活血法運用在腫瘤造成之上腔靜脈症候群之文獻回顧

Literature Review of the Blood-Activating Drugs in Treatment of Supra Vena Cava Syndrome

癌症治療過程中，上腔靜脈症候群（supra vena cava syndrome，SVCS）的出現往往會導致不好的預後，中醫在活血藥物的使用上可以幫助上腔靜脈因腫瘤壓迫之側枝循環的建立，進而改善臨床症狀，替病患爭取時間分析腫瘤細胞型態，及時給予化學藥物、放射線照射或手術治療。而學者普遍擔心活血藥是否也會加強腫瘤細胞血管的新生造成轉移，文獻分析指出活血藥確有增加腫瘤細胞血管新生的能力，但在動物學研究上已證實中藥如黃耆、薑黃等補氣活血中藥，可讓肝腫瘤異常增生的血管細胞「正常化」，正常化的血管則可以改善腫瘤細胞局部缺氧狀況，另透過減少低氧誘導因子（hypoxia--induced factor，HIF），進而使血管內皮生長因子（vascular endothelial growth factor，VEGF）生成下降。上述作用則可抑制腫瘤細胞的生長以及擴散。總結以上，上腔靜脈症候群為腫瘤治療之併發症急症，活血法在上腔靜脈症候群的患者可替其爭取時間獲得抗癌等治療，並明顯緩解臨床不適之症狀。

During the cancer therapy, the appearance of supra vena cava syndrome (SVCS) often leads to poor prognosis. The use of blood-activating drugs in traditional Chinese medicine can help the establishment of the collateral circulation of the superior vena cava which can relieve the clinical symptoms. Patients are able to gain more time to analyze tumor cell type which timely accepted chemotherapy, radiation therapy or surgery. Scholars generally worry about blood-activating drugs will enhance the angiogenesis of tumor cells which may concern its safety. So we analysis the literature which indicates that bloodactivating drugs do have the ability to increase tumor cell angiogenesis, but more over it can establish effective perfusion, in addition to improving local anoxic status of tumor cells. The reduction of hypoxia-induced factor (HIF), which leads to the decrease of vascular endothelial growth factor (VEGF) production. Due to blood-activating drugs established effective perfusion, chemical drugs can poison the tumor cell more directly. To sum up, the superior vena cava syndrome is a urgent clinical complication during cancer therapy. The patients with supra vena cava syndrome can take blood-activating drugs to relieve the symptoms of clinical discomfort, also gain more time to obtain anticancer therapy