| 题名 |
口腔癌（含口咽、下咽、舌癌）的中西醫結合治療策略 |
| 并列篇名 |
Integrated treatment strategy for oral cavity cancer (inlcude oropharyngeal cancer, larynx and hypopharynx cancer, and tongue cancer) with conventional medicine and Chinese medicine |
| DOI |
10.6528/CAMS.202212_10(1).0003 |
| 作者 |
曾瑋恩(Tseng Wei-En)；何宗憲(Ho Chung Hsien)；鄭淑鎂(Shu-Mei Zheng) |
| 关键词 |
口腔癌 ； 舌癌 ； 口咽癌 ； 中醫癌症治療 ； 放射 ； 化學治療副作用 ； Oral cavity cancer ； tongue cancer ； orophyrangeal cancer ； TCM cancer treatment ； radiation therapy side effects ； chemo therapy side effects |
| 期刊名称 |
中國鍼灸學雜誌 |
| 卷期/出版年月 |
10卷1期（2022 / 12 / 18） |
| 页次 |
58 - 76 |
| 内容语文 |
英文 |
| 中文摘要 |
口腔癌是發生於口腔內的各種惡性腫瘤。其發生部位包括唇、頰黏膜、牙齦、舌、口底及顎部，臨床以鱗狀上皮細胞癌最為常見，約佔口腔癌90％以上。早期表現有局部不易癒合的潰瘍或腫塊，不易消失的口咽疼痛、吞嚥困難、聲音嘶啞等，晚期可見病灶出血、壞死、合併感染、淋巴結腫大、遠處轉移。口腔癌的治療，西醫以手術、放射治療及化學治療為主。中醫治療應區分純中醫治療，或中西醫結合治療。純中醫治療在急性期（腫瘤快速增殖期），屬大熱症，以大劑量活血化瘀加清熱解毒淡滲利濕施治。非急性期，如口咽癌增生型，屬血瘀血熱夾濕，以清熱化瘀利濕；口咽癌潰瘍型，屬腎虛夾瘀熱，以清熱化瘀加補腎。口腔癌前期，為預防性治療，屬腎陰陽兩虛夾瘀夾熱，以清熱化瘀，滋補腎陰腎陽。中西醫合療化放療期間，應區分為三階段，第一階段，小柴胡湯合併聖愈湯。第二階段，小柴胡湯合併聖愈湯，加少量乾薑、附子、玉桂子；或補腎方加黃耆、加少量乾薑、附子、玉桂子。第三階段，補腎方加人參、黃耆、乾薑、附子、玉桂子，須加清熱藥反佐。而放射治療局部性副作用的補救，初期紅腫灼熱，以清熱利濕化瘀；緩解期，以補氣養血清熱；萎縮退化期，大補腎陽加清熱化瘀。 |
| 英文摘要 |
Oral cavity cancer is a malignant tumor that situates in the oral cavity with a predilection on the lips, buccal mucosa, gingiva, tongue, the floor of the mouth, and mandible. The most common form of oral cancer is cutaneous squamous cell carcinoma. It makes up about 90% of oral cancer. The early stage manifestation includes localized unhealed ulcer and mass, long-lasting oral pain, dysphagia, and hoarseness. The late manifestation presents bleeding lesions, tissue necrosis, coinfection, lymphadenopathy, and metastasis. The conventional treatment protocol for oral cancer emphasizes surgical removal, radiation therapy, and chemotherapy. The treatment strategy of traditional Chinese medicine for oral cancer is divided into solely TCM treatment and integrated conventional and Chinese medicine. At the acute stage or porliferating stage , the tumor manifests as exacerbating heat syndrome.The treatment focuses on invigorating blood and removing stasis, clearing heat toxin and resolving dampness with high doses Chinese medicine formula with these characteristics. At the subacute stage, such as proliferative oral cavity cancer, the tumor manifest as blood stasis with heat and dampness. The treatment approach for this subtype focuses on removing blood stasis and clearing blood heat. The formula of choice emphasizes on clearing heat, removing stasis and resolving dampness. The subtype of uclerative oral cavity cancer manifest as kideny deficiency with heat stagnation. The TCM treatment approach focuses on clear heat ,removing stasis ,and tonifying kideny. At the precancerous stage of oral cavity cancer, the emphasis is on the preventive care. At this stage, the lesion manifest as kideny yang and yin deficiency with blood stasis and heat. The formula of choice would be clearing heat and blood stasis and tonifying kidney yin and yang. If approaching with integrative medicine , the plan of action would come in three stages. Stage one : Xiao Chai Hu Tang combined with Sheng Yu Tang modified. Stage two : Xiao Chai Hu Tang combined with Sheng Yu Tang modified with low dose of Gan Jiang , Fu Zi , and Rou Gui or Kidney tonifying formula modified with Huang Qi, and low dose of Gan Jiang , Fu Zi, and Rou Gui. Stage three : kidney tonifying formula modified with Ren Shen, Huang Qi, Gan Jiang and Yu Gui zi with clearing heat herbs to counteract. When approaching with localized side effects from chemo, it should also be addressed in stages. In acute stage with inflammation and swelling, the focus of treatment is clearing heat and removing dampness. In subacute stage, we focus on tonifying Qi and blood, and clearing heat at the same time. In the atrophic stage, it should be approached with reinforcing the kidney yang along with clearing heat and dissipating stasis. |
| 主题分类 |
醫藥衛生 >
中醫藥學 |
| 参考文献 |
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