乳癌為我國婦女發生率第一的癌症，而化學治療是最常被使用的治療方式。化療藥物粗略分為兩大類，一類為蒽環類藥物，一類為非蒽環類藥物。本實驗設計選擇蒽環類的化療藥物，它可廣泛用於治療多項癌症，但會造成許多副作用，其中心毒性對人體威脅最大，會使心臟收縮力變差導致供血不順，久而久之可能會心臟衰竭。
除了西醫治療，中醫的介入可以提升患者生活品質以及存活率。本研究中藥的選擇為已證實在癌症治療上有幫助的中藥「寬心飲」作為對照組，與未服用寬心飲受測者做比較，驗證此本實驗室自行開發的系統對於化療副作用的解析能力，期望能即時監控副作用達到提升癌症患者生活品質的目的。
本實驗室所開發之微循環量測系統所包含的設備有心電圖訊號放大器（ECG）、動脈血壓波形模組（BPW）、光血容積訊號儀（PPG）、雷射都卜勒血流儀（LDF），分別可量測到心臟端、動脈端、動脈端與部分微循環端及微循環端。受測者分為兩組: NK組為沒有任何中醫介入並維持原本西醫治療、K組為在化療期間搭配寬心飲治療。
LDF 時域分析、LDF時域分析各項的變異度、LDF頻域分析、LDF複雜度分析以及PPG諧波走勢皆能看出NK組與K組的差異，代表此量測系統對化學治療造成的副作用有解析的能力。兩組的生理表現在EORTC QLQ C-30生活品質評估量表及血液檢查的白血球數量也有明顯的差異。推論我們在循環上量測到的差異與受測者的生理變化有關。此結果代表此套量測系統有機會能以非侵入、即時且客觀的評估化療病人的生活品質。

In Taiwan, breast cancer ranks at the top for cancer incidence in women. Chemotherapy is the most common treatment method for breast cancer and can be roughly divided into two main categories, anthracyclines, and non-Anthracyclines. In this study, anthracyclines were the drug-of-choice used as chemotherapeutic agents. This type of drug can be widely used in the treatment of many types of cancers but can cause many side effects. Amongst these side effects, cardiotoxicity poses the greatest threat to the human body as it can weaken cardiac contractibility, resulting in poor blood supply and may lead to heart failure over a long period of time.
In addition to treatment using Western medicine, traditional Chinese medicine (TCM) interventions can improve the quality of life and survival of patients. For this study, we selected “Kuan-Sin-Yin” which has demonstrated its usefulness in cancer treatment as a control group for comparison with subjects that did not take Kuan-Sin Yin in order to validate the analytical capabilities of the system that our laboratory has developed for chemotherapy side effects. We hope that this system can provide real-time monitoring of side effects and achieve the aim of improving the quality of life for cancer patients.
The devices in the microcirculatory measurement system developed by our laboratory includes ECG, BP, PPG, and LDF, which can respectively measure the heart, arteries, arteries and some microcirculation, and microcirculation. Subjects were divided into 2 groups: the NK group that maintained the original treatment with Western medicine and without TCM intervention while the patients in the K group underwent additional treatment with Kuan-Sin-Yin along with chemotherapy.
LDF time-domain analysis, LDF time-domain analysis of the CV of various items, LDF frequency-domain analysis, LDF Approximate Entropy and PPG harmonic trends all showed differences between the NK and K groups, demonstrating the measurement system’s ability to analyze the side effects caused by chemotherapy. There were also significant differences in the physiological performances of the two groups in the EORTC QLQ C-30 quality of life questionnaires and leukocyte count in blood tests. We deduced that the differences detected by our circulation measurements are related to the physiological changes of the subjects. These results showed that our measurement system can be used for non-invasive, real-time, and objective evaluation of the quality of life of chemotherapy patients.

1.衛生福利部國民健康署. (2018). 乳癌防治. Retrieved from https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=205&pid=1124
2.衛生福利部國民健康署. (2017). 乳癌篩檢介紹. Retrieved from https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=623&pid=1140
3.全球醫學新知. (2015). 乳癌的治療方式有哪些? Retrieved from http://www.globalmednews.tw/epaper.php?no=39
4.Fujiwara, A., Hoshino, T., & Westley, J. W. (1985). Anthracycline Antibiotics. Critical Reviews in Biotechnology, 3(2), 133-157. doi:10.3109/07388558509150782
5.Chatterjee, K., Zhang, J., Honbo, N., et al. (2010). Doxorubicin cardiomyopathy. Cardiology, 115(2), 155-162.
6.賴鴻文. (2015). 常用乳癌化療藥物簡介 -微脂體小紅莓病. Retrieved from http://blog.xuite.net/hungwenlai/twblog/113164824-%E5%B8%B8%E7%94%A8%E4%B9%B3%E7%99%8C%E5%8C%96%E7%99%82%E8%97%A5%E7%89%A9%E7%B0%A1%E4%BB%8B+-%E5%BE%AE%E8%84%82%E9%AB%94%E5%B0%8F%E7%B4%85%E8%8E%93%E7%97%85
7.張金堅. (2014). 乳癌病人治療之心血管問題. 臺灣醫界, 57(2), 13-16.
