[1]孙梦莹张爱琴于爱军 刘敬芳陈莎莎.桂枝茯苓汤联合大黄玄明粉外敷治疗盆腔淋巴囊肿临床研究[J].陕西中医药大学学报,2024,(06):116-120.[doi:10.13424/j.cnki.jsctcm.2024.06.019]
　SUN Mengying?ZHANG Aiqin?YU Aijun?LIU Jingfang?CHEN Shasha.Clinical Study on the Treatment of Pelvic Lymphatic Cysts with Guizhi Fuling Decoction Combined with Dahuang Xuanming Powder External Application[J].Journal of Shaanxi University of Traditional Chinese Medicine,2024,(06):116-120.[doi:10.13424/j.cnki.jsctcm.2024.06.019]
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桂枝茯苓汤联合大黄玄明粉外敷治疗盆腔淋巴囊肿临床研究()
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《陕西中医药大学学报》[ISSN:2096-1340/CN:61-1501/R]

卷:
期数:
2024年06期
页码:
116-120
栏目:
出版日期:
2024-11-20

文章信息/Info

Title:
Clinical Study on the Treatment of Pelvic Lymphatic Cysts with Guizhi Fuling Decoction Combined with Dahuang Xuanming Powder External Application
文章编号:
2096-1340(2024)06-0116-05
作者:
孙梦莹1张爱琴2于爱军2 刘敬芳2陈莎莎3
1.浙江中医药大学第二临床医学院，浙江 杭州 310053；
2.浙江省肿瘤医院，浙江 杭州 310022；3.台州市肿瘤医院，浙江 台州 317502
Author(s):
SUN Mengying1?ZHANG Aiqin2?YU Aijun2?LIU Jingfang2?CHEN Shasha3
1.Second Clinical School of Zhejiang University of Chinese Medicine,Zhejiang Hangzhou 310053,China;
2.Zhejiang Cancer Hospital,Zhejiang Hangzhou 310022,China;
3.Taizhou Cancer Hospital,Zhejiang Taizhou 317502,China
关键词:
关键词：妇科恶性肿瘤; 盆腔淋巴结清扫术; 淋巴囊肿; 桂枝茯苓汤; 大黄玄明粉
Keywords:
Key words： Gynecological malignant tumors; Pelvic lymph node dissection; Lymphatic cyst; Traditional Chinese medicine; Traditional Chinese medicine external treatment; Guizhi Fuling decoction; Dahuang Xuanming powder
分类号:
R271.9
DOI:
10.13424/j.cnki.jsctcm.2024.06.019
文献标志码:
A
摘要:
摘要：目的 观察桂枝茯苓汤联合大黄玄明粉外敷治疗盆腔淋巴结清扫术后并发的淋巴囊肿的临床疗效。方法 纳入2020年7月—2022年5月由浙江省肿瘤医院妇科肿瘤科收治的53例接受盆腔淋巴结清扫术后确诊淋巴囊肿的妇科恶性肿瘤患者，按照2∶3的比例随机分组为治疗组20例和对照组33例。治疗组予桂枝茯苓汤内服，囊肿局部由大黄玄明粉外敷；对照组不做特殊处理，保持观察。比较两组患者治疗后淋巴囊肿消退程度、中医症状积分及不良反应发生情况，评估治疗4 w后两组患者的疗效，统计随访1年内继发感染和下肢水肿发生情况以及淋巴囊肿复发情况。结果 治疗组淋巴囊肿消退程度显著大于对照组（P<0.05）。治疗组有效率90%，对照组有效率30.3%，治疗组高于对照组（P<0.05）。治疗组中医症状评分高于对照组（P<0.05）。两组均未出现血象及肝肾功能异常（P>0.05）。治疗组1年内继发感染率15%，下肢水肿率20%；对照组1年内继发感染率41.4%，下肢水肿率51.7%，治疗组均低于对照组（P<0.05）。治疗组1年内囊肿复发率5.0%，对照组复发率24.1%，两组差异无统计学意义（P>0.05）。结论 桂枝茯苓汤联合大黄玄明粉外敷治疗淋巴囊肿疗效显著，安全性高，能够改善患者生活质量。
Abstract:
