針藥結合治療大腸癌化療後裏急後重之病例報告

A Case Report of Colorectal Chemotherapy-Induced Tenesmus treated by Traditional Chinese Medicine and Acupuncture

10.6718/TJCM.202403_30(1).0013

王靖雯(Ching-Wen Wang)；張鈞賀(Chun-Ho Chang)；徐敬閔(Ching-Min Hsu)；陳朝宗(Chao-Tsung Chen)

裏急後重 ； 化療 ； 木香檳榔丸 ； 調味承氣湯 ； 理中湯 ； tenesmus ； chemotherapy ； Mu xiang Bing lang Wan ； Tiao Wei Cheng Qi Tang ； Li Zhong Tang

台北市中醫醫學雜誌

30卷1期（2024 / 03 / 17）

115 - 124

繁體中文;英文

在現在醫療進步的社會中，雖然癌症已慢慢成為慢性疾病，其需經歷的手術、長期化療、放療等仍然對病患造成許多身體與心理的負擔。裏急後重是形容便意頻繁卻無法排便的一種症狀，最常出現於罹患大腸直腸癌之患者，現代醫學認為此症狀是由於腸道嚴重發炎或便秘使腸道神經受到頻繁刺激所致；而中醫則認為脾胃運化失常為其病因，證型上可分為濕熱、氣滯、氣虛與津傷血虛所致。裏急後重使病患之排便習慣在便秘與腹瀉間交替，若不及時改善，將降低化療患者之生活品質，甚者更會拖延癌症治療的進程，直接影響醫療的效能。本病例為一位大腸癌化療後裏急後重之女性，經由木香檳榔丸、調味承氣湯、理中湯加減給予調理，而獲得改善。

Today, with advanced medical treatments, although cancer has gradually become a chronic disease, the need for surgery, long-term chemotherapy, radiotherapy, etc. still imposes physical and psychological burdens on the cancer patients. Tenesmus is a symptom that appears most often in patients with colorectal cancer. Western medicine believes that these symptoms are caused by severe inflammation or nerve damage of the bowel, while traditional Chinese medicine believes that the abnormal spleen and stomach qi transformation is the key cause, and the syndromes can be divided into damp-heat, qi Stagnation, qi deficiency, and the deficiency of blood and qi. Tenesmus causes the patient's defecation habit to alternate between constipation and diarrhea. If not improved in time, it will reduce the patient's quality of life, and even hamper the treatment of cancer, directly affecting the effectiveness of medical treatments. This case is about a woman who suffered from severe tenesmus symptoms after chemotherapy for colorectal cancer. Her symptoms had improved after receiving a modified dose of Mu Xiang Bing Lang Wan, Tiao Wei Cheng Qi Tang and Li Zhong Decoction.