針藥並用治療乳癌化療後周邊神經異常感覺病例報告

Combined use of Acupuncture and traditional Chinese medicine for the Treatment of Peripheral Neuropathy Following Chemotherapy in Breast Cancer Patients : A Case Report

蕭子瑜(Tzu-Yu Hsiao)；王明仁(Ming-Jen Wang)；陳安履(Andy Chern)；林舜穀(Shun-Ku Lin)

中醫治療 ； 癌症 ； 化學治療誘導周邊神經病變 ； 針灸療法 ； 中藥治療 ； 乳癌 ； Traditional Chinese Medicine (TCM) treatment ； cancer ； peripheral neuropathy ； Chemotherapy-Induced Peripheral Neuropathy(CIPN) ； acupuncture therapy ； Chinese herbal medicine treatment ； breast cancer

臺灣中醫醫學雜誌

21卷1期（2024 / 08 / 31）

16 - 31

繁體中文;英文

本病案介紹一位乳癌患者經化學治療後出現化學治療誘導周邊神經病變（chemotherapy-induced peripheral neuropathy, CIPN）病例，經過連續中醫治療和針灸療程，季小姐病情在一個月時間內有所改善。她最初主訴是四肢僵硬、緊繃和麻木感，伴隨手指腫脹和指甲變形，這些症狀可能是由化學治療引起周邊神經病變所致。中醫診斷指出肝鬱化火、陽亢、肝腎虛衰和血瘀等病證，治療方針包括疏解肝鬱、補益肝腎、活血通絡，以改善神經功能、緩解疼痛和提高整體健康。在治療過程中，逐漸調整處方，根據患者症狀變化和脈診結果。針灸治療主要針對患者神經症狀，包括手腳麻木感和疼痛。針灸點選擇涵蓋頭皮針運動區、頭皮針感覺區、氣海、關元、太衝穴、蠡溝穴、神門穴等。這些點位旨在恢復神經肌肉功能，改善症狀，並提高患者生活品質。經過每週一次，連續五週中藥治療與連續三週針灸後，患者症狀減輕，手指腫脹和僵硬感得到改善，睡眠品質也有所提升。脈診結果反映患者體內氣血變化，治療方針根據證型調整，以更好地滿足她需求。治療總體目標是通過中醫藥物治療和針灸療法，改善神經功能，緩解疼痛，並提高患者整體健康狀態。綜合而言，這位乳癌患者經化學治療後周邊神經病變中醫治療案例突顯中醫藥物治療和針灸療法在緩解化學治療周邊神經病變症狀方面潛力。

This case report describes a patient who developed peripheral neuropathy following chemotherapy for breast cancer. After receiving continuous Traditional Chinese Medicine (TCM) treatment and acupuncture sessions, Ms. Ji's condition improved within one month. Her initial complaints included limb stiffness, tightness, and numbness, accompanied by finger swelling and nail deformities, which were likely attributed to chemotherapy-induced peripheral neuropathy (CIPN). TCM diagnosis identified patterns such as liver depression with fire, excessive yang, liver and kidney deficiency, and blood stasis. The treatment approach aimed to resolve liver depression, nourish the liver and kidneys, and promote blood circulation to improve neural function, alleviate pain, and enhance overall health. Throughout the treatment process, the prescription was gradually adjusted based on changes in the patient's symptoms and pulse diagnosis results. Acupuncture treatment primarily targeted her neurological symptoms, including numbness and pain in the extremities. Acupuncture point selection included scalp needle-movement area, scalp needle-sensation area, Qihai (CV6), Guanyuan (CV4), Taichong (LV3), Ligou (LR5), and Shenmen (HT7), among others. These points aimed to restore neuromuscular function, alleviate symptoms, and improve the patient's quality of life. The effectiveness of the treatment was reflected during each follow-up visit. The patient's symptoms gradually improved, finger swelling and stiffness were alleviated, and sleep quality also improved. Pulse diagnosis results reflected changes in the patient's qi and blood, and the treatment strategy was adjusted accordingly to better meet her needs. The overall goal of the treatment was to improve neural function, alleviate pain, and enhance the patient's overall health through the use of TCM herbal medicine and acupuncture. In summary, this TCM treatment case for peripheral neuropathy following breast cancer chemotherapy highlights the potential of TCM herbal medicine and acupuncture in alleviating CIPN symptoms. While improvement takes time, the patient gradually showed progress throughout the treatment process, offering hope for an improved quality of life and providing empirical evidence for the role of TCM and Chinese herbal medicine in adjunctive cancer care. Furthermore, this case underscores the personalized approach of TCM, adjusting prescriptions based on changes in the patient's condition to ensure optimal treatment outcomes. While further research is needed, it provides a promising reference for breast cancer patients seeking TCM adjunctive therapy.