- 期刊
由子宮內膜異位症病案一例探討龍膽瀉肝湯對血清CA-125指數之影響
Endometriosis with High Level of CA-125 Treated with Traditional Chinese Medicine and Influenced by its Dosage: A Case Report
摘要
子宮內膜異位症是婦科常見的疾病，可導致痛經和不孕。而血清CA-125廣泛地作為子宮內膜異位症的腫瘤生物標記，可用作追蹤子宮內膜異位症治療成效及術後復發的參考。本病例為31歲患有子宮內膜異位症（左側巧克力囊腫）的女性，因長期有經痛及帶下黃稠的症狀，且CA-125指數偏高，經中醫辨證論治，診斷為肝氣鬱結，濕熱瘀阻，使用科學中藥龍膽瀉肝湯及桂枝茯苓丸合方加減治療後症狀改善且CA-125下降，但在桂枝茯苓丸劑量不變之下，隨著龍膽瀉肝湯使用劑量下降至3g／天時，經痛等症狀加重且CA-125指數又上升。此治療經驗顯示3g／天以下無法有效改善患者濕熱下注的情形，故瘀熱內阻症狀又再起，反映在CA-125指數方面，則是數值再度升高，但仍需更多研究及病例追蹤探討之。
並列摘要
Endometriosis, one of the common gynecologic diseases in women of reproductive age, may cause dysmenorrhea and infertility. Serum CA-125 is a valuable tumor biomarker in the evaluation of treatment and follow-up of recurrence in patients with endometriosis and initially elevated CA-125 level. This case is a 31 y/o female who was diagnosed as? endometriosis with dysmenorrhea, yellowish vaginal discharge, and elevated CA-125 level. According to TCM's theory, the patient was diagnosed with Qi Stagnancy in Liver and the blockade of damp-heat and static blood. After the prescription of Longdan Xiegan Tang and Guizhi Fuling Wan, which was aimed to relieving Qi stagnancy in Liver, clearing damp-heat, and promoting blood circulation, the patient's symptoms and CA-125 level has improved. However, when the dosage of Longdan Xiegan Tang decreased, the patient's dysmenorrhea became severe, and CA-125 level elevated again. Therefore, we deduced that the symptoms of blockade of damp-heat and static blood could not be improved, so the CA-125 level elevated again when the dosage of Longdan Xiegan Tang being reduced to 3g/day. But it is still necessary to observe more cases and studies for actual conclusion.