中醫藥配合放射線治療攝護腺癌的病例報告

這位72歲男性患者，於94/10/24因為夜尿頻繁及血尿而到嘉義基督教醫院泌尿科求診，經過一系列檢查發現罹患攝護腺癌及膀胱結石。患者遂於94/11/12接受睪丸切除手術及經尿道膀胱取石術，並在94/12/7開始到放射腫瘤科接受放射線治療(R/T)。當放射線治療第九天時，患者開始出現腹瀉、頻尿等的情形，由一日四或五次到一日三十餘次的大小便不禁，因此患者於94/12/16到嘉基中醫部求診，在放射線治療期間積極尋求中醫的協同治療。就現代醫學而言，此患者因為罹患攝護腺癌而接受放射線治療，進一步造成放射性直腸炎及膀胱炎，但在放射線治療的後期，則會引起膀胱無力、解尿不盡有餘尿、失禁或小便排不出等障礙。另一方面，本病屬於中醫“血淋、癃閉、小便不禁（腎氣不固）、腸癖（脾氣虛弱）”的範疇，其病因是熱毒灼傷中、下二焦而致病。此放射線治療前期，就中醫而言是熱毒傷腎、膀胱及腸腑，導致濕熱滯於中下焦，法當健脾燥濕、清熱解毒、導濁下行。而目前問診時已是放射線治療後期，則是以腎虛及脾氣虛為主證，法當補益脾腎。由本病例可以看出：在攝護腺癌的非外科手術治療中，中醫藥協同放射線治療能夠成功的控制及治療攝護腺癌，並明顯降低放射線治療的損傷性副作用，使患者完成整個放射線治療的療程，大大的提高攝護腺癌患者的生存率及生活品質。

關鍵字

攝護腺癌；放射線治療；頻尿；癃閉

並列摘要

This 72 year-old male patient complained of nocturia, dysuria and gross hematuria, so he visited the urological department of Chiayi Christian hospital on 94/10/24. Unfortunately, prostate carcinoma and bladder stone was confirmed by a lot of examinations. Then he accepted surgical operation of bilateral subcapsular orchiectomy and electrohydraulic lithotripsy on 94/11/23. After that operation, he began to accept radiotherapy for 8 weeks on the radio-oncology department. At the 9th day of radiotherapy, many side effects appeared including of dysuria, polyuria, incontinence and severe watery diarrhea thirty times per day. Due to these discomfort, he visited our Chinese medicine department and asked for our combined treatment on 94/12/16. For the western medicine, this prostate carcinoma patient accepted radiotherapy for 8 weeks, and it induced radio-lesion of rectum and bladder. According to the Chinese medical theories, this disease is the result of radio-responsive heat burning, and it would accumulated on the colon and kidney at the beginning and early phase of radiotherapy. But it would induce the weakness of “kidney qi” (the original source of life) at the late phase of radiotherapy. Thus, we suggested that the principles of Chinese medicine treatment were included of supplementation of spleen, dryness of wet, clearance of evil heat at the early phase of radiotherapy. On the other hand, the supplementation of “kidney qi” was necessary for the late phase of radiotherapy. In this successful case, we found that the combination of Chinese medicine and radiotherapy was a good treatment for prostate carcinoma. This combined treatment would successful control the prostate carcinoma and significantly reduce the side effect of radiotherapy. Therefore, this patient would finish the full course of radiotherapy, elevated the survival rate and the quality of life.

並列關鍵字

prostate carcinoma ； frequent urination ； urinary difficulty

國際替代計量

中醫藥配合放射線治療攝護腺癌的病例報告

全文下載

主題瀏覽