中医药研究论丛

242.7 口腔癌化疗期间急性腹泻之病例报告
TJ TCM.24(2) : 83-92, 2021
口腔癌化疗期间急性腹泻之病例报告
A Case Report of Acute Chemotherapy-
Related Diarrhea in Buccal Cancer with Chinese Medicine
张薇乔1 廖厚勋1*
1 佛教慈济医疗财团法人大林慈济医院中医部,嘉义,台湾
【摘要】
腹泻为化疗药欧洲紫杉醇Taxotere 与铂金类药物同用常见之不良反应,并依严重程度可能同时伴随精神低下、体重下降等症状,甚则危及生命。本病例是一位72 岁男性,为一左颊黏膜癌复发患者复发,pT4aN0M0,stage IVA,此次入院行救援性化疗(salvage chemotherapy),於109/01 月底换化疗药,行第一轮欧洲紫杉醇(Taxotere)与顺铂(Carboplatin)之注射,五天後开始腹泻一日7-8 行,服西药止泻药舒腹达(Smecta)後减为一日3-4行,排便性质为水状便、食後腹泻、排便失禁等,诊断为脾虚湿阻,肾阳虚不固之腹泻,治以四神丸合四君子汤之加减,服用中药三天後腹泻次数减为一日一行,并且转为原先的糊便,且无排便失禁的症状并恢复食欲。显示在中医的辨证论治之下可以有效降低化疗期间产生之不适症状。
【关键词】紫杉醇、腹泻、口腔癌、体质、癌症性质
 
Wei-Chiao Chang1Hou-Hsun Liao1*
1Department of Chinese Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
【Summary】
Diarrhea is a common side effect of the chemotherapy drug Taxane and platinum drugs. Depending on the severity, it may be accompanied by symptoms such as low spirits and weight loss, which can seriously reduce the patient’s quality of life, and even endanger life. In this case, a 72-year-old male with recurrence of left buccal mucosal cancer, pT4aN0M0, stage IVA, was admitted to the hospital for salvage chemotherapy. The chemotherapy was shifted to Taxotere and Carboplatin at 109/01/30. While five days later, he suffered from acute diarrhea 7-8 times a day. After treatment with Smecta, the frequency of diarrhea was reduced to 3-4 times a day. In the view point of TCM, the symptom is due to spleen deficiency, dampness, and kidney yang deficiency. After three days of taking Sishen pill and Decoction of Sijunzi, he relieved from diarrhea and his appetite was improved. It shows that under the syndrome differentiation and treatment of Chinese medicine, it can effectively reduce the uncomfortable symptoms during chemotherapy and improve the quality of life of cancer patients. 
【Keywords】Taxotere; Diarrhea; Oral Cancer, Constitution; Yin-yang Property of Cancer