{"title":"中草药“eppikayuutsuto”治疗孤立性淋巴畸形：一项回顾性多中心研究。","authors":"Naoki Hashizume, Takafumi Kawano, Koshiro Sugita, Motofumi Torikai, Shun Onishi, Daisuke Masui, Saki Sakamoto, Hideaki Egami, Satoshi Ieiri, Tatsuru Kaji","doi":"10.1007/s00383-025-06161-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The present study analyzed the clinical efficacy of the herbal medicine \"Eppikajyutsuto\" (TJ-28) for isolated lymphatic malformation (LM).</p><p><strong>Methods: </strong>LM patients treated with TJ-28 monotherapy were retrospectively reviewed using medical records at three pediatric surgery departments from 2009 to 2023. All patients underwent ultrasound or/and magnetic resonance imaging before and after treatment. The isolated LM lesions were classified as macrocystic, microcystic, and mixed cystic according to the International Society for the Study of Vascular Anomalies classification. The LM volume index (LVI) was defined as the longitudinal length (mm) x width (mm) x depth (mm). The degree of reduction ratio (LVI ratio) was defined as the post-administration LVI divided by the pre-administration LVI.</p><p><strong>Results: </strong>Thirty-three cases (15 males, 18 females) of LM treated with TJ-28 were enrolled. Data are presented as median (range). The median age started treatment was 20 (0, 112) months. The median treatment duration was 12 (1-81) months. Of 28 patients, LVI ratio was calculated. Eighteen cases had macrocystic LM, 2 cases had microcystic LM and 8 cases had mixed macro-microcystic LM. There were significant differences between the pre-administration and post-administration LVI 32118 [1425, 1125000] mm<sup>3</sup> vs 5087 [0, 50000] mm<sup>3</sup>, p < 0.001). Classified ISSVA: there were significant differences between the pre-administration and post-administration LVI of macrocystic (n = 18) (33,646 [3080, 1125000] mm<sup>3</sup> vs 4937.5 [0, 50000] mm<sup>3</sup>, p < 0.001) and mixed macro-microcystic LM cases (n = 8) (37,952 [1425, 124488] mm<sup>3</sup> vs 5134 [24, 41040] mm<sup>3</sup>, p = 0.0078). For microcystic LM cases (n = 2), there were no significant differences between the pre-administration and post-administration LVI (17,420 [5600, 29240] mm<sup>3</sup> vs 30,180.5 [4550, 55811] mm<sup>3</sup>, p = 0.500). The median LVI ratio was 0.20 (0-1.91). The median LVI ratio of macrocystic LM was 0.21 (0-1.05) and the median LAI ratio of mixed macro-microcystic LM was 0.19 (0-1.01). Microcystic LM cases did not improve.</p><p><strong>Conclusions: </strong>This study demonstrates the beneficial effects of TJ-28 for macrocystic LM and mixed macro-microcystic LM.</p><p><strong>Level of evidence: </strong>A prognosis study of level IV.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"257"},"PeriodicalIF":1.6000,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Treatment of isolated lymphatic malformation with the herbal medicine \\\"Eppikajyutsuto\\\": a retrospective multicenter study.\",\"authors\":\"Naoki Hashizume, Takafumi Kawano, Koshiro Sugita, Motofumi Torikai, Shun Onishi, Daisuke Masui, Saki Sakamoto, Hideaki Egami, Satoshi Ieiri, Tatsuru Kaji\",\"doi\":\"10.1007/s00383-025-06161-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The present study analyzed the clinical efficacy of the herbal medicine \\\"Eppikajyutsuto\\\" (TJ-28) for isolated lymphatic malformation (LM).</p><p><strong>Methods: </strong>LM patients treated with TJ-28 monotherapy were retrospectively reviewed using medical records at three pediatric surgery departments from 2009 to 2023. All patients underwent ultrasound or/and magnetic resonance imaging before and after treatment. The isolated LM lesions were classified as macrocystic, microcystic, and mixed cystic according to the International Society for the Study of Vascular Anomalies classification. The LM volume index (LVI) was defined as the longitudinal length (mm) x width (mm) x depth (mm). The degree of reduction ratio (LVI ratio) was defined as the post-administration LVI divided by the pre-administration LVI.