肝細胞癌的發生率約為32.97百萬人年，治療手段涵蓋手術（肝切除、肝移植）、射頻治療、經動脈化學栓塞、放射線治療、免疫治療、標靶藥物等。對於符合肝臟移植標準、且有肝臟捐贈來源的患者，因其較低的復發率，故較為病人所接受。肝移植也是在肝病末期患者唯一的存活選項。近年來此項手術技術及術後處置越來越進步，目前台灣衛服部核可的肝臟移植多家醫院中，手術成功率超過九成，5年存活率也有70%左右，堪稱世界一流的水準。肝臟移植成功率之提昇主要歸功於多種選擇性免疫抑制劑的臨床應用，可因大幅度地減少急性排斥的發生率，進而改善病人術後的預後。但是，尚待解決的部份為此類免疫抑制劑須終身服用，長期可影響心血管系統、神經系統、與腎功能下降等效應。
中西醫的醫學理論及語言大不不相同，造成許多不必要的誤解。以中醫的肝系主要對應現代醫學的精神神經系統、主筋、主目等。實質的（西醫）肝臟則更接近於中醫所言之脾胃系統，所以在中醫治療上則偏重脾胃系統。
中國醫藥大學附設醫院為中西醫結合醫院，致力於中西醫的溝通與共治，故在肝移植的患者身上，希冀納入中醫治療後，對患者的生活品質、三高、肝腎功能有所裨益。自2020年4月起，開設移植外科、中醫內科聯合門診，減少患者返診之舟車勞頓，已有205位肝友接受此項服務，也曾於肝友會進行演講，讓肝友更了解中醫的「致中和」精神。過往在肝移植服用中藥的族群不多，透過這次經驗，我們以肝移植患者為例，逐步建立完整的追蹤、交流、改善制度，追蹤患者服中藥前後之症狀改善、中醫體質變化、抗排斥藥物濃度變化、三高、肝腎功能變化等，兼顧患者之症狀改善與用藥安全，增進患者的健康與醫療滿意度。
The incidence of hepatocellular carcinoma is about 32.97 million person-years. Treatments for hepatocellular carcinoma include surgery (liver resection, liver transplantation), radiofrequency therapy, trans-arterial chemoembolization, radiation therapy, immunotherapy, targeted drugs, and so on. Patients who meet the criteria for liver transplantation and with available liver donation sources are more open to liver transplantation due to a lower recurrence rate. Liver transplantation is also the only survival option for patients with end-stage liver disease. As the surgical technique and post-operative care have become more and more advanced in recent years, the success rate of the operation exceeds 90%, and the 5-year survival rate also reaches around 70% among hospitals approved by the Taiwan Ministry of Health Services for liver transplantation. The improvement of the success rate of liver transplantation could be mainly attributed to the clinical application of a variety of selective immunosuppressants, which could greatly reduce the incidence of acute rejection, thereby improving the postoperative prognosis of patients. However, the downfall of the treatment is that such immunosuppressants must be taken for life, and may further affect the cardiovascular system, the nervous system, and the declining of renal function in the long-term.
Due to different theoretical approaches, communication between the two systems was often confusing. For example, liver in Western medicine and in Chinese medicine（肝）had different meanings. The liver in traditional Chinese medicine had the function similar to the psychogenic and nervous systems, and had functions such as governing the sinews（主筋）and opening at the eyes（開竅於目）. While in Western medicine, liver worked like the spleen in Chinese medicine.
China Medical University Hospital is a hospital of integrated Chinese and Western medicine which is dedicated to the communication and co-treatment of Chinese and Western medicine. Therefore, we hope that the inclusion of Chinese medicine treatment will benefit the quality of life, three highs (hypertension, high blood cholesterol, and high blood sugar), and liver and kidney functions of the patients received liver transplantation. Since April 2020, a joint clinic of transplant surgery and internal medicine of traditional Chinese medicine has been established in favor of the convenience of the patients. 205 patients who had liver transplantation have received this service. They have also given speeches at the liver transplantation patient association, so that other patients can better understand the spirit of "neutralization" in traditional Chinese medicine. In the past, receiving traditional Chinese medicine treatment was not a popular option among patients that had undergone liver transplantation. Through the experience of combining Western and Chinese medicine treatment on liver transplantation patients, we gradually established a tracking, communication, and improvement system to record the improvement of symptoms, changes in body constitution in Chinese medicine, and the dosage of anti-rejection drugs before and after taking Chinese medicine, three highs, changes in liver and kidney functions, and so on, with the consideration of medication safety and medical satisfaction. |
