[台灣蘋果日報 記者 張博亭 蔡明樺]2013/09/20
癌症、高血壓與胃潰瘍是國人3大常見疾病，前兩者更長期名列國人10大死因，但近年來國內醫院持續引進新儀器、研發新療法，已提高治療成效，其中台大醫院找到能根治幽門桿菌的序列性療法，可防範因此菌造成的胃潰瘍；國泰醫院、台北榮總則分別引進治療癌症的放療利器真光刀，與治療頑固性高血壓的腎交感神經阻斷術，為病人帶來康復新契機。 Cancer, hypertension and gastrophy are the three most common causes of death in the country, the first two of which have long been known as the 10 leading causes of death in the country, but in recent years hospitals in the country have continued to introduce new instruments, develop new treatments, and have improved the efficacy of treatments, in which large hospitals have found sequenced treatments capable of treating phantom bacteria, which are resistant to the stomach caused by the fungus; the National Hospital in Thailand and the General Director of Taipei have separately introduced the Lenior Sword for the treatment of cancer; and the treatment of solid hypertension in the kidneys, which have been blocked, bringing new healing machines to patients. /span> 國內約有半數成年人胃部感染幽門桿菌，長期感染恐致胃潰瘍甚至胃癌，由台大醫院內科部教授吳明賢帶領團隊，2010年起進行900人臨床試驗，發現用3種抗生素搭配改善胃酸分泌的藥物--質子幫浦抑制劑序列性療法，滅菌率高於傳統療法的82％，達94％；去年起全台已有近千名幽門桿菌患者接受此療法。 Half of the adult population in the country has a stomach infection with phantom rods, a chronic infection that threatens stomach cyst and even stomach cancer, led by Professor Ng Ming-hyun of the Department of Internal Affairs of the Grand Hospital. 900 bed visits have been conducted since 2010 and three antibiotic combinations with improved gastric acid secretion have been found - the Quality Pump Serial Method, which is higher than 82% of the traditional treatments, up to 94%; nearly a thousand phantoms have been treated since last year.
吳明賢說，傳統療法只用克拉霉素、安莫西林兩種抗生素，療程約1周，在日韓等胃癌高盛行率國家，幽門桿菌抗藥性高、滅菌效果差；新療法則使分別使用3種抗生素：莫西林、服立治兒錠、克拉霉素，療程約14天，滅菌率逾9成。
U Myung-hyun says that traditional treatments are based on only two antibiotics, Kramoxin, Anmosilin, for a period of about one week, in countries with high stomach cancer prevalence, such as Japan and Korea, where phantom rodents are highly resistant and have poor antibacterial effects; the new treatment allows for the use of three different types of antibiotics: Moxillin, Pediatrics, Kramoxin, for about 14 days, with an antibacterial rate of over 90 per cent.
阻斷神經控制血壓
去年高居國人10大死因第8名的高血壓，病患人數達400萬人，其中有70至80萬人更是頑固型高血壓，即服用3種以上降血壓藥物仍無法控制血壓者，這群患者常因血壓高而致腦中風。北榮今年5月創國內之先進行腎交感神經阻斷術，振興醫院隨後也在同月進行。振興心臟內科醫師黃建龍說，連結腎臟的腎動脈有許多腎交感神經纏繞，腎交感神經亢奮時會造成腎動脈收縮，引發使血壓上升的荷爾蒙變化，以該阻斷術破壞腎交感神經，即可望控制血壓。北榮心臟內科醫師宋思賢指，該院已為3名頑固型高血壓患者進行此術，患者術後收縮壓平均降20毫米汞柱，並可減少降血壓藥藥量。
The 8th high blood pressure of last year's 10 leading deaths in high-lying countries has reached 4 million people, of whom 700,000 to 800,000 are suffering from stifling high blood pressure, i.e. taking more than three blood-pressure medications is still uncontrollable. This group of patients often has a stroke caused by high blood pressure. < > > > > >
可滅早期8成腫瘤
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而針對長期居國人10大死因之首的癌症，國泰醫院上月引進國內醫學中心首部真光刀直線加速器，可治療肝癌、肺癌等多種適用放射治療的癌症。該院放射腫瘤科主任吳錦榕指，此儀器以高電壓產生高強度的放射線破壞腫瘤細胞，相較傳統放療，它還具影像導航等功能，更能集中能量、精準殲滅癌細胞。吳指此儀器每部至少上億元，現該院有近20位患者使用，適應症包括頭頸癌、攝護腺癌、子宮頸癌，肺癌、肝癌等，因療程尚未結束，暫無法精確評估療效。台大醫院腫瘤醫學部主任成佳憲說，真光刀直線加速器能量強，較適用早期未轉移的癌症，如可消滅早期肺癌者約8成腫瘤、存活率逾50％；傳統直線加速器較適用晚期癌症治療，如對肺癌末期雖約能消滅6成腫瘤，但因腫瘤較大且已擴散，故存活率低、兩年內即可能死亡。
