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

Clinical Study on the Treatment of Pelvic Lymphatic Cysts with Guizhi Fuling Decoction Combined with Dahuang Xuanming Powder External Application

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。

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.