中药硬膏穴位贴敷联合中药喷雾治疗乳腺癌术后上肢淋巴水肿临床研究
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摘要
目的:观察中药硬膏穴位贴敷联合中药喷雾治疗乳腺癌术后上肢淋巴水肿的临床疗效。方法:选取80例乳腺癌术后上肢淋巴水肿患者,随机分为观察组与对照组,各40例。对照组采取肢体空气波压力循环物理治疗(1次/d)与安慰剂敷贴(1次/d)。观察组在采取肢体空气波压力循环物理治疗(1次/d)基础上联合中药硬膏穴位贴敷(1次/d)与中药喷雾治疗(1次/d)。2组均治疗4 w。分别于治疗前、治疗4 w后测量2组患者的患肢与健肢水肿周径差值、观察患肢疼痛程度[视觉模拟评分法(visual analogue score,VAS)评估]的变化并比较上肢感染率、上肢功能优良率。结果:治疗后2组患者的患肢与健肢水肿周径差值及疼痛VAS评分均较治疗前降低(P<0.05),观察组治疗后的患肢与健肢水肿周径差值与疼痛VAS评分均低于对照组,差异显著(P<0.05)。2组患肢感染率分别为5.00%与15.00%,差异无统计学意义(P>0.05)。观察组上肢功能优良率为100%,显著高于对照组70.00%(P<0.05)。2组均未见严重不良反应发生。结论:中药硬膏穴位贴敷联合中药喷雾治疗,可有效减轻乳腺癌术后上肢淋巴水肿患者患肢水肿与疼痛,促进患肢功能的恢复。
Objective: To observe the clinical effect of traditional Chinese medicine plaster acupoint sticking combined with Chinese medicine spray on postoperative upper limb lymphedema after breast cancer. Methods: 80 cases of upper limb lymphedema after breast cancer operation were randomly divided into observation group and control group, with 40 cases in each group. The control group was treated with physical therapy of air wave pressure circulation limbs(1 time/d) and placebo application(1 time/d). The observation group was treated with physical therapy of air wave pressure circulation limbs(1 time/d) combined with traditional Chinese medicine plaster acupoint sticking(1 time/d) and Chinese medicine spray(1 time/d). Both groups were treated for 4 weeks. The difference in the diameter between the affected limb and the healthy limb edema were measured, the changes in the degree of pain in the affected limb [as assessed by visual analogue score(VAS)] were observed before treatment and 4 weeks after treatment, and the infection rate of upper limbs and the excellent rate of upper limb function were compared between the two groups. Results: After treatment, the difference in the diameter of the affected limb and the edema of the healthy limbs and the pain VAS score were lower than those before the treatment(P<0.05). The difference in the diameter of the affected limb and the healthy limb edema and the pain VAS score in the observation group after treatment were lower than the control group, and the difference were significant(P<0.05). The infection rates of the two groups were 5.00% and 15.00%, respectively, and the difference was not statistically significant(P>0.05). The excellent rate of upper limb function in the observation group was 100%, which was significantly higher than that in the control group(70.00%)(P<0.05). No serious adverse reactions occurred in either group. Conclusion: The traditional Chinese medicine plaster acupoint sticking combined with Chinese medicine spray treatment of postoperative upper limb lymphedema of breast cancer patients can effectively alleviate the limb edema and pain and promote limb function recovery, and no adverse reactions, the operation is simple, worthy of promoting.
Objective: To observe the clinical effect of traditional Chinese medicine plaster acupoint sticking combined with Chinese medicine spray on postoperative upper limb lymphedema after breast cancer. Methods: 80 cases of upper limb lymphedema after breast cancer operation were randomly divided into observation group and control group, with 40 cases in each group. The control group was treated with physical therapy of air wave pressure circulation limbs(1 time/d) and placebo application(1 time/d). The observation group was treated with physical therapy of air wave pressure circulation limbs(1 time/d) combined with traditional Chinese medicine plaster acupoint sticking(1 time/d) and Chinese medicine spray(1 time/d). Both groups were treated for 4 weeks. The difference in the diameter between the affected limb and the healthy limb edema were measured, the changes in the degree of pain in the affected limb [as assessed by visual analogue score(VAS)] were observed before treatment and 4 weeks after treatment, and the infection rate of upper limbs and the excellent rate of upper limb function were compared between the two groups. Results: After treatment, the difference in the diameter of the affected limb and the edema of the healthy limbs and the pain VAS score were lower than those before the treatment(P<0.05). The difference in the diameter of the affected limb and the healthy limb edema and the pain VAS score in the observation group after treatment were lower than the control group, and the difference were significant(P<0.05). The infection rates of the two groups were 5.00% and 15.00%, respectively, and the difference was not statistically significant(P>0.05). The excellent rate of upper limb function in the observation group was 100%, which was significantly higher than that in the control group(70.00%)(P<0.05). No serious adverse reactions occurred in either group. Conclusion: The traditional Chinese medicine plaster acupoint sticking combined with Chinese medicine spray treatment of postoperative upper limb lymphedema of breast cancer patients can effectively alleviate the limb edema and pain and promote limb function recovery, and no adverse reactions, the operation is simple, worthy of promoting.
引文
[1]朱倩男,夏添松,凌立君,等.乳腺癌术后上肢淋巴水肿发生机制及预防进展[J].中华乳腺病杂志(电子版),2013,7(6):442-445.
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[3]陈波,贾实,张文海,等.乳腺癌术后上肢淋巴水肿的危险因素分析[J].中国医科大学学报,2012,41(7):637-641.
[4]中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范(2007版)[J].中国癌症杂志,2011,19(5):410-428.
