中醫治療化療相關的睡醒障礙病例報告

A Case Report of TCM Therapy for Chemotherapy-Related Insomnia

陳有昱(Yu-Yu Chen) ； 蔡嘉一(Chia-I Tsai)

《中醫藥研究論叢》 24卷2期 (2021/06) Pp. 57-64

https://doi.org/10.6516/TJTCM.202106_24(2).0005

摘要

這是一位37歲女性，平素就有入睡困難和淺眠易醒問題，曾至西醫身心科就醫，並服用安眠藥（STILNOX）治療，服用後雖能入睡，但白日仍疲憊。患者於106／5診斷出大腸癌後，在106／6化療（FOLFOX＋Avastin）後，失眠症狀明顯加重，STILNOX劑量增至2顆，因上述症狀故於106／9會診中醫，尋求治療。患者經診斷屬於肝氣鬱滯，導致肝脾不和，上擾心神而致不寐，服用中藥後症狀明顯改善，可逐步降低安眠藥劑量。本病例在探討中醫藥輔助治療癌症患者於化療相關睡眠障礙可望達到之目標。

關鍵字

大腸癌 ； 化學治療 ； 失眠 ； 不寐 ； 肝鬱

並列摘要

We reported a 37-year-old female with history of insomnia and takes STILNOX. The patient was diagnosed of S-colon cancer in 2017/5 and s/p chemotherapy with FOLFOX+Avastin started from 20170607. The patient's insomnia increased significantly after 106/6 chemotherapy (FOLFOX+Avastin). The dose of STILNOX was increased to 2#. Due to the above symptoms, she consulted Chinese medicine at 2017/9 for treatment. The patient was diagnosed as having liver qi stagnation, which caused liver and spleen stagnation, disturbed the mind and caused uneasiness. After taking Chinese medicine, the symptoms improved significantly, and the sleeping dose could be gradually reduced. This case explores the goals that chemotherapy-related sleep disorders can be expected to be achieved by adjuvant Chinese medicine treatment of cancer patients.

並列關鍵字

Colon Cancer ； Chemo-Therapy ； Insomnia ； Sleepless ； Liver-function Stasis

參考文獻

朱哲生、陸梯：失眠之最新概況。台灣醫界 2011；54(6)：8。

Palliative Care in Oncology symposium, Boston; Oct 9-10, 2015: 299-308.

Howell D, Oliver TK, Keller-Olaman S, et al. Sleep disturbance in adults with cancer: a systematic review of evidence for best practices in assessment and management for clinical practice. Ann Oncol 2014; 25: 791

吳龍源：失眠症的中醫辨證論治與臨床探討。傳統醫學雜誌 2010；21(1)：75

黃金昶：黃金昶中醫腫瘤辨治十講。北京中國中醫藥出版社 2012；45-47：132-137