中醫治療大腸癌經化、放療後腹瀉之病例報告

Chinese Medicine Treatment of Colorectal Cancer and Diarrhea after Radiotherapy and Chemotherapy

10.7102/JTCIM.202106_19(1).0007

劉永晴(Liu Yung Ching)；陳俊良(Jiun-Liang Chen)；郭忠禎(Jong-Jen Kuo)

大腸癌腹瀉 ； 化放療腹瀉 ； 中醫藥 ； Colorectal cancer with diarrhea ； Radio-chemotherapy with diarrhea ； Traditional Chinese Medicine

中醫內科醫學雜誌

19卷1期（2021 / 06 / 01）

73 - 83

繁體中文

大腸癌患者經手術切除大腸後，因失去大腸再吸收水分及儲存糞便的功能，或加上其他原因如手術損傷肛門括約肌、術後腸菌叢改變等，會經歷排便習慣改變，常見症狀有排便次數增多、裡急後重、解不盡感、糞便細碎不成形。此病例報告之患者多年前進行手術後，每日排便6-10次，條狀便或稀糊不成形，此次住院期間，因鼠蹊部淋巴結轉移正經歷化療及放療，更加重不正常排便的狀況，排便次數驟增至11-17次，伴腹脹、解不盡感及肛門灼熱。住院期間所開立之中藥雖未能有效減少患者排便次數，但藉由無效病例之記載，及探討其可能原因，亦不失爲日後辨證處方之借鑑。

Patients who underwent colectomy for colorectal cancer often experience a change in bowel habits, including too frequent stools, changes in the consistency of the stool, and urgency to get to the bathroom. These symptoms occur because the normal functions of the colon, like absorbing fluid, is impaired after having a portion of the colon removed. Other associated factors such as anal sphincter damage and changes in the gut microbiome may also aggravate the symptoms. In this case report, the 45-year-old patient underwent a subtotal colectomy after Familial adenomatous polyposis was diagnosed at age 29. Afterwards, she's been suffering from an increase in daily bowel movements, accompanied by loose stool consistency. During hospitalization in our Chinese medicine ward, she received combined chemotherapy and radiation therapy for inguinal nodes metastasis, which worsen the situation. Bowel movement frequency ranged from 11 to 17 times per day that went beyond her standard average, meanwhile, prescription of the Chinese medicine failed to improve the frequency. Although the result wasn't ideal, we can learn a lesson and bring possible progress by recording the case and discussing the possible cause.

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