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中草藥對於Tamoxifen輔助療效研究之文獻回顧

Literature Review of Chinese medicine used with Tamoxifen treatment

摘要


目前乳癌為台灣婦女發生率第1位之癌症,傳統乳癌治療以手術、放射或化學治療為主,後續輔以荷爾蒙治療、標靶治療進行復發的預防,然而因治療本身的副作用帶給病患諸多不適,大部份癌症患者都曾有尋求輔助另類療法(Complementary & Altemative Medicine,CAM)來治療的經驗以減輕他們在接受西醫化學治療中的副作用。近來學術研究發現,某些中藥可能與西藥產生交互作用,甚至刺激乳癌細胞生長,其安全性確實值得商榷;以台灣地區、歐美地區民眾使用中草藥與北美生草藥對於乳癌患者使用Tamoxifen之併發症輔助作用的文獻探討,進一步延伸至發表於國際期刊中相關之動物試驗與進展。本文從體內外試驗及相關動物乳癌細胞試驗中,給予罹患乳癌動物之Tamoxifen治療,同時使用中草藥或北美生草藥,相關乳癌抑制效果以及誘發子宮內膜癌試驗的探討,由動物試驗結果之文獻回顧,對於日後在乳癌患者的臨床試驗,具有一些參考價值;並希望能從實證醫學的觀點,來探討中西整合醫療的現況與重要性,有關於乳癌患者使用Tamoxifen治療過程中能夠提高抗癌效果,減少腫瘤的復發與轉移機率,延長患者的生存期,提高其生活質量,具有臨床上的參考價值與意義。

關鍵字

中醫 乳癌 中草藥 另類療法

並列摘要


Currently the incidence of breast cancer for women in Taiwan is the top one of the cancers. Traditionally we treat breast cancer with surgery, radiation, or chemical therapy, and follow-up combined with hormonal therapy, targeted therapy for prevention of recurrence. However due to the side effects of the treatment itself, most cancer patients have had to seek aid and alternative therapies (Complementary & Alternative Medicine, CAM) to treat the experience of Western medicine to alleviate their acceptance of the side effects of chemotherapy. Recent studies have found that certain traditional Chinese medicine and western medicine interactions may occur, and even stimulate the growth of breast cancer cells, its safety is indeed debatable. Many cancer patients in Taiwan accept the Western medicine primaryly,and take Chinese medicine as supplement treatment. However we need more relevant evidence-based medicine (EBM) studies to provide scientific evidence in order to certify it as safe and effective medical approach. The goals are to ease the side effects caused by cancer treatment and to enhance the quality of life of cancer patients. In the study of invitro and invivo trials with animals ' breast cell line, we discuss Chinese medicine combine with Tamoxifen for breast cancer about hormone therapy and medication-related side effects. The integration of evidence-based medicine is important of health , and elaborate integrative medicine in the treatment of cancer. The differential treatment of Chinese medicine can improve the anti-cancer effect, reduce the chances of recurrence and metastasis of tumors, and prolong survival and improve their quality of life.

參考文獻


衛生福利部國民健康署:乳癌與子宮頸癌防治,http://www.hpa.gov.tw/BHPNet/Web/Index/index.asp
陳俊良: 運用健保資料庫探討臺灣乳癌病患中藥使用之安全與療效,中醫藥年報第一期第五冊CCMP100-RD-034 ; 475-476。
陳竹筠醫師: 乳癌賀爾蒙治療,和信治癌中醫醫院,http://www.kfsyscc.org/cancer/
林莉嘉醫師: 乳癌大作戰,中西醫併治,台北市立聯合醫院院訊第129期,2014: 36-13.
劉建良醫師: 馬偕紀念醫院一般外科,乳癌診療原則與新趨勢,http://www.mmh.org.tw/

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