中医药研究论丛

281.6白血病病人治疗期间血小板骤降经中医介入後之疗效个案报告

TJ TCM.28(1) : 69-83, 2025

DOI : 10.6516/TJTCM.202503_28(1).0006

白血病病人治疗期间血小板骤降经中医介入後之疗效个案报告

A Case Report on the Efficacy of Traditional Chinese Medicine Intervention for Sudden Platelet Decrease During Leukemia Treatment

庄佩蓁1许晋嘉1王瑜婷1,*

1奇美医学中心永康院区中医部,台南,台湾

【摘要】
T细胞大颗粒淋巴性白血病(T-LGL leukemia)是罕见的血液肿瘤疾病,在北美地区大概占2-5%的慢性淋巴性增生性疾病(chronic lymphoproliferative disorders),在亚洲大概占6%。通常在60岁左右发病,男女罹病机率几乎均等,孩童罕见。主要特徵是血液中大量复制的大颗粒性T细胞或NK cells,可能导致正常血球低下和再生不良性贫血,且与其他自体免疫疾病和淋巴性或骨髓性血液恶性疾病有可能相关。病人可能出现反覆发烧、感染,部分病人有淋巴癌的B symptoms。此66岁女性病人因为手脚多处出血点、输血频繁而来到门诊就诊,经过中医辨证,采补气养血、清血热後,自觉生活品质提升许多,输血频率也有下降。
【关键词】白血病 ; 骨髓抑制 ; 血小板低下 ; 归脾汤 ; 黄连解毒汤
【Summary】
T-cell large granular lymphocyte leukemia (T-LGL leukemia) is a rare hematologic malignancy, acing for approximately 2-5% of chronic lymphoproliferative disorders in North America and around 6% in Asia. Typically diagnosed around the age of 60, this condition affects both genders with almost equal frequency and is rarely observed in children. The distinguishing feature of T-LGL leukemia is the proliferation of large granular T-cells or NK cells in the blood, often resulting in cytopenias and refractory anemia. It is associated with various autoimmune diseases and other lymphoproliferative malignancies. Patients may experience recurrent fever, infections, and occasionally exhibit B symptoms of lymphoma. Here, we present the case of a 66-year-old female patient who sought medical attention due to frequent bleeding episodes and a high demand for blood transfusions. Traditional Chinese Medicine (TCM) intervention was administered based on the principles of tonifying qi, nourishing blood, and clearing heat from the blood. Subsequently, the patient reported a significant improvement in her quality of life, accompanied by a reduced frequency of blood transfusions. This case highlights the potential benefits of TCM as a complementary approach in managing T-LGL leukemia and improving patient outcomes.
【Keywords】Leukemia; Myelosuppresson; Thrombocytopenia; Guipi Decoction; Huanglian Jiedu Decoctionl