惡性腫瘤併發症的中醫治療探討

惡性腫瘤併發症常見有：高血壓、高血糖、高血凝、高顱內壓、副癌綜合症、異位激素分泌綜合徵、腫瘤性代謝紊亂、腫瘤心身症…，且中晚期普遍存在惡性胸腹水、虛弱、厭食、體重減輕等。臨床上惡性腫瘤併發症，可能發生在腫瘤尚未確診前，或癌症進展期間，或癌症治療中後期。控制並減輕惡性腫瘤併發症，可有效預防及抑制腫瘤的惡化；反之，併發症的再出現，可能是腫瘤復發的預兆。中醫治療惡性腫瘤併發症，區分三個階段，初、中期：屬瘀熱證，以活血化瘀，清熱解毒，淡滲利濕為主；邪正相爭一段時日後，會進入氣虛、血虛、或血枯的階段。晚期貧血、低蛋白血症、進行性心衰、腎衰，以補氣補血仍無法改善，腫瘤持續增大，為寒瘀或腎陽虛階段，以大補陽藥，同時加入清熱解毒藥反制。

關鍵字

中醫治療；惡性腫瘤併發症；副癌症候群；腫瘤異位激素分泌綜合徵；腫瘤熱；高鈣血症

並列摘要

Complications of cancer, such as hypertension, hyperglycemia, blood hypercoagulability, elevated intracranial pressure (ICP), paraneoplastic syndrome, endocrine paraneoplastic syndromes (＂ectopic＂ hormone production), metabolic tumor disorders, cancer metabolic disorders, cancer psychosomatic disorders, etc. are a common occurrence. Also, during the intermediate and advanced stages malignant pleural effusion, generalized weakness, loss of appetite, and weight loss is common. Clinically the complications of cancer may present prior to being diagnosed, during the progression of cancer, or during the intermediate or advanced stages of cancer treatment. Keeping cancer under control and remedying the complications of cancer can effectively prevent and inhibit the progression of cancer. After all, each time a complication presents it could possibly indicate a sign of cancer relapse. TCM treatment of the complications of cancer can be divided into three stages: 1) the early and intermediate stages are identified as stasis heat pattern, requiring the administration of blood-quickening and stasis transforming, heat-clearing and toxin resolving, and damp-disinhibiting by bland percolation; 2) the stage following the struggle between right and evil can be identified as qi vacuity, blood vacuity, and blood desiccation pattern; and 3) the advanced stage when anemia, hypoalbuminemia, progressive heart failure, and renal failure present, and treatment with qi and blood-supplementing medicinals fails to inhibit persistent tumor growth and progression, can be classified as either cold stasis or kidney yang vacuity pattern, requiring the administration of great yang-supplementing along with the counteraction of heat-abating and toxin-resolving medicinals.

並列關鍵字

TCM treatment ； cancer complications ； paraneoplastic syndrome ； endocrine paraneoplastic syndromes (＂ectopic＂ hormone production) ； neoplastic fever ； hypercalcemia