中医药研究论丛

233.12 针刺治疗伊文氏肉瘤并多重器官转移之顽固性疼痛和恶病质病例报告
TJ TCM.23(3) : 151-172,2020
针刺治疗伊文氏肉瘤并多重器官转移之
顽固性疼痛和恶病质病例报告
Acupuncture Improve Refractory Pain and Cachexia of Ewing’s Sarcoma Patients with
Multiple Organs Metastasis: A Case Report 
林宏恩1 黄明正1*
1 中国医药大学附设医院中医部,台中,台湾
【摘要】
伊文氏肉瘤(Ewing’s sarcoma)是好发於儿童和年轻人的中高度侵袭性和转移性骨肉瘤,多因基因转位并形成融合基因所引发,患者於发病时常有全身性症状如发热、盗汗、疲劳、无食欲及体重下降等。肿瘤是否有转移影响其预後,治疗多以化学疗法为主,并视情况配合手术、放射线治疗,然而这些疗法多伴随着严重的副作用,其中又以顽固性疼痛和恶病质最为难缠。本病例为30 岁男性患者,六年前因反覆腰背痛而诊断出伊文氏肉瘤,
虽经手术但肿瘤仍转移至荐骨、肺、横膈、肾上腺,住院期间因患者腹胀痛伴随腰背牵引痛而无法有效控制,故会诊中医协助治疗,四次针灸治疗後疼痛大减,成功脱离吗啡,改善肠胃症状,增进食欲和进食,出院後追踪发现疼痛控制稳定,不须服用止痛药,体重亦随之增加。因此我们认为针灸具有稳定、长效的止痛作用,并可改善患者的肠胃功能、食欲和营养摄取,进而提升癌症患者的生活品质。
【关键词】针灸、伊文氏肉瘤、顽固性疼痛、恶病质、慢性疼痛
 
Hung-En Lin1Ming-Cheng Huang1*
1Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
【Summary】
Ewing’s sarcoma is a highly invasive and metastatic osteosarcoma usually occurs in children and teenagers. It is mostly caused by gene trans-location and fusion. Patients with Ewing’s sarcoma often have systemic symptoms such as fever, night sweats, fatigue, loss of appetite, and weight loss. The prognosis of Ewing’s sarcoma is determined by whether the tumor has metastasized or not. The treatment plan of Ewing’s sarcoma is mainly based on chemotherapy usually combined with surgery and radiation treatment as appropriate. However, these treatments are often accompanied by serious side effects, of which refractory pain and cachexia are the most difficult to deal with.
This case is a 30-year-old male patient who was diagnosed with Ewing’s sarcoma six years ago attributing to repeated low back pain. Although the surgery had completed, the tumor still metastasized to sacrum, lung, diaphragm, and adrenal glands. During the hospitalization, the patient was suffered from abdominal pain accompanied with uncontrollably low back referred dragging pain so he consulted Chinese medicine doctor for help. The pain was greatly reduced after four sessions of acupuncture treatments, hence morphine was successfully discontinued. In addition, the gastrointestinal symptoms, appetite and intake were also improved. After discharged on stable status, the patient reported the reduced dosage of painkillers and increased body weight during the follow-up in the outpatient clinic. Therefore, we believe that acupuncture may exert beneficial effect to the analgesia, gastrointestinal function, appetite and intake, thereby improving the quality of life.
【Keywords】Acupuncture; Ewing’s Sarcoma; Refractory Pain; Cachexia; Chronic Pain