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243.5 小細胞肺癌合併腦轉移性腫瘤出血之病例報告

TJ TCM.24(3) : 69-80, 2021

DOI : 10.6516/TJTCM.202109_24(3).0005

小細胞肺癌合併腦轉移性腫瘤出血之病例報告

Small Cell Lung Cancer Complicated with

Metastatic Brain Tumor Hemorrhage A Case Report of Treating

歐虹汝1　朱清蘭1　林經偉1,2*

1 花蓮慈濟醫院中醫部，花蓮，台灣

2 慈濟大學學士後中醫學系，花蓮，台灣

【摘要】

顱內腫瘤有一半以上屬於轉移性腦腫瘤，而肺癌是最容易轉移到腦部的癌症，其中小細胞肺癌因為惡性度高、發現時多為末期等因素而影響病患存活率。本病例提出一名66 歲男性患者，以突發性眩暈伴隨左側肢體無力為主證，至本院診斷為小細胞肺癌合併轉移性腦腫塊癌出血而住院接受手術治療。患者於住院期間同時會診中醫共同照護，出院後仍持續在門診追蹤治療。臨床上轉移性腦癌以出血合併神經功能受限為表現並不常見，而中醫藥在癌症的末期階段治療上有其一定的臨床價值，主要著重於扶正祛邪、調補氣血、清熱解毒、活血化瘀以幫助復原，改善生活品質，本病案於服用中藥後，頭暈、納差、左側肌力較差等症狀皆有改善，並可藉由改善不適症狀，以達順利完成西醫療程之目標。在此提出中西醫合作治療小細胞肺癌合併轉移性腦腫瘤出血的病案，以提供臨床上治療癌症腦轉移的參考。

【關鍵詞】小細胞肺癌、轉移性腦腫瘤、腦腫瘤出血、中醫藥

Hung-ju Ou1　Ching-lan Chu1　Ching-wei Lin1,2*

1Department of Traditional Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan

2Tzu Chi University School of Post-Baccalaureate Chinese Medicine, Hualien, Taiwan

【Summary】

There were more than half of the intracranial tumors which came from metastatic brain tumor. In all cases, lung cancer is the most likely cancer to become metastatic brain tumor. Small cell lung cancer which is a highly malignant cancer affects the survival rate of patients, especially patients in the terminal stage. In this case, we propose a 66-year-old male patient who suffered from sudden onset of dizziness which accompanied with left limbs weakness before admission. This patient was diagnosed with metastatic brain cancer with hemorrhagic mass, and then admitted for further treatment after admission. This patient consulted with Chinese medicine for integrated care during the hospitalization. After discharged, he kept follow up in the outpatient clinic. Clinically, it is not a common situation for a metastatic brain cancer which is manifested as a hemorrhagic stroke. Chinese medicine could strengthen the body and eliminate evil, regulate qi and blood, increase anti-inflammatory effect and detoxify, decrease blood stasis, and improve the quality of life which had certain clinical value. With the help of oriental medicine, there were more patient who could achieve the goal of successfully completing the terminal stage treatment of western medicine. We propose an integrated treatment of Chinese and Western medicine in the small cell lung cancer with brain metastasis, which provides a clinical reference for treating metastatic

brain tumor and for further research.

【Keywords】Small Cell Lung Cancer; Metastatic Brain Tumor; Brain Hemorrhagic Stroke

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