中藥對於子宮內膜異位症患者血清CA-125指數之影響初探

The Effects of Traditional Chinese Medicines in Endometriosis Patients with Screening Serum CA- 125: A Retrospective Data-Based Study

許聿榕(Yu-Jung Hsu) ； 鄭為仁(Wei-Jen Cheng) ； 高銘偵(Ming-Chen Kao) ； 郭靜諭(Jing-Yu Guo) ； 郭順利(Shun-Li Kuo) ； 陳曉暐(Hsiao-Wei Chen) ； 林玫君(Mei-Jiun Lin) ； 楊淑齡(Shu-Ling Yang)

《中醫藥雜誌》 29卷2期 (2018/12) Pp. 51-71

https://doi.org/10.3966/241139642018122902004

摘要

子宮內膜異位症為育齡婦女中常見的疾病之一，臨床上常見症狀有經痛、性交疼痛及骨盆疼痛等，子宮內膜異位症的標準診斷方式為腹腔鏡檢查，但因腹腔鏡檢查具有侵入性及費用昂貴，所以現多以臨床症狀加上超音波檢查、血清CA- 125指數等作為診斷依據及後續症狀追蹤與治療效果評估。近年來使用中醫治療子宮內膜異位症已逐漸普遍且廣為患者接受，然而實證上卻缺乏中醫藥的有效證據。本研究案從長庚研究資料庫（CGRD）收集146名子宮內膜異位症患者之資料，發現68.2%子宮內膜異位症患者併高血清CA-125指數患者，接受中藥治療後其指數有下降的趨勢；且78.8%子宮內膜異位症患者未合併高血清CA-125指數患者，不因服用中藥而惡化血清CA-125指數，因此保守推估中藥對於子宮內膜異位症的治療具有潛在效果，但仍需近一步的實驗證明。另外分析臨床上最常使用的方劑分別是桂枝茯苓丸、加味逍遙散及龍膽瀉肝湯等；常見與方劑配伍之單味藥物為蒲公英、香附及延胡索等，治療方向以理血、行氣、清熱、補氣為主。

關鍵字

子宮內膜異位症 ； 血清CA-125 ； 中醫藥

並列摘要

Endometriosis is one of the common gynecologic diseases in women of reproductive age. The most common clinical symptoms include dysmenorrhea, dyspareunia, and chronic pelvic pain. Diagnostic laparoscopy is considered the gold standard for the diagnosis of endometriosis. However, it is an invasive and expensive procedure for clinical practice, and therefore endometriosis is usually diagnosed based on clinical symptoms, sonography, and serum CA-125. In recent years, Traditional chinese Medicine (TCM) has been widely used for the treatment of endometriosis, but evidence-based studies on its efficacy remain insufficient. In this study, we collected data on 146 endometriosis patients who underwent TCM treatment from Chang Gung Research Database (CGRD) and analyzed the prescriptions. The most common formulas are Gui-zhi-fu-ling-wan, Jia-wei-xiao-yao-san, and Long-dan-xie-gan-tang, and the most common single herbs are Pu-gong-ying (Herba Taraxaci), Xiang-fu (Rhizoma Cyperi), and Yan-hu-suo (Rhizoma Corydalis). After TCM treatments, 68.2% of patients with elevated serum CA-125 level had their level decreased (p ＜ 0.01), and 78.8% of patients with normal serum CA-125 level had their level remained normal. As a result, we assumed that TCMs have potential effects on the treatment of endometriosis via regulating blood, rectifying qi, clearing heat, and invigorating qi. However, further studies are needed to prove the efficacy of these botanical drugs.

並列關鍵字

Endometriosis ； CA-125 ； Traditional Chinese Medicine

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