中草藥複合物對癌症病人細胞免疫力及治療毒性之研究

惡性腫瘤從1993年起一直是台灣十大死亡原因的第一位，除了癌症疾病本身外，化學治療、放射線治療及手術治療所帶來的副作用，將導致癌症病人之免疫功能不全，如白血球低下症、嗜中性球低下症、血小板低下症、噁心、嘔吐等副作用而使得癌症治療療程中斷，生活品質不良。除了醫院傳統的療程外，大多數的癌症治療患者會搭配使用替代性醫學療法（complementary and alternative medicine；CAM），如中草藥及營養補充劑，他們希望藉由使用替代性醫學療法來降低副作用的產生、器官毒性、保護與刺激免疫系統及預防癌症復發率。中醫認為，放療使用的放射線屬於熱毒之邪，除了局部殺滅腫瘤細胞外，亦會燒灼周圍正常細胞和組織器官，損傷機體津液，耗氣傷陰，同時還損害脾胃運化功能及肝腎功能，導致氣陰兩虛，或氣虛血淤或淤毒熱盛等症。而中醫防治化療副作用主要是依據化療中出現的全身和局部的症狀進行辨症論治。健脾和胃、降逆止嘔的中藥有助於減輕放化療對胃腸的刺激，使患者盡快恢復食慾。清熱解毒、養陰生津的中藥可以減輕放化療所引起的口乾舌燥、泌尿系統的刺激、放射性肺炎等”熱毒”所造成的副作用，補益氣血、養肝補腎的中藥可以保護骨髓，有助於化學治療骨髓抑制的恢復。從其他基礎研究中發現，傳統中醫藥常使用的藥方（靈芝、黨蔘、當歸）具有改善食慾及調節免疫等功能，但目前針對中草藥的臨床試驗較少，在免疫方面的研究主要仍是以細胞或動物實驗為主，因此，本次研究主要是要探討：在癌症的療程中搭配使用靈芝、黨蔘、當歸等萃取物之中藥複方，是否會降低化療與放療所造成的副作用及提升病患之生活品質。結果發現，實驗組及對照組在化放療治療過程中白血球及嗜中性均有下降的情況，中草藥複方介入的組別，白血球下降率為14.2%，嗜中性球下降率為11.0%，而對照組白血球下降率高達28.2%，嗜中性球下降率達29.1%。且中草藥複方的介入可以維持癌症病患體內較佳的輔助型T淋巴球及自然殺手細胞濃度及較佳的身體及社會的生活品質。本研究顯示，靈芝、黨蔘、當歸等萃取物之中藥複方的介入可以維持癌症病人較佳的免疫狀況。

關鍵字

中草藥；癌症；免疫；生活品質；化學治療/放射線治療

並列摘要

Malignant tumors have been the major cause of death in Taiwan since 1993. Not only the cancer itself but also the therapy for cancer such as chemotherapy, surgery, and radiation therapy impair the patient’s immunity. Immune system dysfunction, including leukopenia, neutropenia and thrombocytopenia, is attributable to bone marrow suppression, as well as suppression of the proliferation or function of lymphocyte subsets. Cancer patients exposed to chemotherapy/radiotherapy are at higher risk of therapy induced toxicity. Cancer and its treatment affect cancer survivors’ quality of life (QoL). Many patients undergoing cancer therapy consider complementary and alternative medicine (CAM) options, which can include vitamins, Chinese medical herbs, or other biological products. Usually, these products are taken to reduce side effects and organ toxicity, to protect and stimulate immunity, or to prevent further the development of additional cancers or recurrence. However, scientific evidence regarding the efficacy and safety of herbs and nutritional supplements remains limited. Rose geranium (Pelargonium graveolens, Geraniaceae) has anti-cancer, anti-inflammatory properties, and promotes wound healing. Similarly, Ganoderma tsugae (Ganodermataceae), Codonopsis pilosula (Campanulaceae), and Angelica sinensis (Apiaceae) are traditional Chinese herbs associated with immunomodulatory functions. In this study, a randomized, double-blind, placebo-controlled study was conducted to examine whether the Chinese medicinal herb complex, RG-CMH, which represents a mixture of Rose geranium and extracts of G. tsugae, C. pilosula and A. sinensis, can improve the immune cell count of cancer patients receiving chemotherapy and/or radiotherapy to prevent leucopoenia and immune impairment that usually occurs during cancer therapy. RG-CMH significantly reduced the depletion of leukocytes (14.2% compared to 28.2%) and neutrophils (11.0% compared to 29.1%). Analysis of the lymphocyte phenotype revealed that the patients receiving the placebo had reduced CD4 lymphocytes and natural killer (NK) cells than RG-CMH -treated patients. Quality of life and toxicity (Tx) were assessed before and after six weeks of administration of RG-CMH. Physical and social scores were significantly increased after RG-CMH treatment (P=0.017, P=0.033). Treatment with RG-CMH for patients receiving chemotherapy and/or radiotherapy may improve their immune function and QoL, improving their ability to fight off the cancer, as well as any secondary infections that could compromise their treatment and their health.

並列關鍵字

Chinese medical herbs ； Cancer ； Immune ； Quality of life

參考文獻

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國際替代計量

中草藥複合物對癌症病人細胞免疫力及治療毒性之研究

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