肺癌手術後中西醫結合治療文獻整理

Integration of Traditional Chinese and Western Medicine for post operation treatment of lung cancer

吳宏乾(Hung-Chien Wu) ； 黃品涵(Pin-Han Huang)

《北台灣中醫醫學雜誌》 13卷1期 (2021/03) Pp. 1-15

摘要

過去肺癌被認為只有吸菸與二手菸者才容易罹患，但隨著環境與生活型態的改變，越來越多非吸菸者罹患肺癌。肺部最常見的原發性惡性腫瘤是上皮癌，又依照細胞型態分為小細胞癌（SCLC）和非小細胞癌（NSCLC）。現代西醫發展越來越多的治療手段，除了過去傳統的手術、化療與電療，現今熱門的標靶與免疫療法都帶來新的曙光。而中醫也不斷進行研究與西醫更好的結合，肺癌在中醫多屬於「肺癰」一類範疇，根據經典可以大略分為四種常見證型：陰虛肺熱、肺脾兩虛、痰熱肺壅和肺腎兩虛，多因為患者長期正氣虛損而邪毒侵襲導致。現在提倡中西醫療結合，病患可以有效打擊癌細胞、並進行根本鞏固，治療效果遠大於單純西醫或中醫的單一治療手段，比如中醫可以舒緩肺癌術後的傷口疼痛與神經竄痛、改善肺葉切除後的肺功能下降與常見的術後長期咳嗽和倦怠感，更能改善肺癌患者進行化療、標靶與其他治療時難以忍受的失眠與疼痛控制等等，使患者提高治療意願、使療程不需要中斷進行下去，中醫能為肺癌患者西醫治療之餘帶來更多的生活與醫療品質提升，以及生命尊嚴的實現。

關鍵字

肺癌 ； 胸腔鏡 ； 開胸手術 ； 術後調理 ； 中醫治療

並列摘要

As time goes by, scientists found that there are more and more non-smokers with lung cancer in these years, which is totally different from what we thought before. The most common is Squamous-Cell Carcinoma(SqCC), including Small Cell Lung Cancer(SCLC) and Non Small Cell Lung Cancer(NSCLC). In addition to traditional surgery, chemical therapy and electrotherapy, targeted therapy and immunotherapy are getting more and more popular. Therefore, we can find more successful cooperation of Chinese Medicine and Modern Medicine. We usually call Lung Cancer as ＂Fei-Yung＂(肺癰) in Chinese Medicine. According to classics, we can separate ＂Fei-Yung＂(肺癰) into four types, Yin deficiency and Lung heat, Lung and Spleen deficiency, Obstruction of phlegm heat in lung, Lung and Kidney deficiency. The benefits of Chinese Medicine include the relief of wound pain and scurrying pain from nerve after surgery, improvement of lung function after Lobectomy or Wedge resection, and common chronic cough and insomnia due to surgery, chemical therapy or others, etc. Chinese Medicine not only can help patients improve the discomfort from Modern Medicine therapy but also give them more confidence to keep going. Besides, Chinese Medicine can bring patients better life quality and help them live with dignity.

並列關鍵字

lung cancer ； Chinese Medicine ； acupuncture ； chronic cough ； insomnia ； targeted therapy and immunotherapy

參考文獻

Horn L, Lovly CM, Johnson DH. Chapter 107: Neoplasms of the lung. （編） Kasper DL, Hauser SL, Jameson JL, Fauci AS, Longo DL, Loscalzo J. Harrison's Principles of Internal Medicine 19th. McGraw-Hill. 2015. ISBN 978-0-07-180216-1.

孟博、李杰，基於中醫體質學說對肺癌的認識及預後分析，遼寧中醫雜誌，第 42卷第 6 期，2015。

李靈萍，中醫護理在改善 32 例肺癌患者不良情緒及化療不良反應中的應用，中國民族民間醫藥雜誌，2014。

葛寶晶、侯雲霞、詹慶娟，中醫護理對肺癌晚期患者疼痛控制及睡眠質量的影響，天津護理雜誌第 24 卷第 2 期，2016。

Oksholm T，Miaskowski C, Solberg S, et al. Changes in Symptom Occurrence and Severity Before and After Lung Cancer Surgery[J]. Cancer Nurs, 38( 5) : 351-357, 2015.