上腔靜脈症候群之中醫會診病例報告

Case Study of Conference Diagnosis on TCM Treatment of Superior Vena Cava Syndrome

戴有志(Yu-Chih Tai) ； 李怡慧(Yi-Hui Lee) ； 沈芳如(Fang-Ju Shen) ； 黄慧君(Hui-Chun Huang)

《台灣中醫臨床醫學雜誌》 16卷2期 (2010/06) Pp. 79-87

https://doi.org/10.6968/TJCCM.201006.0079

摘要

現今中醫會診治療疾病強調整體觀、辨證與辨病相結合的思維，結合西醫藥物、手術、放射治療、化學治療等療法合併治療病人。本文提出一罹患肺腺癌第4期合併上腔靜脈症候群之會診病例，經過西醫放射治療、化學藥物治療，腫瘤繼續擴展壓迫上腔靜脈，出現上腔靜脈症候群相關的症狀，病人呼吸喘促無法平躺併嚴重咳嗽胸悶及全身水腫，因而會診中醫，中醫辨證後處方，以盆氣活血化瘀、瀉肺化痰、寬胸理氣、補腎納氣、遖陽利水和升陽除濕等法貫穿治療，幫助病人改善症狀，提昇其生活品質。在處方過程中，提出了治療需重視疾病機轉與相關解剖構造引發不同病症的重要性，期使達到較好的療效。

關鍵字

上腔靜脈症候群 ； 肺腺癌 ； 中醫治療

並列摘要

Nowadays the conference diagnosis on Traditional Chinese Medicine (TCM) treatment puts emphases on the thoughts of holistic care, the differentiation of syndromes and the differentiation of diseases that are combined with medication, surgery, radiotherapy and chemotherapy to treat patients. In this report we present a conference case of lung adenocarcinoma (pT4N3MI, stage Ⅳ) with superior vena cava syndrome (SVCS) in a 67-year-old female who had undergone palliative radiotherapy and chemotherapy but tumor still expanded and compressed SVC which led to SVCS. Due to her suffering from short of breath, incapability of lying down, severe cough, and generalized edema, Traditional Chinese Medicine was consulted. After differentiating syndromes of the patient, we prescribed a remedy to supplement qi, promote blood circulation to remove blood stasis, purge the lung and resolve phlegm, regulate the flow of qi and relieve depression in the chest, nourish kidney and absorb qi, and activate Yang and induce diuresis. All the above-mentioned ways were used to help the patient improve the symptoms and elevate the quality of life.
In the progress of prescribing, we found it is the mechanism of the disease and the anatomy relative to diverse symptoms to approach a better curative effect.

並列關鍵字

Superior vena cava syndrome SVCS ； Lung adenocarcinoma ； Traditional Chinese Medicine