中医药研究论丛

212.19 中西医结合治疗男性摄护腺癌合并多发性骨转移病案
TJ TCM.21(2) : 221-232, 2018
中西医结合治疗男性摄护腺癌合并多发性骨转移病案
A Case Report of Prostatic Cancer with Multiple Bone Metastasis Treated with Combination of Traditional Chinese Medicine and Western Medicine
黄志男1 陈稼洺1*
1 财团法人彰化基督教医院中医部,彰化,台湾
【摘要】
案例这位58岁男性,於2013814日因下腹痛、便秘等症状急诊至彰基医院,并被诊断为摄护腺癌合并多发性骨转移,即第四期摄护腺癌。一般末期摄护腺癌平均存活率只剩下3.5年,此时只能靠荷尔蒙疗法、放射线疗法、化学治疗延续生命。本病案於2013/82015/8二年间,以放射线疗法结合荷尔蒙疗法,2015/82015/12进行第一阶段化学疗法(taxotere),因产生身倦、汗多、呕逆、便秘诸多不适症状,於2015 12 月经西医泌尿科医师推荐,合并中医治疗其放、化疗之副作用,经中药介入後身倦、汗多、呕逆、便秘症状大幅改善,且PSA(前列腺特异抗原,prostate specificantigen)<4 ng/mL维持长达一年半,但2017 5 月起发现PSA 开始升高,於20176月开始进行第二阶段化学疗法(taxotere),泌尿科医师原考虑要换化疗药进一步治疗,而在此期间患者希望中医能提供协助,改善癌症复发的问题。经中医辨证论治後处以散肿溃坚汤加减,协同泌尿科医师於第二次化疗期间使用化疗药taxotere相同剂量,於2017年八月PSA开始降低,之後维持在理想值PSA4 ng/mL,也停止了化学治疗,目前仍於中、西门诊持追踪治疗,病患生理状况良好,可正常从事一般性质活动,积极配合後续的医疗追踪及处置。
【关键词】中西医结合、摄护腺癌、多发性骨转移、PSA、散肿溃坚汤
Chih-Nan Huang1Jia-Ming Chen1*
1Department of Traditional Chinese Medicine, Changhua Christian Hospital, Changhua, Taiwan
【Summary】
The 58-year-old man of this case had no obvious symptoms before he was diagnosed with prostate cancer, the diagnosis on 2013/8 had found that the cancer has metastasized to end-stage prostate cancer complicated with multiple bone metastases. Generally, end-stage prostate cancer patients aren’t able to live over 3.5 years, under such circumstance, the only ways to extend life are hormone therapy, radiotherapy, and chemotherapy. The patient was continuously treated with combination of radiotherapy and hormonal therapy from 2013/8 to 2015/8, and 2015/8~2017/12 for the first phase of chemotherapy (taxotere). Due to a number of discomfort symptoms: tired, sweat, vomit inverse, constipation, urologists recommended to merge traditional Chinese medicine into treatment to treat the side effects caused by radiotherapy and chemotherapy. Symptoms including tired, sweat, vomit inverse, constipation and PSA (prostate specific antigen 4 ng/mL) stability were significantly improved for up to 1.5 years after the intervention of Chinese medicine. However, it was found that the PSA began to rise in May 2017, so the second phase of the taxotere was started in June 2017. Urologists originally considered the need for further treatment with chemotherapeutic drugs, and during this period the patient hoped that the Chinese medicine practitioners could provide assistance in resisting the recurrence of cancer. We prescribed the San Zhong Kwei Jien Tang by syndrome differentiation and treatment of traditional Chinese medicine, and collaborate with Urology physicians during the second chemotherapy by using the same dose of chemotherapy drug (taxotere). The PSA began to drop in August 2017/9 and maintained within the desired value PSA4 ng/mL, the chemotherapy was also stopped. The patient is still in the urology and Chinese medicine clinics follow-up treatment, his physical condition is good enough to engage in normal activities.
【Keywords】Integrative Medicine, Prostatic cancer, multiple bone metastasis,PSA, San Zhong Kwei Jien Tang