</p><p><strong>Results: </strong>Thirty-three cases (15 males, 18 females) of LM treated with TJ-28 were enrolled. Data are presented as median (range). The median age started treatment was 20 (0, 112) months. The median treatment duration was 12 (1-81) months. Of 28 patients, LVI ratio was calculated. Eighteen cases had macrocystic LM, 2 cases had microcystic LM and 8 cases had mixed macro-microcystic LM. There were significant differences between the pre-administration and post-administration LVI 32118 [1425, 1125000] mm<sup>3</sup> vs 5087 [0, 50000] mm<sup>3</sup>, p < 0.001). Classified ISSVA: there were significant differences between the pre-administration and post-administration LVI of macrocystic (n = 18) (33,646 [3080, 1125000] mm<sup>3</sup> vs 4937.5 [0, 50000] mm<sup>3</sup>, p < 0.001) and mixed macro-microcystic LM cases (n = 8) (37,952 [1425, 124488] mm<sup>3</sup> vs 5134 [24, 41040] mm<sup>3</sup>, p = 0.0078). For microcystic LM cases (n = 2), there were no significant differences between the pre-administration and post-administration LVI (17,420 [5600, 29240] mm<sup>3</sup> vs 30,180.5 [4550, 55811] mm<sup>3</sup>, p = 0.500). The median LVI ratio was 0.20 (0-1.91). The median LVI ratio of macrocystic LM was 0.21 (0-1.05) and the median LAI ratio of mixed macro-microcystic LM was 0.19 (0-1.01). Microcystic LM cases did not improve.</p><p><strong>Conclusions: </strong>This study demonstrates the beneficial effects of TJ-28 for macrocystic LM and mixed macro-microcystic LM.</p><p><strong>Level of evidence: </strong>A prognosis study of level IV.</p>\",\"PeriodicalId\":19832,\"journal\":{\"name\":\"Pediatric Surgery International\",\"volume\":\"41 1\",\"pages\":\"257\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-08-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Surgery International\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00383-025-06161-0\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Surgery International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00383-025-06161-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
摘要
目的：本研究分析中药埃匹卡育素（TJ-28）治疗孤立性淋巴畸形的临床疗效。方法：回顾性分析2009 - 2023年3个儿科外科收治的接受TJ-28单药治疗的LM患者病历。所有患者在治疗前后均行超声或/和磁共振成像检查。根据国际血管异常研究协会的分类，分离的LM病变分为大囊性、微囊性和混合囊性。LM体积指数（LVI）定义为纵向长度（mm） x宽度（mm） x深度（mm）。减少程度比（LVI ratio）定义为给药后LVI除以给药前LVI。结果：经TJ-28治疗的LM患者33例（男15例，女18例）。数据以中位数（范围）表示。开始治疗的中位年龄为20（0.112）个月。中位治疗时间为12（1-81）个月。计算28例患者的LVI比值。大囊性LM 18例，微囊性LM 2例，大-微囊性LM混合8例。给药前和给药后LVI分别为32118 [1425,1125000]mm3和5087 [0,50000]mm3， p3和4937.5 [0,50000]mm3， p3和5134 [24,41040]mm3, p = 0.0078)。对于微囊性LM病例（n = 2），给药前和给药后LVI无显著差异（17,420 [5600,29240]mm3 vs 30,180.5 [4550, 55811] mm3, p = 0.500）。LVI比率中位数为0.20（0-1.91）。大囊性LM的中位LVI比为0.21(0-1.05)，混合大-微囊性LM的中位LAI比为0.19（0-1.01）。微囊性LM病例没有改善。结论：本研究证实TJ-28对大囊性LM和大微囊性LM的有益作用。证据等级：一项IV级预后研究。
Treatment of isolated lymphatic malformation with the herbal medicine "Eppikajyutsuto": a retrospective multicenter study.
Purpose: The present study analyzed the clinical efficacy of the herbal medicine "Eppikajyutsuto" (TJ-28) for isolated lymphatic malformation (LM).
Methods: LM patients treated with TJ-28 monotherapy were retrospectively reviewed using medical records at three pediatric surgery departments from 2009 to 2023. All patients underwent ultrasound or/and magnetic resonance imaging before and after treatment. The isolated LM lesions were classified as macrocystic, microcystic, and mixed cystic according to the International Society for the Study of Vascular Anomalies classification. The LM volume index (LVI) was defined as the longitudinal length (mm) x width (mm) x depth (mm). The degree of reduction ratio (LVI ratio) was defined as the post-administration LVI divided by the pre-administration LVI.
Results: Thirty-three cases (15 males, 18 females) of LM treated with TJ-28 were enrolled. Data are presented as median (range). The median age started treatment was 20 (0, 112) months. The median treatment duration was 12 (1-81) months. Of 28 patients, LVI ratio was calculated. Eighteen cases had macrocystic LM, 2 cases had microcystic LM and 8 cases had mixed macro-microcystic LM. There were significant differences between the pre-administration and post-administration LVI 32118 [1425, 1125000] mm3 vs 5087 [0, 50000] mm3, p < 0.001). Classified ISSVA: there were significant differences between the pre-administration and post-administration LVI of macrocystic (n = 18) (33,646 [3080, 1125000] mm3 vs 4937.5 [0, 50000] mm3, p < 0.001) and mixed macro-microcystic LM cases (n = 8) (37,952 [1425, 124488] mm3 vs 5134 [24, 41040] mm3, p = 0.0078). For microcystic LM cases (n = 2), there were no significant differences between the pre-administration and post-administration LVI (17,420 [5600, 29240] mm3 vs 30,180.5 [4550, 55811] mm3, p = 0.500). The median LVI ratio was 0.20 (0-1.91). The median LVI ratio of macrocystic LM was 0.21 (0-1.05) and the median LAI ratio of mixed macro-microcystic LM was 0.19 (0-1.01). Microcystic LM cases did not improve.
Conclusions: This study demonstrates the beneficial effects of TJ-28 for macrocystic LM and mixed macro-microcystic LM.
期刊介绍：
Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children.
The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include:
-Review articles-
Original articles-
Technical innovations-
Letters to the editor
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