[5]马跃海,胡莹,李秋华,等.中药内服外治联合综合消肿治疗技术在中老年乳腺癌患者术后上肢淋巴水肿中的应用[J].实用药物与临床,2017,20(6):627-630.
[6]陈晓洁,韩淼,裘张利,等.可控温灸疗对乳腺癌术侧肩关节功能的影响[J].浙江中医药大学学报,2016,40(9):702-704.
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[8]郑小利.四子散外敷辅以物理治疗对乳腺癌术后上肢淋巴水肿的改善作用[J].检验医学与临床,2017,14(12):1791-1793.
[9]李艳宏.中药结合理疗治疗乳腺癌术后上肢淋巴水肿[J].吉林中医药,2014,34(5):480-482.
[10]张丽娟,黄中英,朱晓丽,等.徒手淋巴引流预防乳腺癌术后上肢淋巴水肿的效果[J].实用医学杂志,2015,31(17):2910-2913.
[11]陈佳佳,汪立,于子优,等.手法淋巴引流治疗乳腺癌术后上肢淋巴水肿[J].组织工程与重建外科杂志,2015,13(5):310-312.
[12]姜晓玲,史增友,王晓静,等.中药组方治疗乳腺癌术后上肢淋巴水肿40例疗效观察[J].河北中医,2013,35(12):1795-1796.
[13]张微微,江科,陈洁,等.“通阳利水方”治疗乳腺癌淋巴清扫术后上肢淋巴水肿62例临床研究[J].江苏中医药,2014,46(2):33-34,35.
[14]高杰,郭英硕,付晨菲,等.自制中药治疗乳腺癌术后淋巴水肿的临床观察[J].中国老年学杂志,2017,37(22):5620-5621.
[15]何静谷,陈晓洁,汪永坚,等.经皮穴位电刺激干预乳腺癌术后早期患肢肿胀的临床研究[J].上海针灸杂志,2016,35(3):301-303.
[16]张惠婷,钟巧玲,张慧珍,等.七步综合消肿疗法对乳腺癌术后上肢淋巴水肿的效果[J].中国康复理论与实践,2017,23(9):1015-1020.
[17]谭璇妮,陈显春,王明浩,等.手法淋巴引流与腧穴按压对乳腺癌术后上肢淋巴水肿的疗效[J].中华乳腺病杂志(电子版),2015,9(5):342-343.
[18]石岚,吴毓东,徐卫英,等.乳腺癌术后上肢淋巴水肿的护理干预及效果评价[J].实用临床医学,2012,13(5):89-92.
[2]宋健,关竞红,龙笑,等.乳腺癌术后上肢淋巴水肿及其手法淋巴引流治疗[J].中国康复,2017,32(3):253-256.
[3]陈波,贾实,张文海,等.乳腺癌术后上肢淋巴水肿的危险因素分析[J].中国医科大学学报,2012,41(7):637-641.
[4]中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范(2007版)[J].中国癌症杂志,2011,19(5):410-428.
[5]马跃海,胡莹,李秋华,等.中药内服外治联合综合消肿治疗技术在中老年乳腺癌患者术后上肢淋巴水肿中的应用[J].实用药物与临床,2017,20(6):627-630.
[6]陈晓洁,韩淼,裘张利,等.可控温灸疗对乳腺癌术侧肩关节功能的影响[J].浙江中医药大学学报,2016,40(9):702-704.
[7]朱永军,马文辉.中药治疗乳腺癌术后上肢淋巴水肿的临床效果观察[J].中国医药,2016,11(10):1502-1504.
[8]郑小利.四子散外敷辅以物理治疗对乳腺癌术后上肢淋巴水肿的改善作用[J].检验医学与临床,2017,14(12):1791-1793.
[9]李艳宏.中药结合理疗治疗乳腺癌术后上肢淋巴水肿[J].吉林中医药,2014,34(5):480-482.
[10]张丽娟,黄中英,朱晓丽,等.徒手淋巴引流预防乳腺癌术后上肢淋巴水肿的效果[J].实用医学杂志,2015,31(17):2910-2913.
[11]陈佳佳,汪立,于子优,等.手法淋巴引流治疗乳腺癌术后上肢淋巴水肿[J].组织工程与重建外科杂志,2015,13(5):310-312.
[12]姜晓玲,史增友,王晓静,等.中药组方治疗乳腺癌术后上肢淋巴水肿40例疗效观察[J].河北中医,2013,35(12):1795-1796.
[13]张微微,江科,陈洁,等.“通阳利水方”治疗乳腺癌淋巴清扫术后上肢淋巴水肿62例临床研究[J].江苏中医药,2014,46(2):33-34,35.
[14]高杰,郭英硕,付晨菲,等.自制中药治疗乳腺癌术后淋巴水肿的临床观察[J].中国老年学杂志,2017,37(22):5620-5621.
[15]何静谷,陈晓洁,汪永坚,等.经皮穴位电刺激干预乳腺癌术后早期患肢肿胀的临床研究[J].上海针灸杂志,2016,35(3):301-303.
[16]张惠婷,钟巧玲,张慧珍,等.七步综合消肿疗法对乳腺癌术后上肢淋巴水肿的效果[J].中国康复理论与实践,2017,23(9):1015-1020.
[17]谭璇妮,陈显春,王明浩,等.手法淋巴引流与腧穴按压对乳腺癌术后上肢淋巴水肿的疗效[J].中华乳腺病杂志(电子版),2015,9(5):342-343.
[18]石岚,吴毓东,徐卫英,等.乳腺癌术后上肢淋巴水肿的护理干预及效果评价[J].实用临床医学,2012,13(5):89-92.