Yoshikawa Nobuhisa, Kajiyama Hiroaki, Otsuka Naoki, Tamauchi Satoshi, Ikeda Yoshiki, Nishino Kimihiro, Niimi Kaoru, Suzuki Shiro, Utsumi Fumi, Shibata Kiyosumi, Kikkawa Fumitaka
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya 4668550, Japan.
Department of Obstetrics and Gynecology, Fujita Health University Bantane Hospital, Nagoya 4548509, Japan.
Evid Based Complement Alternat Med. 2020 Apr 17;2020:6298293. doi: 10.1155/2020/6298293. eCollection 2020.
Lower-limb lymphedema (LLL) is a chronic and progressive complication of gynecologic cancer treatment, including pelvic lymphadenectomy. This study aims to investigate the therapeutic effect of goreisan, a traditional Japanese medicine, which has been used for hydrostatic modulation on patients with LLL.
Patients diagnosed with LLL in our hospital in 2018 were included and principally treated with complex decongestive therapy (CDT), including elastic clothing and lymph drainage. The patients who received a combination therapy of CDT and goreisan (CDT-G group) were prescribed goreisan extract granules, with a dose of 7.5 g per os daily in three doses. Patients who were not prescribed goreisan received CDT alone (CDT group). The severity of lymphedema was evaluated by the estimated limb volume calculated by limb circumferences and the ratio of extracellular water (ECW) to total body water (TBW).
Nineteen women with LLL after pelvic lymphadenectomy were included in the study. The number of patients in the CDT and CDT-G groups was 8 and 11, respectively. There were no statistically significant differences between the CDT and CDT-G groups in terms of patient characteristics and severity of LLL before treatment. Reduction in ECW/TBW in the CDT-G group (in the whole body and the affected lower limb) after the intervention was significantly more remarkable than that in the CDT group.
Goreisan-based Japanese herbal therapy may be effective in patients with LLL after retroperitoneal lymphadenectomy.
下肢淋巴水肿（LLL）是妇科癌症治疗（包括盆腔淋巴结清扫术）的一种慢性进行性并发症。本研究旨在探讨日本传统药物“五苓散”对LLL患者的治疗效果，该药物已用于静水压调节。
纳入2018年在我院诊断为LLL的患者，主要采用综合消肿治疗（CDT），包括弹力衣物和淋巴引流。接受CDT与五苓散联合治疗的患者（CDT-G组）服用五苓散提取物颗粒，剂量为每日7.5克，分三次口服。未服用五苓散的患者仅接受CDT治疗（CDT组）。通过肢体周长计算的估计肢体体积以及细胞外液（ECW）与总体液（TBW）的比值来评估淋巴水肿的严重程度。
本研究纳入了19例盆腔淋巴结清扫术后发生LLL的女性患者。CDT组和CDT-G组的患者人数分别为8例和11例。治疗前，CDT组和CDT-G组在患者特征和LLL严重程度方面无统计学显著差异。干预后，CDT-G组（全身及患侧下肢）的ECW/TBW降低幅度明显大于CDT组。
基于五苓散的日本草药疗法可能对腹膜后淋巴结清扫术后的LLL患者有效。
