hydrogen-rich water, generated via a magnesium stick, would reduce adverse events in patients receiving radiotherapy.我們推測，口服攝入含氫的水，減少不良事件的患者在接受放療。

Methods方法

Subjects and design題材和設計

The study was a two-arm, randomized, controlled clinical trial.這項研究是一個雙手臂，隨機，對照臨床試驗。 Patients were randomly assigned to receive either hydrogen-rich water or placebo water on the first day of radiation treatment, and received follow-up questionnaires on compliance and potential adverse effects.患者被隨機分配接受放射治療的第一天，要么富含氫的水或安慰劑水，而收到的對合規性和潛在的不利影響後續調查問卷。 Eligible patients were informed of the study during scheduling of pre-radiation testing.符合條件的患者被告知在預輻射測試調度的研究。 Patient characteristics, including tumor origin and the specifics of radiotherapy, are listed in Table病人的特點，包括腫瘤的起源和放療的具體，列於表 1 . 1 。 Forty-nine subjects (33 men and 16 women) were enrolled between April and October 2006.四十九名受試者（33名男性和16名女性），參加 4月和2006年10月之間。 The age of the patients ranged from 21 to 82 years (mean age 58.6 years).患者年齡從 21歲到82歲不等（平均年齡 58.6歲）。 All patients were diagnosed either histologically or pathologically with hepatocellular carcinoma (HCC) or metastatic hepatic tumors.所有患者均組織學或病理診斷與肝細胞癌（HCC）或轉移性肝腫瘤。 All participants received 5040-6500 cGy of radiotherapy for 7-8 weeks using a 6 MV system (Cyber Knife, Fanuc, Yamanashi, Japan).所有與會者都收到7-8週使用了6 mV的系統（網絡刀，發那科，山梨，日本）5040-6500放療 CGY。 The planned target volume of the initial field was assessed by a localization/simulation procedure or by computed tomography (CT)-assisted planning and encompassed the primary tumors and a 2 cm margin.計劃靶體積的初始場進行了評估本地化/仿真程序或計算機斷層掃描（CT），協助規劃，包括原發腫瘤和2厘米的保證金。 Blocks were used to shield normal tissue.塊被用來屏蔽正常組織。

Table 1. Patient Characteristics 表1患者特徵

Hydrogen-rich water was produced by placing a metallic magnesium stick (Doctor SUISOSUI ^® , Friendear, Tokyo, Japan) into drinking water (Mg + 2H ₂ O → Mg (OH) ₂ + H ₂ ; final hydrogen concentration: 0.55~0.65 mM). Subjects were provided with four 500 mL bottles of drinking water per day and instructed to place two magnesium sticks in each bottle of water at the end of each day in preparation for consumption the following day.受試者提供了四個 500毫升。 Participants were asked to drink 200-300 mL from one bottle each morning, and 100-200 mL every a few hours from the remaining three bottles.參與者被要求每天早上喝一瓶200-300毫升，和100-200毫升每幾個小時，從剩下的三瓶。 Subjects were instructed to reuse the magnesium sticks by transferring the sticks to a new bottle of water after use.The subjects were expected to consume 100-300 mL of hydrogen-rich water more than 10 times per day for a total minimum consumption of 1500 mL (1.5 L) and a maximum consumption of 2000 mL (2.0 L).受試者預計將消耗100-300毫升富含氫的水超過 10倍，總消費量最低的1500毫升（1.5升）和2000毫升（2.0升）每天最大消費。 Oral intake of hydrogen water or placebo water started on the first day of radiotherapy and continued for 6 weeks.氫的水或安慰劑水誤服放射治療的第一天開始，持續 6個星期。 All the patients survived through the 6 week follow-up period when the QOL questionnaire was administered.所有患者存活通過 6週的隨訪期間，生活質量問卷調查時，被管理。 This study was conducted in accordance with Good Clinical Practice guidelines and the ethical principles of the Declaration of Helsinki (2000).這項研究是根據具有良好的臨床實踐準則和倫理原則的赫爾辛基宣言“（2000）。 The study protocol and materials were approved by the Institutional Review Board of Catholic University Medical College, and all subjects provided written informed consent prior to participation.天主教大學醫學院的機構審查委員會批准的研究方案和材料，並提供所有受試者知情同意書參與前。

