中醫治療乳癌賀爾蒙療法副作用之病例報告

根據2015年衛生署統計，台灣婦女罹患乳癌比率約為0.18%(高居婦女罹癌率之首位)，因此近年來乳癌的防治與治療受到極高的重視。賀爾蒙抑制療法係藉由減少甚或消除雌激素之產生，或阻斷雌激素與乳癌細胞雌激素受體之結合來達成減少乳癌復發及轉移的機率，但患者可能深受熱潮紅、睡眠障礙、月經失調等副作用所苦，在這方面中醫如何適當的介入治療值得我們深入探討。本病案為一51歲乳癌第二期女性患者服用泰莫西芬後開始出現上述問題。經歷中醫治療後，熱潮紅程度在第二周由嚴重轉為輕微，再經歷一個月的持續治療，熱潮紅、盜汗及睡眠障礙等症狀已基本消失。此治療策略係透過養陰清熱、疏肝理氣及潛陽安神為原則，並證實了其良好的療效。

關鍵字

乳癌；賀爾蒙治療副作用；傳統中藥

並列摘要

According to the statistics of Ministry of Health and Welfare in 2015, the population of Taiwanese women suffering from breast cancer (ranking top one among cancer diseases) was about 0.18%. Thus, prevention and cure of breast cancer have attracted increasing attention in recent years. Endocrine therapy can effectively reduce the probability of relapse and metastasis of breast cancer by alleviating (or even eliminating) generation of estrogen or by preventing estrogen from combining with the estrogen receptor of breast cancer cells. However, patients may suffer from side effects such as hot flashes, sleep disorder menstrual disorder, etc. How to adequately incorporate Chinese medication into the breast cancer cure process to address this issue certainly deserves further investigation. In this work, a case study involving a 51 year old woman with the stage II breast cancer showed that this patient took Tamoxifen and showed various side effects. Two weeks after Chinese medication, the side effect of serious hot flashes became minor. Furthermore, the symptoms of hot flashes, night sweats and sleep disorder eventually disappeared after continuous medication over a period of one month. The treatment was primarily based on nourishing yin to clear away heat, dispersing the liver depression in combination with suppressing yang to calm the nerves throughout the cure process, and its cure effectiveness confirmed.

並列關鍵字

Breast cancer ； Side effects of endocrine therapy ； Traditional Chinese medication

參考文獻

Kathleen I Pritchard, MD, FRCPC. Adjuvant endocrine therapy for non-metastatic, hormone receptor-positive breast cancer. Available at : https://www.uptodate.com/contents/adjuvant-endocrinetherapy-for-non-metastatichormone-receptor-positive-breast-cancer

Google Scholar

Suzanne A.W. Fuqua, PhD, Rachel Schiff, PhD. Mechanisms of action of selective estrogen receptor modulators and down-regulators. Available at : http://www.uptodate.com/contents/mechanisms-of-action-of-selective-estrogen-receptor-modulators-and- down-regulators