EBM- ????? ?????? ??????? ???? ????

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• ?"?.

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EBM- ????? ?????? ??????? ???? ????

• ????? ??????.
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• ?? ???? ?? ???? ????? ????? ??????? ???? ?????
  (?????? ??? ?????...).

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• ?????? ???? ??????? ???? ????? !
• (??? ?? ????? ????? ???, ??? ?????? ???
  ??????, ??? ???????...)

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????? ??? ??????????? ?????? ??????

• ??? ???? ??????- ??? ????? ??????. ??? ????? ??
  ??????? ??? ???????.
• ??? ????????, ??? ?? ???????? ???? ?????? ???????
  ?????? ???- ?????? ????? ????? ?????.

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6
Fluoxetine Versus Placebo in Advanced Cancer
Outpatients A Double-Blinded Trial of the
Hoosier Oncology Group

• Michael J. Fisch, Patrick J. Loehrer, Jean
  Kristeller, Steven Passik, Sin-Ho Jung, Jianzhao
  Shen, Matthew A. Arquette,Mary J. Brames, and
  Lawrence H. Einhorn.

• Journal of Clinical Oncology, Vol 21, No 10 (May
  15), 2003 pp 1937-1943

7
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• 163 ????? ?? ????? ???? ????? ?? 3-24 ??????,
  ???? ?????.
• ?? ????? ????? ?????? ???? ???? ????? ?????
  ??????, ?? ????????.
• ????? ?????? ?????? (20 ?"?) ?? ?????.
• ???? ???? 12 ??????.
• ????? ???? (QOL) ??? ?????. ?????? ??? ????. ?? ?
  3 ??????.
• 80 ?????? ????? ????? ???? ???.

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1. During the past month, have you often been
   bothered by feeling down, depressed, or
   hopeless?
2. During the past month, have you often been
   bothered by having little interest or pleasure in
   doing things?

9
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• In summary, this study demonstrated that
  simple two-question screening for depressive
  symptoms followed by treatment with a once-a-day
  pill proved effective in identifying and treating
  depressive symptoms and, hence, improving QOL in
  patients with advanced cancer.

10
????? ?????

• ???? ?????? ???? ????? ??????? ?? ??? ??????
  ??????.
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  ??????. ???? ???? -???? ??? ????? ??? ???? ?????
  ?????.
• ?? ????? ??????????? ???? ?????. ???? ?????
  ??????? ?? ????? ????...

11
Improvement in mood, physical symptoms, and
function with nortriptyline for depression in
patients with chronic obstructive pulmonary
disease

• Borson S, McDonald GJ, Gayle T, Deffebach M,
  Lakshminarayan S, Van Tuinen C.

• Psychosomatics 199233190- 201.

12
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• Thirty patients completed a 12-week,
  randomized controlled trial of nortriptyline.
  Nortriptyline was clearly superior to placebo for
  treatment of depression. Nortriptyline treatment
  was accompanied by marked improvements in
  anxiety, certain respiratory symptoms, overall
  physical comfort, and day-to-day function
  placebo effects were negligible

13
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• Trazodil- Trazadone- Depyerl
• Bonserin-Mianserin
• Remeron-Miro-Mitrazepine

14
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15
Patient-Controlled Methylphenidate for Cancer
Fatigue A Double-Blind, Randomized,
Placebo-Controlled Trial

• JOURNAL OF CLINICAL ONCOLOGY, VOLUME 24 NUMBER
  13, MAY 1 2006

• Eduardo Bruera, Vicente Valero, Larry Driver,
  Loren Shen, Jie Willey, Tao Zhang, and J. Lynn
  Palmer

16
??? ??? ?????? ((Methylphenidate

• ?? 4 ????? ????.
• 5 ?"? ??? ???.
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• Both methylphenidate and placebo resulted in
  significant symptom improvement. Methylphenidate
  was not significantly superior to placebo after 1
  week of treatment. Longer study duration is
  justified.

18
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• daily telephone call by a research nurse. We
  believe that this telephone
• call was a powerful intervention, enhancing the
  patients overall symptom relief and comfort

20
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22
Psychostimulants in supportive care Support Care
Cancer (2000) 8 385397Jade Homsi, Declan
Walsh, Kristine A. Nelson
23
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• 2007- ????? ???? ????? ????? ?????...
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  ?????? ??? ???? ??????? ?? ??????.

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