Abstract： Objective To observe the clinical efficacy of Guizhi Fuling decoction combined with Dahuang Xuanming powder external application in the treatment of lymphatic cysts after pelvic lymph node dissection.Methods A total of 53 gynecological malignant tumor patients diagnosed with lymphatic cysts after pelvic lymph node dissection admitted to the Gynecological Oncology Department of Zhejiang Cancer Hospital from July 2020 to May 2022 were randomly divided into a treatment group of 20 cases and a control group of 33 cases in a 2∶3 ratio.The treatment group was given Guizhi Fuling decoction orally,and the cyst was locally treated with external application of Dahuang Xuanming powder;The control group will not receive special treatment and will be observed.Compare the degree of lymphatic cyst regression,traditional Chinese medicine symptom scores,and incidence of adverse reactions between two groups of patients after treatment,evaluate the efficacy of the two groups of patients after 4 weeks of treatment,and record the occurrence of secondary infections,lower limb edema,and lymphatic cyst recurrence within 1 year of follow-up.Results The degree of regression of lymphatic cysts in the treatment group was significantly greater than that in the control group (P<0.05).The effective rate of the treatment group was 90%,while the effective rate of the control group was 30.3%,which was higher in the treatment group than in the control group (P<0.05).The TCM symptom score of the treatment group was higher than that of the control group (P<0.05).Both groups did not show any abnormal blood count or liver or kidney function (P>0.05).The secondary infection rate of the treatment group within 1 year is 15%,and the lower limb edema rate is 20%;The secondary infection rate in the control group within one year was 41.4%,and the lower limb edema rate was 51.7%,both of which were lower in the treatment group than in the control group (P<0.05).The recurrence rate of cysts within one year in the treatment group was 5.0%,while the recurrence rate in the control group was 24.1%.There was no statistically significant difference between the two groups (P>0.05).Conclusion The combination of Guizhi Fuling decoction and Dahuang Xuanming powder for external application has significant therapeutic effect and high safety in the treatment of lymphatic cysts,and can improve the quality of life of patients.