8.Partridge, A. H., Burstein, H. J., & Winer, E. P. (2001). Side effects of chemotherapy and combined chemohormonal therapy in women with early-stage breast cancer. JNCI Monographs, 2001(30), 135-142.
9.Chien, T.-J., Liu, C.-Y., Ko, P.-H., et al. (2016). A Chinese decoction, Kuan-Sin-Yin, improves autonomic function and cancer-related symptoms of metastatic colon cancer. Integrative cancer therapies, 15(1), 113-123.
10.Lee, Y. W., Chen, T. L., Shih, Y. R. V., et al. (2014). Adjunctive traditional Chinese medicine therapy improves survival in patients with advanced breast cancer: A population‐based study. Cancer, 120(9), 1338-1344.
11.Chien, T.-J., Liu, C.-Y., Lu, R.-H., et al. (2016). Therapeutic efficacy of Traditional Chinese medicine, “Kuan-Sin-Yin”, in patients undergoing chemotherapy for advanced colon cancer – A controlled trial. Complementary Therapies in Medicine, 29, 204-212. doi:https://doi.org/10.1016/j.ctim.2016.10.001
12.Roskoski, R. (2007). Vascular endothelial growth factor (VEGF) signaling in tumor progression. Critical Reviews in Oncology/Hematology, 62(3), 179-213. doi:https://doi.org/10.1016/j.critrevonc.2007.01.006
13.陳志明. 血管新生是什麼. Retrieved from https://sites.google.com/site/angiogenesisdrbalance/
14.Folkman, J. (2006). Angiogenesis. Annu Rev Med, 57, 1-18. doi:10.1146/annurev.med.57.121304.131306
15.Gonzalez-Perez, R. R., & Rueda, B. R. (2013). Tumor Angiogenesis Regulators: CRC Press.
16.Hida, K., & Maishi, N. (2018). Abnormalities of tumor endothelial cells and cancer progression. Oral Science International, 15(1), 1-6. doi:https://doi.org/10.1016/S1348-8643(17)30041-1
17.Patan, S., Tanda, S., Roberge, S., et al. (2001). Vascular Morphogenesis and Remodeling in a Human Tumor Xenograft: Blood Vessel Formation and Growth After Ovariectomy and Tumor Implantation. Circulation research, 89(8), 732-739.
18.Dudley, A. C. (2012). Tumor Endothelial Cells. Cold Spring Harbor Perspectives in Medicine, 2(3), a006536. doi:10.1101/cshperspect.a006536
19.陳冠彰. (2016). 循環訊號量測應用於乳癌患者病程監控之研究.
20.Hsu, T. L., Chao, P. T., Hsiu, H., et al. (2006). Organ-specific ligation-induced changes in harmonic components of the pulse spectrum and regional vasoconstrictor selectivity in Wistar rats. Experimental Physiology, 91(1), 163-170. doi:10.1113/expphysiol.2005.031575
21.Dewan, R. 切診. Retrieved from http://www.shen-nong.com/chi/exam/exam_diagnostic_palpation.html
22.吳奇燊. (2014). 基於脈象結構開發輔助中醫脈診之行動 APP.
23.宋巧娟. (2016). 循環量測指標應用於冠狀動脈狹窄疾病之研究.
24.林明政, 李名世, 王俊民, et al. (2002). 雷射杜卜勒微流儀之原理與臨床醫學之應用, 醫檢會報.
25.Instruments, M. Laser Doppler Monitor moorVMS-LDF. Retrieved from https://us.moor.co.uk/product/moorvms-ldf-laser-doppler-monitor/1
26.ADLINK官方網站. Multi-Function DAQ PCI-9111 Series. Retrieved from https://www.adlinktech.com/Products/Data_Acquisition/Multi-Function_DAQ/PCI-9111_Series?lang=en
27.Bernardi, L., Rossi, M., Fratino, P., et al. (1989). Relationship between phasic changes in human skin blood flow and autonomic tone. Microvascular research, 37(1), 16-27.
28.Kvandal, P., Landsverk, S. A., Bernjak, A., et al. (2006). Low-frequency oscillations of the laser Doppler perfusion signal in human skin. Microvascular research, 72(3), 120-127.
29.Pincus, S. M. (1991). Approximate entropy as a measure of system complexity. Proceedings of the National Academy of Sciences, 88(6), 2297-2301.
30.Pincus, S. (1995). Approximate entropy (ApEn) as a complexity measure. Chaos: An Interdisciplinary Journal of Nonlinear Science, 5(1), 110-117.
31.胡曉峯. (2017). 利用雷射杜卜勒血流訊號分析應用於糖尿病早期偵測及調控機制探討研究.
32.萬崇華, 陳明清, 張燦珍, et al. (2005). 癌症患者生命質量測定量表 EORTC QLQ-C30 中文版評介. 實用腫瘤雜誌, 20(4), 353-355.
33.Lu, W., Cheng, C., Wang, Y. L., et al. (1996). Pulse spectrum analysis of hospital patients with possible liver problems. The American journal of Chinese medicine, 24(03n04), 315-320.
34.Politano, L., Palladino, A., Nigro, G., et al. (2008). Usefulness of heart rate variability as a predictor of sudden cardiac death in muscular dystrophies. Acta Myologica, 27(3), 114-122.