中医药研究论丛

231.6 活血法运用在肿瘤造成之上腔静脉症候群之文献回顾
TJ TCM.23(1) : 71-76, 2020
DOI : 10.6516/TJTCM.202003_23(1).0006
活血法运用在肿瘤造成之上腔静脉症候群之文献回顾
Literature Review of the Blood-Activating Drugs in Treatment of Supra Vena Cava Syndrome
杨雅媜1 蔡嘉一1*
1 台中荣民总医院传统医学科,台中,台湾
【摘要】
癌症治疗过程中,上腔静脉症候群(supra vena cava syndrome,SVCS)的出现往往会导致不好的预後,中医在活血药物的使用上可以帮助上腔静脉因肿瘤压迫之侧枝循环的建立,进而改善临床症状,替病患争取时间分析肿瘤细胞型态,及时给予化学药物、放射线照射或手术治疗。而学者普遍担心活血药是否也会加强肿瘤细胞血管的新生造成转移,文献分析指出活血药确有增加肿瘤细胞血管新生的能力,但在动物学研究上已证实中药如黄耆、姜黄等补气活血中药,可让肝肿瘤异常增生的血管细胞「正常化」,正常化的血管则可以改善肿瘤细胞局部缺氧状况,另透过减少低氧诱导因子(hypoxia--induced factor,HIF),进而使血管内皮生长因子(vascular endothelial growth factor,VEGF)生成下降。上述作用则可抑制肿瘤细胞的生长以及扩散。
总结以上,上腔静脉症候群为肿瘤治疗之并发症急症,活血法在上腔静脉症候群的患者可替其争取时间获得抗癌等治疗,并明显缓解临床不适之症状。
【关键词】上腔静脉症候群、supra vena cava syndrome、SVCS、活血法、中西医治疗
Ya-Chen Yang1 Chia-I Tsai1*
1Department of Chinese Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
【Summary】
During the cancer therapy, the appearance of supra vena cava syndrome (SVCS) often leads to poor prognosis. The use of blood-activating drugs in traditional Chinese medicine can help the establishment of the collateral circulation of the superior vena cava which can relieve the clinical symptoms.
Patients are able to gain more time to analyze tumor cell type which timely accepted chemotherapy, radiation therapy or surgery. Scholars generally worry about blood-activating drugs will enhance the angiogenesis of tumor cells which may concern its safety. So we analysis the literature which indicates that bloodactivating drugs do have the ability to increase tumor cell angiogenesis, but more over it can establish effective perfusion, in addition to improving local anoxic status of tumor cells. The reduction of hypoxia-induced factor (HIF), which leads to the decrease of vascular endothelial growth factor (VEGF) production. Due to blood-activating drugs established effective perfusion, chemical drugs can poison the tumor cell more directly.
To sum up, the superior vena cava syndrome is a urgent clinical complication during cancer therapy. The patients with supra vena cava syndrome can take blood-activating drugs to relieve the symptoms of clinical discomfort, also gain more time to obtain anticancer therapy.
Keywordssupra vena cava syndrome, SVCS, blood-activating drugs, Chinese medicine combine care