運用中醫藥改善乳癌治療期間耳鳴病例報告

Improvement of Tinnitus During Breast Cancer Treatment Using Traditional Chinese Medicine: A case report

本例為一位51歲已婚女性，於2022年10月05日乳癌一期開刀，2022年11月有三週接受放療，於開刀後持續服用復乳納治療至今。耳鳴症狀之前完全沒有，但從2023年3月開始因房租漲五成始出現並逐漸加重，兩側耳朵皆有，高音為主；伴隨肩頸痠痛及手指關節僵硬症狀。中醫認為此患者耳鳴主要為陰虛胃熱及肝鬱化火所引起，故在本案例中採用滋陰清熱、疏肝瀉火的方式來治療；並適當衛教患者。經治療後，患者自覺耳鳴程度及頻率減輕，生活品質增加。病患每周看診自2022年9月28日至今共計看診89次。治療均以內科用藥，無接受針灸治療，目前仍持續門診追蹤中。期間耳鳴及關節痠痛仍時有提及，但症狀輕微。

This case involves a 51-year-old married female who underwent surgery and radiotherapy for stage I breast cancer on January 5, 2022. She has been on continued treatment with Femara since then. The patient reported the onset of tinnitus—primarily high-pitched—after starting the medication. The tinnitus was accompanied by shoulder and neck soreness, as well as stiffness in the finger joints. According to TCM theory, the patient's mechanism of tinnitus might drive from what TCM called yin deficiency with damp-heat and liver qi stagnation transforming into fire. Accordingly, the treatment approach included nourishing yin, clearing heat, eliminating dampness, soothing the liver, and draining fire. Appropriate lifestyle and health education were also provided to the patient. After treatment, the patient reported a noticeable reduction in the intensity and frequency of tinnitus symptoms, along with an improvement in quality of life.