均須自費有副作用 with side effects at your own expense 但新療法也有缺點。如進行幽門桿菌序性療法患者，服藥後恐有腹瀉等副作用，也須自費約3千元藥費；腎上腺交感神經阻斷術費用則須12到14萬元，高血壓學會秘書長、心臟內科醫師王宗道並指患者術後只能減藥，仍無法停用降血壓藥。進行真光刀療法患者則有噁心等副作用，且若使用影像導航等附加功能，費用將達20多萬元。民間健保監督聯盟發言人滕西華則指，新療法未必好，但一定貴，民眾應多方諮詢。衛生福利部醫事司司長李偉強也說，新療法為治療選擇之一，但未必適合每個人。40歲的廖先生2年前罹患肝癌，先以栓塞療法成功將腫瘤縮小，再手術切除，現仍持續放療，他說若新療法有效，貴也會去嘗試。民眾蔡先生指自己進行幽門桿菌的序列性療法兩周後，已大幅改善常吐胃酸情況。
幽門桿菌序列性療法小檔案 ◎原理：以質子幫浦抑制劑搭配3種抗生素，消滅胃部幽門桿菌◎適應症：感染胃部幽門桿菌◎費用：療程10～14天，費用約3000元◎優點：對幽門桿菌的滅菌率達94％，優於傳統療法的82％◎缺點：恐有腹瀉、頭暈、過敏等副作用；健保不給付資料來源：吳明賢醫師 Rationale: three antibiotics with a proton-pump inhibitor to eliminate phantom strains of the stomach: costs of phantom bacterium infections in the stomach: 10-14 days of treatment of approximately $3,000: 94 per cent of fungicides to phantom bacterium and 82 per cent of defectes to traditional methods: fear of abdominal, dizziness, allergies, etc.; insuring non-payment of data: Doctor Oh Myung /span > 真光刀直線加速器小檔案
◎原理：以高強度的放射線照射腫瘤，破壞癌細胞◎適應症：所有適用於放射治療的癌症◎費用：放射治療有健保給付，若使用影像導航、呼吸調控等附加功能需自費，一個療程約20餘萬元◎優點：適用於早期未轉移的癌症治療，因效果較傳統放療強，可縮短療程可精準於腫瘤破壞，較不傷及周遭組織◎缺點：附加功能需自費仍會出現放療副作用，如口乾舌燥、噁心、吞嚥困難等資料來源：成佳憲醫師、《蘋果》採訪整理 Rationale: High-intensity radiation exposure to tumors and damage to cancer cells: all cancer costs suitable for radiotherapy: radiotherapy is covered by health care, and if additional functions such as video navigation, respiratory control, etc. are used at their own expense, a treatment of about 200,000 yuan would be preferable to early non-transferable cancer treatments, which, due to their more traditional effects, can be used to reduce the short course of treatment to mamma damage, rather than to trauma and organizational deficiencies: additional functions would still require side effects, such as dry tongue, nausea, odiousness, etc. 腎交感神經阻斷術小檔案
◎原理：透過燒灼破壞腎動脈的腎交感神經，以達到控制血壓目的◎適應症：頑固型高血壓◎費用：需自費約12到14萬元◎優點：對服用降血壓藥仍無法控制血壓的高血壓患者，提供新選擇◎缺點：腎動脈直徑小於0.4公分的患者不適用進行阻斷術後，降血壓藥量雖可減少，無法停藥無健保給付資料來源：黃建龍醫師、蘋果採訪整理 Rationale: Adaptive to control blood pressure through the burning of kidney arteries to meet the need for stress management: the cost of steroid hypertension: the need to spend about $120,000 to 140,000 of its own: provide new options for high blood pressure patients who are still unable to control blood pressure: patients with an aphrodisiac diameter of less than 0.4 cm are less likely to be able to reduce the amount of blood pressure than they are able to provide without safe access to data after dissusions: Yellow Dragon Doctor, Apple interview 腎交感神經阻斷術示意圖 indication of neural resistance to kidneys 在鼠蹊部開一個小洞，將導引管穿入，沿著股動脈接到主動脈，之後來到主動脈與腎動脈的交接處，將導引管中的軟管伸出放熱燒灼腎動脈血管，以破壞血管外壁上附著的腎交感神經，使其無法發揮會使血壓飆升的作用，達到控制血壓目的。資料來源：黃建龍醫師 opens a small hole in the rat's croak, passes the tube through the main artery along the feline, then comes to the interface between the main arteries and the kidney arteries, stretches the tubes in the lead tubes out of the hot burning kidney arteries in order to destroy the neurosynthesis attached to the external walls of the veins, preventing them from performing the function of causing blood pressure to rise to the point of blood pressure control. Data source: Yellow Dragon Doctor
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