参考文献/References:

［1］郭勤浩,余敏,吴小华.2022年度妇科肿瘤诊治进展［J］.中国癌症杂志,2023,33(1):14-24.
［2］姜涛,张亚,何雅静,等.妇科盆腔淋巴结清扫术后淋巴囊肿的预防［J］.热带医学杂志,2015,15(5):638-641.
［3］卢淮武,林仲秋,周晖,等.盆腔淋巴结切除术后盆腔淋巴囊肿形成与防治［J］.中国妇产科临床杂志,2007,8(4):308-310.
［4］林蓓,凌斌,张师前,等.妇科恶性肿瘤盆腔淋巴结切除术后淋巴囊肿诊治专家共识(2020年版)［J］.中国实用妇科与产科杂志,2020,36(10):959-964.
［5］WEINBERGER V,CIBULA D,ZIKAN M.Lymphocele:prevalence and management in gynecological malignancies［J］.Expert Review of Anticancer Therapy,2014,14(3):307-317.
［6］张志毅.妇癌临床手术学［M］.上海:上海科学技术出版社,1994:139-140.
［7］ZIKAN M,FISCHEROVA D,PINKAVOVA I,et al.A prospective study examining the incidence of asymptomatic and symptomatic lymphoceles following lymphadenectomy in patients with gynecological cancer［J］.GynecologicOncology,2015,137(2):291-298.
［8］许沙沙,王玲,靖丽娟,等.女性盆腔恶性肿瘤患者术中及术后淋巴囊肿预防和治疗的研究进展［J］.吉林大学学报(医学版),2020,46(4):888-893.
［9］卢淮武,林仲秋,周晖,等.盆腔淋巴结切除术后盆腔淋巴囊肿形成与防治［J］.中国妇产科临床杂志,2007,8(4):308-310.
［10］张莉,刘慧.宫颈癌术后盆腔淋巴囊肿的发病相关因素及疗效［J］.中国老年学杂志,2020,40(24):5190-5192.
［11］YOON PN,JOON SW,OH CG,et al.The effect of nonperitonization and laparoscopic lymphadenectomy for minimizing the incidence of lymphocyst formation after radical hysterectomy for cervical cancer［J］.International Journal of Gynecological Cancer:Official Journal of the International Gynecological Cancer Society,2010,20(3):443-448.
［12］李伟玲,谌永毅,汤新辉,等.宫颈癌术后盆腔淋巴囊肿形成的相关因素及防治进展［J］.癌症进展,2018,16(7):812-815.
［13］张景岳.妇人规［M］.罗元恺，点注.广州:广东科技出版社,1984.
［14］巢元方.诸病源候论［M］.黄作阵，点校.沈阳:辽宁科学技术出版社,1997.
［15］凌婉雯,宋鑫,黄佩茹,等.健脾利水化瘀解毒法治疗宫颈癌根治术后盆腔淋巴囊肿［J］.亚太传统医药,2021,17(4):111-113.
［16］黄元御.四圣心源校注与验案［M］.赵文举,吕宇剑，校注.沈阳:辽宁科学技术出版社,2017.
［17］赵永见,牛凯,唐德志,等.桃仁药理作用研究近况［J］.辽宁中医杂志,2015,42(4):888-890.
［18］裴瑾,颜永刚,万德光,等.桃仁油对动物血液流变学及微循环的影响［J］.中成药,2011,33(4):587-589.
［19］程江雪,武旭,郭东艳,等.基于网络药理学研究当归-赤芍药对治疗心绞痛作用机制［J］.陕西中医药大学学报,2022,45(3):97-104.
［20］叶青,刘东升,王兰霞,等.茯苓化学成分、药理作用及质量控制研究进展［J］.中医药信息,2023,40(2):75-79.
［21］刘军,戴燚,林吉良.桂枝茯苓汤对下肢胫骨骨折术后血液粘度和下肢肿胀疼痛程度的影响［J］.四川中医,2020,38(3):144-146.
［22］钟赣生.中药学［M］.4版.北京:中国中医药出版社,2016:141-142.
［23］曹强,郭亚菲,叶蕾蕾,等.大黄及其活性成分抗炎作用及机制的研究进展［J］.中草药,2022,53(22):7285-7294.
［24］董文燊,李清,瞿发林.大黄与玄明粉配伍的临床应用［J］.光明中医,2014,29(1):207-208.
［25］李时珍.本草纲目［M］.北京:北京出版社,2007.
［26］陈萌,丛军,李甫,等.芒硝外敷对ERCP术后急性胰腺炎模型大鼠的防治作用及其机制研究［J］.上海中医药杂志,2020,54(S1):162-166.
［27］刘陆晨,王怀泽,张芬,等.中药热奄包联合塞来昔布治疗神经根型颈椎病临床研究［J］.陕西中医药大学学报,2021,44(5):83-86.
［28］刘利娟,周德生,胡华,等.《五十二病方》液体辅料研究［J］.环球中医药,2021,14(8):1411-1415.
［29］闫敏敏,李天昊,杨舒佳,等.医用“苦酒”文献源流考辨［J］.中华中医药杂志,2021,36(7):3900-3903.
［30］高燕.醋调大黄芒硝外敷预防剖宫产切口脂肪液化的护理［J］.河北医药,2012,34(15):2400.

备注/Memo

备注/Memo:
基金项目：浙江省中医药科技计划项目(2019ZA021)
更新日期/Last Update: 2024-11-21