耳穴贴压、穴位贴敷、经络艾灸联合情志疗法对乳腺癌根治术患者的效果研究
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摘要
目的探讨耳穴贴压、穴位贴敷、经络艾灸联合情志疗法对行乳腺癌根治术患者的治疗效果,为行乳腺癌根治术患者的临床治疗提供参考。方法选取2012—2018年在浙江中医药大学附属第三医院治疗的60例乳腺癌手术患者,采用随机数字表法将其分为对照组(30例)和观察组(30例)。对照组采用常规护理方法,观察组在对照组的基础上采用耳穴贴压、穴位贴敷、经络艾灸联合情志疗法进行护理。于术后7 d测量患者臂围、检测患肢伴随症状(上肢皮肤紧绷、肿胀、疼痛)发生情况,于术前及术后7 d采用阿森斯失眠量表测评患者的睡眠质量,术后3个月测量肩关节活动度,术后7 d采用焦虑、抑郁自评量表测评患者的焦虑、抑郁状态,比较2组患者术后7 d并发症(患肢水肿、皮下积液、皮瓣坏死)、伴随症状(上肢皮肤紧绷、肿胀、疼痛)、睡眠情况及焦虑抑郁发生情况,以及术后3个月肩关节功能障碍的发生情况。结果术后7 d,2组患者术后并发症发生率比较差异无统计学意义(P>0.05),观察组术后伴随症状、睡眠情况、焦虑、抑郁情况均明显优于对照组(均P<0.05),术后3个月,观察组肩关节功能障碍发生情况明显低于对照组(P<0.05)。结论耳穴贴压、穴位贴敷、经络艾灸联合情志疗法对行乳腺癌根治术患者具有较好的临床护理疗效,可有效降低患者术后伴随症状及焦虑、抑郁情况的发生率,明显改善患者的睡眠质量,且有助于患者肩关节功能恢复。
Objective To explore the clinical effect of auricular pressing therapy,acupoint sticking,meridian moxibustion combined with emotional therapy on breast cancer patients after radical surgery,and to provide reference for clinical treatment of patients undergoing radical mastectomy.Methods A total of 60 breast cancer patients undergoing radical mastectomy in the third affiliated physician of Zhejiang University of Traditional Chinese Medicine from 2012 to 2018 were selected and divided into control group(30 cases) and observation group(30 cases) by random number table method.The control group received routine nursing,while the observation group received additional auricular application pressure,acupoint sticking,meridian moxibustion combined with emotional therapy.Seven days after surgery,the arm circumference was measured,the concomitant symptom(upper limb skin tightness,swelling and pain) were examined,and the anxiety and depression of the patients were assessed by the depression self-rating scale and anxiety self-rating scales.The sleep quality of the patients was assessed by using the Athens Insomnia Scale(AIS) before the surgery and 7 days after the surgery.The activity of shoulder joint was measured 3 months after surgery.The postoperative complications(limb edema,scalp hydrops and flap necrosis),concomitant symptom(upper limb skin tightness,swelling and pain),sleep quality,anxiety and depression of patients at 7 d after the surgery,and the range of motion of shoulder joint at 3 months after surgery were compared between the two groups.Results There was no significant difference in the incidence of postoperative complications between the two groups at 7 days after the surgery(P > 0.05).The concomitant symptom,sleep quality,anxiety and depression in the observation group was improved significantly when compared with the control group(all P < 0.05).The incidence of shoulder dysfunction in the observation group was significantly lower than that in the control group at 3 months after the surgery(P < 0.05).Conclusion The auricular pressing therapy,acupoint sticking,meridian moxibustion combined with emotional therapy show a good clinical nursing effect on patients undergoing radical mastectomy,which can effectively reduce the occurrence of accompanying symptoms,anxiety and depression after breast cancer surgery,significantly improve the sleep quality of patients,and contribute to the recovery of shoulder joint function.
