口腔癌化療期間急性腹瀉之病例報告

A Case Report of Acute Chemotherapy-Related Diarrhea in Buccal Cancer with Chinese Medicine

腹瀉為化療藥歐洲紫杉醇Taxotere與鉑金類藥物同用常見之不良反應，並依嚴重程度可能同時伴隨精神低下、體重下降等症狀，甚則危及生命。本病例是一位72歲男性，為一左頰黏膜癌復發患者復發，pT4aN0M0，stage IVA，此次入院行救援性化療（salvage chemotherapy），於109/01月底換化療藥，行第一輪歐洲紫杉醇（Taxotere）與順鉑（Carboplatin）之注射，五天後開始腹瀉一日7-8行，服西藥止瀉藥舒腹達（Smecta）後減為一日3-4行，排便性質為水狀便、食後腹瀉、排便失禁等，診斷為脾虛濕阻，腎陽虛不固之腹瀉，治以四神丸合四君子湯之加減，服用中藥三天後腹瀉次數減為一日一行，並且轉為原先的糊便，且無排便失禁的症狀並恢復食慾。顯示在中醫的辨證論治之下可以有效降低化療期間產生之不適症狀。

Diarrhea is a common side effect of the chemotherapy drug Taxane and platinum drugs. Depending on the severity, it may be accompanied by symptoms such as low spirits and weight loss, which can seriously reduce the patient's quality of life, and even endanger life. In this case, a 72-year-old male with recurrence of left buccal mucosal cancer, pT4aN0M0, stage IVA, was admitted to the hospital for salvage chemotherapy. The chemotherapy was shifted to Taxotere and Carboplatin at 109/01/30. While five days later, he suffered from acute diarrhea 7-8 times a day. After treatment with Smecta, the frequency of diarrhea was reduced to 3-4 times a day. In the view point of TCM, the symptom is due to spleen deficiency, dampness, and kidney yang deficiency. After three days of taking Sishen pill and Decoction of Sijunzi, he relieved from diarrhea and his appetite was improved. It shows that under the syndrome differentiation and treatment of Chinese medicine, it can effectively reduce the uncomfortable symptoms during chemotherapy and improve the quality of life of cancer patients.