急性淋巴性白血病住院化療之中醫會診病例報告

Integrated Chinese and Western Medicine Treatment for Chemotherapy of Acute Lymphoblastic Leukemia Related Pancytopenia - A Case Report

10.7102/JTCIM.202312_21(2).0003

許芳綺(Fang-Chi Hsu)；馮盈勳(Yin-Hsun Feng)；許堯欽(Yao-Chin Hsu)

急性淋巴性白血病 ； 全血球減少症 ； 脾胃內傷 ； 補中益氣湯 ； Acute Lymphoblastic Leukemia ； Pancytopenia ； Deficiency of the spleen and stomach ； Bu Zhong Yi Qi Tang

中醫內科醫學雜誌

21卷2期（2023 / 12 / 01）

18 - 33

繁體中文;英文

這是一位60歲男性，有長期失眠的病史。近3個月嚴重失眠、全身起紅疹、唇周與齒齦腫痛，經血腫科診斷為急性淋巴性白血病。在住院進行第一次化療後疑因骨髓抑制而產生全血球減少症（pancytopenia），且因敗血性休克進入加護病房，經過西醫給予多種抗生素、類固醇、Levophed（正腎上腺素）、白血球生成素、輸血等來治療，住院約4週才出院。故本次入院準備接受第二次化療時會診中醫共同治療。本次住院，在化療前，患者失眠甚、唇紅偏乾、口角炎、牙齦熱感、手足心熱、心悸，證型為熱毒熾盛、氣陰兩虛，以知柏八味丸為主方來滋陰清熱；化療後，出現全血球減少症、疲憊、脹氣、噯氣…等脾胃內傷、氣虛下陷的表現，西醫給予白血球生成素治療，中醫處方用補中益氣湯加減大補元氣，服藥3帖後，病人的白血球順利由最低點回升到正常值，且腸胃道症狀均減緩，病情控制穩定後出院。在此案例，我們發現中醫藥的介入有助改善本急性淋巴性白血病病人接受化療後產生的白血球減少現象。

This is a 60-year-old male with a long history of insomnia. For the past 3 months, he had severe insomnia, a generalized red rash, and swelling around his lips and gums, and then he was diagnosed with acute lymphoid leukemia by the hematology and oncology doctor. After the first chemotherapy, he was suspected to have pancytopenia due to myelosuppression and admitted to the intensive care unit (ICU) due to infection. In ICU, he was treated with various antibiotics, steroids, Levophed, Filgrastim, and blood transfusion and was hospitalized for about 4 weeks before being discharged. Therefore, he asked for integrating Chinese medicine treatment at the same time of the second course of chemotherapy. Before the second course of chemotherapy regiment, the patient suffered from insomnia, red and dry lips, corns, hot and dry gums, heat in the hands and feet, and palpitations. The major syndrome was Qi and Yin deficiency. After chemotherapy, he was suspected to have pancytopenia due to myelosuppression. The patient's white blood cells were raised from the lowest point to the normal value after taking the Chinese herbal decoction for 3 days. The intervention of Chinese medicine helped to improve the decrease of white blood cells in this patient with acute lymphoid leukemia after receiving chemotherapy.

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