小柴胡湯加減治療食道癌併發食道吞嚥困難之病例

Case Study of Traditional Chinese Medicine Treatment by Xiao-Chai-Hu-Tang in Esophageal Cancer Complicated with Esophageal Dysphagia

吞嚥困難通常是食道癌患者最早出現的症狀，會引起體重減輕、呼吸有臭味、咳嗽、聲音嘶啞、胸痛、呼吸困難、貧血、喀血或解黑便等症狀，食道癌病患在接受誘導性同步化學及放射治療期間，產生吞嚥困難會導致病患營養不良。本病例為46歲男性患者因食道癌造成吞嚥困難，採取空腸造口（Jejunostomy），以改善其營養狀況。術後病人因jejunostomy阻塞，引起上腹嚴重疼痛感，影響餵食，導致體重下降，在進行化、放療（CCRT）後，腹脹加重，經中醫診斷為肝氣鬱結，上焦氣機不利，導致阻滯，治療依傷寒論之少陽病主方－小柴胡湯加減。經治療一天後上腹痛減緩，並開始可吞嚥水，消化轉佳，精神恢復。顯示中醫治療可改善食道癌的併發症，並且有效的增進其生活品質。

Dysphagia is usually first appeared symptom in the patients of esophageal cancer and cause weight loss, foul-breathed, cough, hoarseness, chest pain, dyspnea, anemia, hemoptysis or tarry stool. Dysphagia and malnutrition were caused byconcurrentchemoradiotherapy（CCRT）inesophageal cancer patients. The case of 46-year-old male was suffered esophageal cancer and sometimes with jejunostomy obstruction.After operation, he complained dysphagia, severe abdominal pain, feeding problem, and resulting in weight loss, then sited jejunostomy in order to improve his mal-nutritional status.Dysphagiagot worse after CCRT. The diagnosis of this patient made by Chinese medicine physician wasstagnation of liver-Qi anddisorder of Qiinupper Jiao, then resulting functional activities of qi obstructed. According to the treatise of febrile disease, the prescription ＂Xiao-chai-hu-tang＂ wasprescribed to him. After one day of treatment, the complications were subsided on his pain and dysphagia. He began to drink water and turn good appetite, andgetaspirit. Those demonstrated that traditional Chinese medicine treatment can improve the complications of esophageal cancer, and effectively enhance their quality of life.