Objective To explore the clinical effect of auricular pressing therapy,acupoint sticking,meridian moxibustion combined with emotional therapy on breast cancer patients after radical surgery,and to provide reference for clinical treatment of patients undergoing radical mastectomy.Methods A total of 60 breast cancer patients undergoing radical mastectomy in the third affiliated physician of Zhejiang University of Traditional Chinese Medicine from 2012 to 2018 were selected and divided into control group(30 cases) and observation group(30 cases) by random number table method.The control group received routine nursing,while the observation group received additional auricular application pressure,acupoint sticking,meridian moxibustion combined with emotional therapy.Seven days after surgery,the arm circumference was measured,the concomitant symptom(upper limb skin tightness,swelling and pain) were examined,and the anxiety and depression of the patients were assessed by the depression self-rating scale and anxiety self-rating scales.The sleep quality of the patients was assessed by using the Athens Insomnia Scale(AIS) before the surgery and 7 days after the surgery.The activity of shoulder joint was measured 3 months after surgery.The postoperative complications(limb edema,scalp hydrops and flap necrosis),concomitant symptom(upper limb skin tightness,swelling and pain),sleep quality,anxiety and depression of patients at 7 d after the surgery,and the range of motion of shoulder joint at 3 months after surgery were compared between the two groups.Results There was no significant difference in the incidence of postoperative complications between the two groups at 7 days after the surgery(P > 0.05).The concomitant symptom,sleep quality,anxiety and depression in the observation group was improved significantly when compared with the control group(all P < 0.05).The incidence of shoulder dysfunction in the observation group was significantly lower than that in the control group at 3 months after the surgery(P < 0.05).Conclusion The auricular pressing therapy,acupoint sticking,meridian moxibustion combined with emotional therapy show a good clinical nursing effect on patients undergoing radical mastectomy,which can effectively reduce the occurrence of accompanying symptoms,anxiety and depression after breast cancer surgery,significantly improve the sleep quality of patients,and contribute to the recovery of shoulder joint function.
引文
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[13]乔敏敏.心理护理对乳腺癌术后化疗患者焦虑、抑郁情绪及生活质量的影响[J].临床医学研究与实践,2016,1(18):173-174.
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[18]祝亚男,俞国红,杨方英,等.中医护理技术对减少乳腺癌患者术后并发症的效果研究[J].中华护理杂志,2017,52(3):289-292.
[19]曾正英,余佳蔓,胡钰.围绝经期失眠症患者耳穴贴压及辩证护理的效果观察[J].护理学报,2015,22(13):59-61.
[20]梁惠琼,庄纯,朱妙芬.吴茱萸穴位贴敷联合耳穴压豆治疗失眠的效果观察[J].中国当代医药,2017,24(18):97-99.
[21]张慧兰.吴茱萸贴敷涌泉穴防治艾素静脉化疗患者失眠症的临床观察[J].上海针灸杂志,2014,33(3):204-205.
[22]曾玉丹.中药外洗与艾灸疗法在乳腺癌术后上肢淋巴水肿治疗中疗效观察[J].辽宁中医药大学学报,2014,16(12):183-185.
[23]吴加花,冯燕虹,黎玉婵.耳穴压籽配合穴位按摩对乳腺癌改良根治术患者睡眠质量的影响[J].陕西中医,2017,38(1):103-104.
[24]王妤,胡静,梁海英,等.耳穴贴压治疗乳腺癌患者失眠效果观察[J].护理学报,2014,21(22):68-70.
[25]蔡铁如,伍大华.化痰解郁安神汤联合中医情志疗法治疗失眠伴抑郁症的临床研究[J].中医药导报,2017,23(13):101-104.
[26]汪超,周兰,姚诗清,等.从瘀论治乳腺癌术后患侧上肢淋巴水肿验案[J].新中医,2015,47(6):323-324.
[27]蔡中博,方桂珍.乳腺癌术后肩关节功能障碍及其影响因素调查研究[J].护理与康复,2015,14(12):1113-1117.
[28]王萍丽,栗红利.乳腺癌术后患者功能锻炼中护理干预的效果观察[J].陕西医学杂志,2014,43(6):767-768.
[29]孙莉,左亚芹,高玲,等.艾灸促进乳腺癌改良根治术后病人患侧肢体功能康复的效果评价[J].护理研究,2015,29(12):4282-4284.
[30]俞国红,胡婵娟,汪永坚.耳穴贴压对乳腺癌改良根治术后焦虑和疼痛的影响[J].上海针灸杂志,2014,33(4):332-334.
[31]路艳星,郭智涛,李雪真,等.中医情志疗法在康复期乳腺癌中的运用与体会[J].内蒙古中医药,2017,36(6):100.
[2]侯公楷.中医药防治乳腺癌进展[J].辽宁中医药大学学报,2016,18(5):249-253.
[3]周旭葵,方华瑾.放松疗法结合耳穴贴压对缓解乳腺癌患者化疗期间焦虑的影响[J].护理管理杂志,2015,15(9):653-655.
