中医药研究论丛

212.16 胃淋巴癌的中西医理与治疗的整合思维
TJ TCM.21(2) : 179-190, 2018
胃淋巴癌的中西医理与治疗的整合思维
The Integration of Gastric Lymphatic Carcinoma About Its Treatment and the Principles of Traditional Chinese Medicine and Western Medicine
郑宇雅1 姚朝元1 陈建仲1,2 王人澍1,2*
1 佛教慈济医疗财团法人台中慈济医院,台中,台湾
2 慈济大学学士後中医学系,花莲,台湾
【摘要】
根据WHO 淋巴癌分类系统,具MALT (mucosa-associated lymphoid tissue lymphoma) 组织的弥漫性大B 细胞淋巴瘤 (diffuse large B cell lymphomaDLBCL (MALT)),与幽门螺旋杆菌(H.pylori) 有密切关系。因此,根除治疗幽门螺旋杆菌是有助於避免DLBCL 的复发;就中医而言,本病案的病机主轴为胃湿热实证,因幽门螺旋杆菌(属热毒)的侵入,而长期反覆的胃发炎、黏膜充血、血热壅滞,甚至在化放疗後因湿热下注的肠道发炎,故有腹痛、腹泻、胃闷胀痛的症状。然而,对应於西医的淋巴癌分类系统,在治疗过程中考虑幽门杆菌(热毒)的因素,及肿瘤的病理变化,处方以散肿溃坚汤,可消坚散肿,符合中医的微观辨证。同时,因研究结果指出“阴虚证候与癌症预後有正相关”,故搭配中医辨证系统,改善胃阴虚证候、期望提高预後机率。况且,在治疗过程中发现,长期使用清热解毒药物,反而有助於偏低的白血球数目回复正常。因此,藉此病案分享讨论,期望以中西医整合思维提升治疗癌症的疗效。
【关键词】胃淋巴癌、弥漫性大B 细胞淋巴瘤(DLBCL)、中西医整合思维、黄芩汤
Yu-Ya Cheng1Chao-Yuan Yao1Jian-Jung Chen1,2Ren-Shu Wang1,2*
1Department of Chinese Medicine Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical
Foundation, Taichung ,Taiwan
2School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
【Summary】
According to classification system of World Health Organization, it is a close relationship between mucosa-associated lymphoid tissue of diffuse large B cell lymphoma and Helicobacter pylori. Thus, eradication therapy of Helicobacter pylori contributes to prevent from relapse of diffuse large B cell lymphoma. For traditional medicine, the main pathogenesis of this medical case is demp heat and empirical sympton of stomach. By the invasion of Helicobacter pylori, a heat toxin, that resulted demp heat of stomach to become the long term repeatedly gastric inflammation and mucosal hyperemia, blood stasis. Even that, the hot and humid of stomach flows down to the intestinal tract, and resulting the tract in inflammation. Therefore, there are abdominal pain, diarrhea, stomach ache and bloating symptoms. However, corresponding to classification system of medicine, we consider that the reason of Helicobacter pylori, a heat toxin, is and that pathological changes of tumors is at the process of treatment. That is why we prescribe the SAN ZHONG KWZI JIEN TANG for eliminating the mass and relieving swelling becouse it is in line with microscorpic syndrome differentiation of traditional chinese medicine. At the same time, according to the previous study, Yin-deficiency syndrome is positive correlation to prognosis of cancer. Therefore, we prescribe drugs by using syndrome differentiation to improve Yin-deficiency syndrome of stomach, and to enhance prognostic probability. Besides, we find that taking medicine of clearing heat toxin for long term contributes to make the numbers of leukocyte return to normal. In short, sharing this medical case offers us to discuss how to enhance curing effect of cancer by using integrated thinking of traditional medicine and western medicine.
【Keywords】gastric lymphatic carcinoma, diffuse large B cell lymphoma,integrated thinking of traditional medicine and western medicine,Scutellaria baicalensis