研究背景：化療是癌症治療的常用方法，但治療副作用之一的骨髓抑制會導致免疫功能下降及造血功能障礙，嚴重時可能危害生命，影響患者的生活品質和治療意願。目前治療骨髓抑制副作用的方法包含注射白血球生長因子，可能會伴隨肌肉骨骼疼痛、發燒等，嚴重的話可能會導致心臟衰竭和血栓，也會再次影響患者的生活品質和治療意願。在台灣，中醫藥經常用於輔助癌症治療，減輕化療所造成的副作用，過去已有動物細胞研究及臨床研究，針對不同的中藥介入不同的癌症及不同的化療方案，在部分的研究中顯示中藥介入能改善骨髓抑制，但該研究設計有潛在的偏誤風險；部分研究中醫介入的效果並不明顯，因此目前研究結果仍存在爭議，且目前並無台灣本土的中醫介入研究。
研究目的：探討中醫輔助治療對於乳癌患者化療相關骨髓抑制的影響，分析化療期間中藥介入對白血球、血紅素、血小板數量的影響，並同時探討是否對肝腎功能造成損傷。
研究方法：本研究為回溯性世代研究，以2009-2018 年間於嘉義基督教醫院新診斷為乳癌且接受化療的女性患者為研究對象，根據中藥使用記錄分為中醫介入組和無中醫介入組。以最靠近下一次治療日的檢驗數據作為化療後之血液檢驗數據，持續追蹤整個化療療程期間，數次化療後血球的變化及肝腎功能指標。使用GEE 線性模型處理同一人的血液檢驗數值重複測量的相依性，分析中醫介入與骨髓抑制相關血液檢驗指標和肝腎功能指標之間的相關性，並調整潛在干擾因子，包含檢驗數值的基礎值、年齡、都市化程度、化療方案的種類、查爾斯共病指標、接受化療的次數、是否注射白血球生長因子促進白血球生長、是否輸血補充紅血球或血小板等。
研究結果：共納入1236 名患者，中醫介入組524 人，無中醫介入組712 人。兩組患者在年齡、化療次數、化療方案選擇和白血球生長因子使用上有統計上顯著差異。長期追蹤數據顯示，中醫介入與否對血紅素、血小板、白血球數量並無顯著差異，對肝腎功能指標也沒有顯著影響。排除白血球生長因子使用後的敏感度分析結果亦無顯著差異。
結論：本研究結果顯示，中醫介入對於乳癌患者化療期間的骨髓抑制和肝腎功能沒有顯著影響。未來需要更多前瞻性研究設計，以更精確地評估中醫藥介入對化療相關骨髓抑制的影響。

Chemotherapy-induced myelosuppression can significantly impact patients’ health. While Granulocyte colony-stimulating factor (G-CSF) injections are commonly used to manage myelosuppression, they may have side effects. In Taiwan, Traditional Chinese Medicine (TCM) is frequently employed to mitigate chemotherapy side effects, although its effectiveness remains a subject of debate. This study aimed to assess the impact of TCM on myelosuppression in breast cancer patients. Researchers analyzed data from female patients undergoing chemotherapy at Chiayi Christian Hospital. TCM intervention and its effects on blood cell counts, liver, and kidney function were investigated using statistical models. The results revealed no significant differences in blood test indicators between the TCM and non-TCM groups, and TCM intervention did not adversely affect liver and kidney function. Future studies should further explore TCM’s effects on chemotherapy-induced myelosuppression in breast cancer patients to provide more accurate insights.

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