宫颈癌术后放疗后下肢淋巴水肿的危险因素及行桂枝茯苓丸治疗的效果分析  

Analysis of risk factors of lower limb lymphedema after radiotherapy for cervical cancer and the therapeutic effect of Guizhi Fuling Pills

作　　者：年亮 刘宁宁[1] 郭东栋[2] NIAN Liang;LIU Ning-ning;GUO Dong-dong(Department of Oncology,The Affiliated Hospital of Yan'an University,Yan'an Shaanxi 716000,China;Department of Oncology,Yan'an People's Hospital,Yan'an Shaanxi 716000,China)

机构地区：[1]延安大学附属医院肿瘤科,陕西延安716000 [2]延安市人民医院肿瘤科,陕西延安716000

出　　处：《临床和实验医学杂志》2025年第4期394-398,共5页Journal of Clinical and Experimental Medicine

基　　金：陕西省自然科学基础研究计划项目(编号:2023-JC-QN-0995);延安市科技计划项目(编号:2023-SFGG-046)。

摘　　要：目的分析宫颈癌术后放疗后下肢淋巴水肿的危险因素及行桂枝茯苓丸治疗的效果。方法前瞻性选取2022年1月至2024年1月延安大学附属医院收治的140例宫颈癌患者,所有患者均接受宫颈癌根治手术及术后放疗;根据术后放疗后6个月是否发生下肢淋巴水肿,分为水肿组(n=62)和非水肿组(n=78);使用单因素分析和多因素Logistic回归分析对宫颈癌术后放疗后下肢淋巴水肿的危险因素进行分析。依据随机数字表法将下肢淋巴水肿患者分为对照组和观察组,每组各31例。对照组进行常规治疗,观察组在此基础上加用桂枝茯苓丸治疗。比较两组总有效率,治疗前、治疗20 d后的小腿周径、大腿周径、妇科癌症淋巴水肿问卷(GCLQ)评分、功能独立性评定量表(FIM)评分及下肢功能量表(LEFS)评分及药物不良反应发生情况。结果单因素分析结果显示,水肿组的年龄、淋巴结清扫数目、放疗持续时间、每日站立时间、规律运动锻炼比例与非水肿组比较,差异均有统计学意义(P<0.05)。经多因素Logistic回归分析,高龄、淋巴结清扫数目较多、放疗持续时间较长和每日站立时间较长均为独立危险因素(P<0.05),规律运动锻炼为保护因素(P<0.05)。观察组总有效率为96.77%,高于对照组(70.97%),差异有统计学意义(P<0.05)。治疗20 d后,观察组小腿周径、大腿周径分别为(30.22±2.51)、(33.01±2.78)cm,均小于对照组[(35.16±4.15)、(38.15±3.97)cm],差异均有统计学意义(P<0.05)。治疗20 d后,观察组GCLQ评分为(2.56±0.52)分,低于对照组[(4.65±0.83)分],观察组FIM评分、LEFS评分分别为(101.23±14.46)、(70.42±10.49)分,均高于对照组[(91.74±12.07)、(60.55±8.36)分],差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论宫颈癌术后放疗后下肢淋巴水肿的独立危险因素是高龄、淋巴结清扫数目较多、放疗持续时间较长和�Objective To analyze the risk factors of lower limb lymphedema after radiotherapy for cervical cancer and the therapeutic effect of Guizhi Fuling Pills.Methods A total of 140 patients with cervical cancer admitted to the Affiliated Hospital of Yan'an University from January 2022 to January 2024 were prospectively selected,all patients received radical cervical cancer surgery and postoperative radiotherapy.Based on whether lower limb lymphedema occurs 6 months after postoperative radiotherapy,they were divided into the oedema group(n=62)and the non-oedema group(n=78);risk factors of lower limb lymphedema after radiotherapy for cervical cancer were analyzed using single factor analysis and multivariate Logistic regression.According to the random number table method,the patients with lower extremity lymphedema were divided into the control group and the observation group,31 cases in each group.The control group was treated with routine treatment,and the observation group was treated with Guizhi Fuling Pills on this basis.The total effective rate,the circumference of the calf,the diameter of the thigh,the gynecological cancer lymphedema questionnaire(GCLQ),the score of the functional independence measure(FIM)and the score of the lower extremity functional scale(LEFS)before treatment and after 20 days of treatment,and the adverse drug reactions were compared between the two groups.Results Single factor analysis showed that the age,number of lymph node dissection,duration of radiotherapy,daily standing time,and proportion of regular exercise in the edema group were significantly different from those in the non-edema group(P<0.05).Multivariate Logistic regression analysis showed that advanced age,the number of lymph node dissection,longer daily standing time and longer duration of radiotherapy were independent risk factors(P<0.05),and regular exercise was a protective factor(P<0.05).The total effective rate of the observation group was 96.77%,which was higher than that of the control group(70.97%),and the difference was

关 键 词：宫颈肿瘤 淋巴水肿 危险因素 放疗 桂枝茯苓丸 

分 类 号：R273[医药卫生—中西医结合]