QOL Assessment生活質量評估

The Korean version of the European Organization for Research and Treatment of Cancer’s QLQ-C30 instrument with modifications was used to evaluate global health status and create QOL scales韓版的研究和治療癌症的QLQ – C30儀器進行了修改歐洲組織用於評估全球健康狀況，並創造生活質量的尺度 [ 12 ]. [ 12 ]。 The descriptive, mailed survey developed by our institute was used in this study.在這項研究中使用的描述，郵寄調查研究所開發。 The questionnaire contains five functional scales (physical, cognitive, emotional, social, and role-functioning), three symptom scales (pain, fatigue, and nausea/vomiting), and six single items to assess additional symptoms (dyspnea, insomnia, loss of appetite, constipation, diarrhea).問卷包含五個功能尺度的身體，認知，情感，社會，和角色運作，三個尺度症狀（疼痛，疲勞，噁心 /嘔吐），和6個單品，以評估其他症狀（呼吸困難，失眠，喪失食慾不振，便秘，腹瀉）。 For all items, a response scale ranging from 0-5 was used.所有項目，規模不等，從 0-5響應。 A higher score reflected a higher level of symptoms and decreased QOL.分數越高，反映了一個更高的症狀水平，降低生活質量。 Assessments were performed before radiotherapy and every week for 6 weeks after the initiation of radiotherapy.評估進行了6週後開始放療，放療前和每週。

Biomarker analysis生物標誌物分析

The concentrations of derivatives of reactive oxidative metabolites (dROMs) and biological antioxidant power (BAP) in the peripheral blood were assessed using a free Radical Analytical System (FRAS4; H&D, Parma, Italy) on the first day of radiation therapy (week 0) and after 6 weeks of radiotherapy.活性氧化代謝物（dROMs）和外周血中生物抗氧化劑功率（BAP）等衍生物的濃度是評估使用一個免費自由基分析系統（FRAS4; H＆D帕爾馬，意大利）的放射治療的第一天（0週）放療後 6個星期。 Blood samples were obtained from all patients after overnight fasting.隔夜空腹後，所有患者的血液標本。 FRAS4 dROMs kits were used to measure total hydroperoxide levels, which are representative of the total dROMs produced as a result of peroxidation chain reactions of proteins, lipids, and amino acids. FRAS4 dROMs包被用來衡量總氫的水平，這是代表的蛋白質，脂肪，和氨基酸的過氧化連鎖反應的結果所產生的總 dROMs。 Results were expressed in U.CARR; 1 U.CARR is equivalent to 0.08 mg/dl of hydrogen peroxide and the value is directly proportional to the concentration, according to Lambert-Beer’s law.結果表示U中卡爾; 1 U。卡爾相當於 0.08毫克/升的過氧化氫和價值是成正比的濃度，根據朗伯 – 比爾定律。

Redox potential, including glutathione peroxidase and superoxide dismutase, were determined using the FRAS4 BAP test氧化還原電位，包括穀胱甘肽過氧化物酶和超氧化物歧化酶，確定使用FRAS4 BAP的測試 [ 13 ]. [ 13 ]。 Described briefly, the samples to be tested were dissolved in a colored solution containing a source of ferric ions and a chromogenic substance (a sulfur-derived compound).簡要介紹，被測試的樣品溶解在彩色含有鐵離子源和顯色物質（一種含硫派生的化合物）的解決方案。 After a 5-minute incubation period, the degree of discoloration and intensity of the change were directly proportional to the ability of the plasma to reduce ferric ions.經過 5分鐘的潛伏期，變色和強度的變化程度是成正比的能力，以減少鐵離子的等離子體。 The amount of reduced ferric ions was calculated using a photometer to assess the intensity of discoloration; BAP results were expressed as µmol/l of reduced Fe/l.降低鐵離子的數量計算使用光度計評估變色的力度;μmol/ L的減少鐵 / L BAP的結果表示

Blood chemistry tests for aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transpeptidase ( γ -GTP), and total cholesterol, as well as blood hematology tests for red blood cell count, white blood cell count, and platelet count were conducted at week 0 and week 6 using standard assays in an accredited hospital laboratory.在0週和穀草轉氨酶，谷丙轉氨酶，γ-谷氨酰transpeptidase（γ- GTP），總膽固醇，以及血紅細胞計數，白細胞計數，血小板計數血液學檢驗血液化學測試進行第6週在認可的醫院實驗室使用的標準檢測。

