- 期刊
攝護腺癌合併骨轉移的中西醫整合治療病例報告
Prostatic Cancer with BoneMetastasis Treated with Combination of Traditional Chinese Medicine andWestern Medicine- A Case Report
摘要
這是一位七十二歲的男性，於2006/10/25 因長期解尿困難入院接受門診檢查，發現其血清攝護腺特異抗原數值（prostatic specific antigen, PSA）升高，且全身性骨掃描發現多處顯影，進一步入院接受經尿道攝護腺切除，確診為攝護腺癌後，在二年多的時間接受荷爾蒙療法治療共24次。之後追蹤發現其PSA逐漸升高和骨掃描有多處轉移，診斷為對荷爾蒙療法無效的攝護腺癌（hormone refractory prostate cancer, HRPC）合併骨轉移。患者進一步接受docetaxel的化學治療，經常有頭暈、身倦、腹瀉、納差等情形，求診於中醫門診並接受中西醫合併治療，臨證診斷為脾虛夾濕，心血不足，本虛標實，治療上則以養心健脾，扶正祛邪為主，佐以清化濕濁，搭配活絡止痛，處方以參苓白朮散、歸脾湯等加減，期間搭配利腰膝強筋骨等藥物。在近八個月的中醫輔助治療下，骨掃描發現病灶部份減少，同時PSA也大幅下降，化療後不適感明顯減少，轉移的骨腫瘤病灶逐漸減少，提供作為中西醫結合治療攝護腺癌合併骨轉移的一有效臨床案例。
並列摘要
This 72 y/o male who had long-term difficulty in urination visited OPD clinic, the raised PSA level and bone scan revealed positive finding were noted. He was performed transurethral resection of the prostate because prostatic cancer was suspected. He took hormone therapy from 2006/12/19 to 2009/05/06. The follow-up results revealed PSA gradually raising and bone scan showed diffuse advanced metastasis and hormone refractory prostate cancer (HRPC) with bony metastasis was diagnosed. He took chemotherapy for advanced treatment. He suffered from dizziness, fatigue, and diarrhea due to chemotherapy, docetaxel, could cause leukopenia, fatigue, nausea, vomit, and diarrhea. Based on the patient’s condition, the method of Qi-Blood-Enriching and Spleen-Nourishing was prescribed throughout the whole treatment period, and herbal remedies such as Shenling Baizhu San and Gui Pi Tang. The antitumor herb, Spreading Hedyotis Herb, was applied until the middle treatment period. After nearly 8 months of combination Traditional Chinese medicine and chemotherapy, the patient’s bone scan revealed diffusely decreased activity noted for the original lesions and PSA level substantially reduced. The result suggested us confidently that chemotherapy combined with Chinese medicine as complementary medicine would provide better medical care for prostatic cancer with bone metastasis.