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212.20 中医在安宁疗护的角色－晚期摄护腺癌案例报告

TJ TCM.21(2) : 233-244, 2018

DOI : 10.6516/TJTCM.201809_21(2).0020

中医在安宁疗护的角色－晚期摄护腺癌案例报告

The Role of Chinese Medicine in Hospice Palliative Care: A Case Report of Advanced Prostate Cancer

苏三华1　詹书宛2　王健豪1*

1 花莲慈济医院中医部，花莲，台湾

2 中国医药大学学士後中医学系，台中，台湾

【摘要】

现今安宁照护观念已逐渐受到重视，目前仍以西医照护为主，缺乏中西医整合医疗团队的研究与探讨，本案例可提供以中医观点及治疗，作为中医介入癌末病人安宁疗护的叁考。本案例为高龄96岁的摄护腺癌症患者合并膀胱转移，经历多次经尿道前列腺切手术及尿道膀胱肿瘤切除术，并接受双侧睾丸切除术。病患本身年老体衰，加上长期卧床，造成气血两虚，有血尿、小便不利及出现疲倦、意识不清等问题，中医证型属脾肾两虚，痰瘀阻滞下焦，合并手术伤及血络，气血衰微。在会诊中医後，以中医药治疗近一年，期间以济生肾气丸及五苓散补肾利水治疗，及用川七、白芨达到活血止血、减缓血尿，并加上黄耆及当归益气、补营血，提升病患体力，後期以生脉保元汤益气生津，提升体力，加上苓汤改善肿瘤压迫所造成的排尿困难及水肿症状，病患在安宁病房出院後最後於花莲荣民之家安详辞世。中医药的介入，可适当的给予治疗并缓解病人身体上的不适，提升在晚期安宁照护的品质，让病患及家属圆满完成最後的旅程。

【关键词】摄护腺癌、安宁疗护、中医

San-Hua Su1Shu-Wan Chan2Chien-Hao Wang1*

1Hualien Tzu Chi General Hospital, Hualien, Taiwan

2School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan

【Summary】

The concept of Hospice Palliative Care has gradually received attention now, but lack of research and discussion on the integrated medical team of Chinese and Western medicine. This article provides Chinese medicine viewpoint as a reference for Chinese medicine intervention in the treatment of hospice care for cancer patients. This case is a 96-year-old prostate cancer patient with bladder metastases undergoing multiple transurethral resections of the prostate and urethral bladder tumor resections, and bilateral splenectomy. The long term bedridden elderly patient has hematuria, dysuria, fatigue, and unconsciousness after multiple surgery, causing both qi and blood deficiency. After consultation with the Department of Chinese Medicine, the patient was treated with Chinese medicine to relieve edema and hematuria and improve his physical strength for nearly one year. The patient was discharged from the hospital in the hospice ward and died peacefully at the Hualien Veterans Home. This article shows that the intervention of Chinese medicine can alleviate the physical discomfort of patients in the late stages and improve the quality of Hospice Palliative Care.

【Keywords】Chinese medicine, Hospice Palliative Care, advanced prostate cancer

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