大腸直腸癌化療毒性與舌象特徵之關係：一觀察型研究

The Relationship between Chemotherapy Toxicity and Tongue Features in Colorectal Cancer Patients - An Observational Study

10.6516/TJTCM.202209_25(3).0001

林原禾(Yuan-Ho Lin)；蔡金川(Chin-Chuan Tsai)；游榮聖(Jung Sheng Yu)

大腸直腸癌 ； 化學治療 ； 舌診 ； 自動化舌診儀 ； Colorectal cancer ； Chemotherapy ； Tongue diagnosis ； Automatic tongue diagnosis system

中醫藥研究論叢

25卷3期（2022 / 09 / 30）

1 - 12

繁體中文

目的：大腸直腸癌化療處方常用的包括FOLFOX（5-FU/leucovorin/oxaliplatin）、FOLFIRI（Folinic acid/5-fluorouracil/irinotecan），並可能合併使用標靶藥物治療。此研究希望能藉由自動化舌診儀了解化療過程中舌象特徵的變化，並藉此探討舌象及化療處方之寒熱特性。方法：招募受試者於義大醫院結腸直腸癌患者接受化學治療療程，期間持續一年，藉自動化舌診儀評估舌象特徵。結果：受試者分為FOLFOX組（9人）、FOLFIRI組（9人）與其他處方組（11人），舌苔量在脾胃區、腎區、平均面積、最大面積在FOLFOX組皆較FOLFIRI組多（p=0.041, 0.038, 0.026 及0.03）；FOLFIRI組肝膽左區齒痕數量較FOLFOX組多；FOLFIRI組平均朱點量個數在脾胃區與FOLFOX組相比有顯著的差別，FOLFIRI組較FOLFOX組多（p=0.03）；其他如舌形、瘀斑、則無差異。結論：從本研究可知，經過FOLFOX化療後，舌苔的面積其程度有加大的趨勢，尤其是脾胃及心肺區，符合FOLFOX藥物影響脾胃升降，以至於體內濕濁邪氣增加的特性；FOLFIRI化療患者脾胃區朱點增加，與FOLFOX組相比有顯著意義，FOLFIRI造成齒痕的量也較FOLFOX組多，FOLFIRI表現出造成患者寒熱錯雜的特性。

Objectives: FOLFOX (5-FU/leucovorin/oxaliplatin) and FOLFIRI (Folinic acid/5-fluorouracil/irinotecan) are frequently used for colorectal cancer, and combined with target therapies. This study aims to investigate in using automatic tongue diagnosis system on the tongue features and properties of chemotherapy drugs by observation of the tongue features during chemotherapy process. Methods: We recruited cancer patients who received chemotherapy in E-DA hospital for a year. We divided participants into three groups: FOLFOX group (N=9), FOLFIRI group (N=9), and another prescription group (N=11). Results: As a result, the amount of tongue fur at the spleen and stomach area, kidney area, average area, and maximum area is more in FOLFOX group than in FOLFIRI group (p=0.041, 0.038, 0.026 and 0.03). The number of dental marks at left liver-gal area is more in FOLFIRI group than in FOLFOX group. The number of red dots is more in FOLFIRI group than in FOLFOX group at the spleen and stomach area (p=0.03). Conclusions: Our study shows after FOLFOX treatment, the tongue fur area tends to increase, especially in the spleen-stomach and heart-lungs area. This outcome is consistent with previous findings that FOLFOX disturb the spleen-stomach system and result in the dampness accumulation. By contrast, the FOLFIRI increase the red dots at the spleen-stomach area and lead to more left liver-gal area dental marks than FOLFOX group. Our study shows FOLFIRI has the mixture properties with cold and heat.

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