Assessment of response響應評估

Patients underwent dynamic CT scans 1-2 months after completion of radiation treatment and tumor response was checked at 2-3 month intervals thereafter.對患者進行動態 CT掃描的放射治療和腫瘤的反應是在此後每隔2-3個月檢查完成後 1-2個月。 Treatment response and local recurrence were evaluated using follow-up dynamic CT scans and serum tests for alpha-fetoprotein (AFP) and prothrombin, which is induced by vitamin K absence or antagonist-II (PIVKA-II).使用後續的動態 CT掃描和血清甲胎蛋白（AFP）和凝血酶原，這是由維生素 K缺乏或拮抗劑 II（PIVKA -Ⅱ）誘導試驗評估治療的反應和局部復發。 Tumor response was determined by the criteria established by Kwon et al. Kwon 等人建立的標準確定腫瘤反應。 [ 14 ]. [ 14 ]。 Described briefly, complete response (CR) was defined as the disappearance of any intratumoral arterial enhancement in all target lesions.簡要介紹，被定義為完全緩解（CR）的任何靶病變動脈瘤在增強消失。 Partial response (PR) was defined as at least a 30% decrease in the sum of the diameters of viable target lesions.部分緩解（PR）被定義為至少是可行的靶病變直徑的總和減少 30％。 Progressive disease (PD) was defined as an at least 20% increase in the sum of the diameters of viable target lesions or the appearance of a new lesion.疾病進展（PD）被定義為一個可行的靶病變或出現一個新的病變直徑的總和增加至少20％。 Stable disease (SD) was defined as a tumor status that did not meet any of the above criteria.疾病穩定（SD）被定義為一個腫瘤的狀態，不符合上述任何條件。

Statistical analysis統計分析

Unpaired t tests were used to compare numerical data and the Yates 2 x 2 chi-square test or Fisher exact probability test was used to compare categorical data. 配對 t檢驗來比較數值數據和耶茨2 × 2的卡方檢驗或Fisher確切概率試驗比較採用分類數據。 Statistical analyses were performed using SAS 6.13 software (SAS Institute Inc., Cary, NC).統計分析採用 SAS 6.13軟件（SAS Institute公司，卡里，北卡羅來納州）。 The sample size of 49 patients was sufficient to detect a change in mean scores of RORTC QLQ-C30. 49例患者的樣本大小是足夠的檢測 RORTC QLQ – C30的平均分數的變化。

Results結果

Hydrogen water improved the QOL of patients receiving radiotherapy氫水接受放療的患者提高了生活質量

The QOL of the patients who were given placebo water deteriorated significantly within the first month of radiotherapy (Figure在服用安慰劑水的患者的生活質量惡化顯著放療的第一個月內（圖 1A ). 1A ）。 There were no differences between the groups in the QOL subscales for fatigue, depression, or sleep.疲勞，抑鬱，或睡眠有沒有在生活質量分量表組之間的差異。 Gastrointestinal (GI) symptoms are one of the most common complaints of patients undergoing radiotherapy and are considered to have a high impact on the patient’s QOL after 6 weeks of radiotherapy.胃腸道（GI）的症狀是患者接受放射治療的最常見的投訴之一，被認為有6週的放射治療後對病人的生活質量高衝擊。 The patients consuming hydrogen water experienced significantly less appetite loss and fewer tasting disorders compared to the patients consuming placebo water.患者的消耗氫水經歷了顯著食慾不振相比，患者耗時安慰劑水和品嚐障礙較少。 No significant difference was seen in the mean scores for vomiting or diarrhea (Figure在嘔吐或腹瀉（圖的平均得分沒有顯著差異 1B ). 1B ）。

Figure 1. Placebo water and hydrogen water improved the QOL of patients receiving radiotherapy . 圖1。安慰劑水和氫水接受放療的患者提高了生活質量。 A. Weekly assessment of the patients’ QOL. A.每週評估患者的生活質量。 B. Scoring system of GI symptoms after 6 weeks of radiotherapy with or without hydrogen water. B.氫水帶或不帶放療後 6個星期的胃腸道症狀評分系統。

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歡迎來電索取氫水辨認方法(防止喝到傷身的假氫水) 

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