針灸輔助治療乳癌骨轉移疼痛：一病例報告

Acupuncture Treatment for Metastatic Bone Pain from Breast Cancer: A Case Report

李俐雯(Li-Wen Lee)；黃明正(Ming-Cheng Huang)

針灸 ； 乳癌 ； 疼痛 ； 骨轉移 ； acupuncture ； breast cancer ； pain ； bone metastasis

中華針灸醫學會雜誌

20卷3-4期（2017 / 12 / 01）

55 - 63

繁體中文

本病例為一位59歲女性患者，因乳癌骨轉移壓迫腰椎椎間盤導致下肢疼痛，止痛藥物無法有效控制疼痛，故會診中醫針灸協助治療。患者之疼痛程度在針灸後立即明顯緩解，住院期間每周接受三次針灸治療，針灸治療後疼痛控制情況良好，不須另外施打嗎啡針劑來止痛。一個月的療程中，其疼痛程度下降，止痛藥物與類固醇的劑量皆減輕。根據此患者之臨床症狀變化，發現針灸配合止痛藥物治療癌症骨轉移疼痛，可以延長藥物的止痛時間，並減少疼痛發生頻率，且讓患者有更好的生活品質。

This 59-year-old woman was diagnosed as breast cancer with bone metastasis. Shesuffered from radiating pain from her left hip to left foot for several months and developed progression within one week prior to this consultation. The physician prescribed oral analgesics and anti-inflammatory drugs as well as morphine injection, but her refractory left buttock and lower limb pain with poor response to all analgesic strategies was still noted. After one month of the acupuncture treatments, the score of visual analogue pain scale, the dosage of morphine and consumption of dexamethasone were all significantly decreased. In this case report, we demonstrated the acupuncture combine with analgesics can effectively alleviate pain.Acupuncture is beneficial to reduce pain and improve quality of life for cancer patients.

1. Benedetti, C,Brock, C(2000).NCCN Practice Guidelines for Cancer Pain.Oncology,14(11),135-150.
2. Caraceni, A,Portenoy, RK(1999).An international survey of cancer pain characteristics and syndromes. IASP Task Force on Cancer Pain. International Association for the Study of Pain.Pain,82(3),263.
3. Choi, TY,Lee, MS(2012).Acupuncture for the treatment of cancer pain: a systematic review of randomized clinical trials.Support Care Cancer,20(6),1147-1158.
4. Dy, SM,Asch, SM(2008).Evidence-based standards for cancer pain management.Journal of Clinical Oncology journal,26(23),3879-3885.
5. Goudas, LC,Bloch, R(2005).The epidemiology of cancer pain.Cancer Investigation,23(2),182-190.
6. Green, CR,Hart-Johnson, T(2011).Cancer-related chronic pain: examining quality of life in diverse cancer survivors.Cancer,117(9),1994-2003.
7. Jonathan, W(2007).Acupuncture in pain management.Continuing Education in Anaesthesia Critical Care Pain,7(4),135-138.
8. Loblaw, DA,James, P(2005).Systematic Review of the Diagnosis and Management of Malignant Extradural Spinal Cord Compression: The Cancer Care Ontario Practice Guidelines Initiative´s Neuro-Oncology Disease Site Group.Journal of Clinical Oncology,23(9),2028-2037.
9. Paley, CA,Johnson, MI(2012).Acupuncture for cancer pain in adults.The Cochrane Database of Systematic Reviews,16(5),112-145.
10. Portenoy, RK(2011).Treatment of cancer pain.Lancet,377,2236-2247.
11. Rausch, T,Jansen, T(2012).Gastrointestinal Side Effects of Opioid Analgesics.US Pharm,37,36-39.
12. Ripamonti, CI,Bandieri, E(2011).Management of cancer pain: ESMO clinical Practice Guidelines.Annals of Oncology,22(6),69-77.
13. Running, A,Seright, T(2012).Integrative oncology: managing cancer pain with complementary and alternative therapies.Current Pain and Headache Reports,16(4),325-331.
14. Schweizerhof, M,Stösser, S(2009).Hematopoietic colony-stimulating factors mediate tumor-nerve interactions and bone cancer pain.Nature Medicine,15(7),802.
15. Ziqi, Z,Ganghui, J(2006).Clinical Study on Acupuncture at Xi Xue( Cleft Points) Combined with Injection of Chinese Medicine f or Treatment of 30 Cases of Lumbar Intervertebral Disc Prolapse of Blood Stasis Type.Journal of Traditional Chinese Medicine,47(3),184-186.
16. 王文炎,米建平(2012)。董氏奇穴治療痛證淺探。針灸臨床雜誌，28(2)，51-52。
17. 王詩惠,龍杞,劉清國(2014)。穴位診斷法的研究概況與展望。上海針灸雜誌，33(1)，91-94。
18. 陳仲傑,郭宇鵬,吳中朝(2008)。以痛為俞針刺治療癌性疼痛療效觀察。中國針灸，28(4)，251-253。
19. 談太鵬,王順(2015)。淺述張縉教授“二十四式單式手法＂之揣法。中醫學報，30(8)，1135-1136。
20. 譚彩玲,程建明,彭力(2015)。郄穴治療痛證臨床應用現狀。湖北中醫藥大學學報，4(17)，122-123。

1. 鄧雪妹,曾詩婷(2022)。一位轉移性乳癌個案接受化學治療之中西醫結合照護經驗。新臺北護理期刊，24(1)，138-146。