台北中医医学杂志

105.12 针药结合治疗大肠癌化疗後裏急後重之 病例报告

 

针药结合治疗大肠癌化疗後裏急後重之
病例报告
A Case Report of Colorectal Chemotherapy-
Induced Tenesmus treated by Traditional
Chinese Medicine and Acupuncture
王靖雯1 张钧贺1 徐敬闵1 陈朝宗1,2,3*
【摘要】
在现在医疗进步的社会中,虽然癌症已慢慢成为慢性疾病,其需经历的手术、长期
化疗、放疗等仍然对病患造成许多身体与心理的负担。裏急後重是形容便意频繁却无法
排便的一种症状,最常出现於罹患大肠直肠癌之患者,现代医学认为此症状是由於肠道
严重发炎或便秘使肠道神经受到频繁刺激所致;而中医则认为脾胃运化失常为其病因,
证型上可分为湿热、气滞、气虚与津伤血虚所致。裏急後重使病患之排便习惯在便秘与
腹泻间交替,若不及时改善,将降低化疗患者之生活品质,甚者更会拖延癌症治疗的进
程,直接影响医疗的效能。本病例为一位大肠癌化疗後裏急後重之女性,经由木香槟榔
丸、调味承气汤、理中汤加减给予调理,而获得改善。
【关键词】裏急後重、化疗、木香槟榔丸、调味承气汤、理中汤
Ching-Wen Wang1, Chun-Ho Chang1,Ching-Min Hsu1, Chao-Tsung Chen123*
1Department of Traditional Chinese Medicine, Taipei City Hospital RenAi Branch,Taipei, Taiwan
2Institute of Traditional Medicine, School of Medicine, National Yang-Ming Chiao-Tung
University,Taipei, Taiwan
3Department of Recreation and Sport Management, University of Taipei, Taipei, Taiwan
【Summary】
Today, with advanced medical treatments, although cancer has gradually become a chronic disease, the need for surgery, long-term chemotherapy, radiotherapy, etc. still imposes physical and psychological burdens on the cancer patients.
Tenesmus is a symptom that appears most often in patients with colorectal cancer. Western medicine believes that these symptoms are caused by severe inflammation or nerve damage of the bowel, while traditional Chinese medicine believes that the abnormal spleen and stomach qi transformation is the key cause, and the syndromes can be divided into damp-heat, qi Stagnation, qi deficiency, and the deficiency of blood and qi. Tenesmus causes the patient’s defecation habit to alternate between constipation and diarrhea. If not improved in time, it will reduce the patient’s quality of life, and even hamper the treatment of cancer, directly affecting the effectiveness of medical treatments.
This case is about a woman who suffered from severe tenesmus symptoms after
chemotherapy for colorectal cancer. Her symptoms had improved after receiving a modified dose of Mu Xiang Bing Lang Wan, Tiao Wei Cheng Qi Tang and Li Zhong Decoction.
【Keywords】 tenesmus, chemotherapy, Mu xiang Bing lang Wan, Tiao Wei Cheng Qi Tang, Li Zhong Tang