癌末患者臟躁之中西醫治療病例

A Case Report of Terminal Stage of Cancer Patient with Mental Disorder Treated by Chinese Medicine Combined Western Medicine

邱碧瑩(Bi-Ying Chiu) ； 許堯欽(Yao-Chin Hsu)

《中西整合醫學雜誌》 12卷4期 (2010/12) Pp. 31-37

https://doi.org/10.29613/JICWM.201012.0004

摘要

本案例是一位40歲女性癌末患者，在95年1月確診爲大腸癌(T3N0)，雖經手術、放化療，卻仍於97年6月發現腹腔轉移，後又接受多次輔助性化療，99年4月因長期腸阻塞、反覆泌尿道感染、消化道潰瘍出血、癌痛等病情膠著，身心靈狀態得不到平靜和緩，生活品質每況愈下，遂決定接受安寧共同照護。然患者因精神不穩定、情緒失控，常嚎啕大哭、囂嚷似童，醫護人員、社工、宗教師、家人介入皆束手無策，經會診中醫後診斷不腎陽不足、氣血兩虛、心神失養所致臟躁，主要使用甘麥大棗湯合真武湯加黃耆、熟地、肉桂治療，患者服用後情緒逐漸穩定，哭泣情況減少，能理性平和地與醫護人員及家人溝通、對談，生命的最後終能圓滿。此爲中西醫結合在安寧共照團隊中治療癌末患者精神疾患之有效案例。

關鍵字

癌末 ； 安寧 ； 臟躁 ； 中醫 ； 甘麥大棗湯

並列摘要

This is a case of 40-year-old female diagnosed with colorectal cancer (T3N0) in January 2006. Despite surgery, radiotherapy and chemotherapy, peritoneal metastasis was found in June 2008. After receiving several adjuvant chemotherapy, she still suffered from intestinal obstruction, chrome urinary tract infection, peptic ulcer bleeding and severe cancer pain in April 2010. Her mental state was not calm and relaxed, life quality also deteriorated. She finally decided to accept palliative care. However, during hospice care the patient present mental instability and often cried like a child. Health care workers, social workers, chaplains and family members all felt helpless, and then they requested Chinese Medicine for complementary treatment. The diagnosis of Chinese Medicine is hysteria. The identify patterns are kidney-Yang insufficiency, dual vacuity of qi and blood and losing nourish of the heart spirit. After administered the Gan Mai Da Zao Tang, Zhen Wu Tang, Astragalus, Rehmannia glutinosa and Cinnamon, the patient illness was gradually stable, crying was reduced, and her behavior became rational and peaceful when she talk with the medical staff and family members. The patient final days of life were peaceful. The present effective case underline integrated Chinese and Western Medicine in hospice care.

並列關鍵字

Terminal Cancer Patient ； Mental Disorder ； Hospice care ； Chinese Medicine ； Gan Mal Da Zao Tang