261.3 针药并用辅助治疗乳癌末期蕈状伤口溃烂脓血之病例报告
TJ TCM.26(1) : 29-42, 2023
DOI : 10.6516/TJTCM.202303_26(1).0003
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针药并用辅助治疗乳癌末期蕈状伤口溃烂脓血之病例报告
The Therapeutic Experience of Malignant Fungating Wounds in End-Stage Breast
Cancer with Traditional Chinese Medicine and Acupuncture-A Case Report
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陈豪君1,2*
1 奇美医院中医部，台南，台湾
2 义守大学学士後中医学系，高雄，台湾
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【摘要】
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48 岁女性左侧乳房肿块两年但不愿就医，前年1 月乳房肿块开始变大变硬，而後开始触摸到左侧腋下肿块，但此时患者仍不愿就医，自行以网路偏方治疗，直到去年四月乳房肿块上皮肤开始渗出脓液，再半年後因乳房肿块疼痛、虚弱、眠差、纳差、体重减轻才於2021/09/28 才第一次至西医就诊，就诊时乳房肿块已8 公分，肿瘤皮肤蕈状伤口溃疡流脓血、肉芽组织范围已达10cmx10cm，诊断为左侧侵袭性乳管癌（T4bN2M1, Stage IV）合并淋巴结转移，影像学上并已有肺部转移，无法开刀。2021/10/18 装置port-A 开始化疗，第一次Docetaxel、第二次Docetaxel 化疗+Trastuzumab、Pertuzumab标靶完成後，因肿块仍持续流脓血及化疗副作用水泻频急而於2021/11/20 至中医门诊就诊，伴随疲倦、纳差、夜间眠差难入睡易醒、情绪紧张、胸闷心悸，两耳耳鸣闷塞感、口乾口苦、双手十指红疹痒、小便频而黄⋯等症状，经中医辨证为肝郁气滞化热痰凝乳络、化疗後脾胃气虚湿聚，经治以益气健脾、疏肝清热，用药二个多月後患者左侧乳房肿块皮肤溃破收口，范围缩小至6.5cmx5.5cm，且已无脓血渗出。
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【关键词】乳癌末期、蕈状伤口、肿瘤、化疗副作用、中医、针灸、癌症辅助治疗
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Hao-Chun Chen1,2*
1Division of Chinese Medicine, Chi-Mei Medical Center, Tainan, Taiwan
2The School of Chinese Medicine for Post-Baccalaureate, I-Shou University, Kaohsiung, Taiwan
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【Summary】
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Fungating wounds arise from primary, secondary or recurrent malignant disease and are associated with advanced cancer. Care usually aims to slow down disease progression, and improve quality of life by relieving the physical symptoms caused by the wounds (leakage, bad smell, pain and the risk of haemorrhage). This case is about a 48-year-old woman who has locally advanced invasive ductal carcinoma with lung metastasis and lymph nodes metastasis with a fungating malignant wound on her left breast. After 2nd chemotherapy, the skin ulceration was still oozing and painful and the chemotherapy-related diarrhea, fatigue, poor-appetite, hair loss, insomnia, anemia and palpitation were also noticed. With sink pulsation and the above symptoms, the major diagnosis in traditional Chinese medicine is “liver qi stagnation and dampness-heat congestion” and “spleen and kidney deficiency”. After benefiting spleen qi, dispersing stagnated liver qi and reducing the damp and heat, the fungating malignant wound has shrunk from 10 cm to 6.5 cm in diameter and no longer oozing within two months treating with acupuncture and traditional Chinese medicine. Also, the chemotherapy-related diarrhea in the 3rd chemotherapy was reduced.
【Keywords】Breast cancer; Malignant Fungating Wounds; Tumor; Side effects of
chemotherapy; Complementary and alternative medicine; Traditional
Chinese medicine (TCM); Acupuncture
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