[4]张玉卫,杨瑞东.热疗联合手法对乳腺癌术后患肢功能障碍的影响[J].陕西中医,2014,35(11):1448-1449.
[5]刘进,刘小红.合理情绪行为疗法对晚期女性乳腺癌患者心理干预的作用[J].中华全科医学,2016,14(1):98-100.
[6]孙菲.中医临床护理路径应用于乳腺癌手术患者的临床观察[J].新中医,2014,46(12):228-230.
[7]卜彩菊,庞永慧.乳腺癌术后患侧上肢水肿的预防护理进展[J].护理研究,2016,30(30):3716-3719.
[8]叶英,陈伟光,李梅,等.乳腺癌术后不同伤口加压包扎时间对术后并发症的影响[J].世界最新医学信息文摘,2015,15(23):15-16,18.
[9]翟安琪,于逢春,唐春燕.原发性失眠症患者认知功能及焦虑、抑郁的分析[J].实用临床医学,2017,18(3):15-17.
[10]杜妍华,杨名钫,关琼瑶.渐进式康复护理对乳腺癌患者术后肩关节活动度及生命质量的影响[J].护理实践与研究,2016,13(16):150-151.
[11]杨敏,谢娟,刘爱兰,等.护理干预对乳腺癌患者负面情绪的改善及生活质量的影响[J].实用临床医药杂志,2016,20(14):69-71.
[12]杨文艺.乳腺癌改良根治手术并发症原因分析及预防对策[J].医学理论与实践,2015,28(5):637-638.
[13]乔敏敏.心理护理对乳腺癌术后化疗患者焦虑、抑郁情绪及生活质量的影响[J].临床医学研究与实践,2016,1(18):173-174.
[14]王海林,宣锦花,彭鹏,等.乳癌患者术后睡眠障碍原因分析及护理对策[J].实用临床护理学电子杂志,2017,2(32):119,124.
[15]李阳,黄立中,龚辉,等.中医情志疗法对三阴性乳腺癌患者术后恢复期的生存质量的影响[J].湖南中医药大学学报,2015,35(10):54-56.
[16]徐川,仝欣,于小伟,等.乳腺癌术后中医药治疗的现状分析[J].云南中医中药杂志,2016,37(4):66-67.
[17]李左芹.耳穴贴压配合护理治疗失眠的疗效观察[J].云南中医中药杂志,2016,37(8):97-98.
[18]祝亚男,俞国红,杨方英,等.中医护理技术对减少乳腺癌患者术后并发症的效果研究[J].中华护理杂志,2017,52(3):289-292.
[19]曾正英,余佳蔓,胡钰.围绝经期失眠症患者耳穴贴压及辩证护理的效果观察[J].护理学报,2015,22(13):59-61.
[20]梁惠琼,庄纯,朱妙芬.吴茱萸穴位贴敷联合耳穴压豆治疗失眠的效果观察[J].中国当代医药,2017,24(18):97-99.
[21]张慧兰.吴茱萸贴敷涌泉穴防治艾素静脉化疗患者失眠症的临床观察[J].上海针灸杂志,2014,33(3):204-205.
[22]曾玉丹.中药外洗与艾灸疗法在乳腺癌术后上肢淋巴水肿治疗中疗效观察[J].辽宁中医药大学学报,2014,16(12):183-185.
[23]吴加花,冯燕虹,黎玉婵.耳穴压籽配合穴位按摩对乳腺癌改良根治术患者睡眠质量的影响[J].陕西中医,2017,38(1):103-104.
[24]王妤,胡静,梁海英,等.耳穴贴压治疗乳腺癌患者失眠效果观察[J].护理学报,2014,21(22):68-70.
[25]蔡铁如,伍大华.化痰解郁安神汤联合中医情志疗法治疗失眠伴抑郁症的临床研究[J].中医药导报,2017,23(13):101-104.
[26]汪超,周兰,姚诗清,等.从瘀论治乳腺癌术后患侧上肢淋巴水肿验案[J].新中医,2015,47(6):323-324.
[27]蔡中博,方桂珍.乳腺癌术后肩关节功能障碍及其影响因素调查研究[J].护理与康复,2015,14(12):1113-1117.
[28]王萍丽,栗红利.乳腺癌术后患者功能锻炼中护理干预的效果观察[J].陕西医学杂志,2014,43(6):767-768.
[29]孙莉,左亚芹,高玲,等.艾灸促进乳腺癌改良根治术后病人患侧肢体功能康复的效果评价[J].护理研究,2015,29(12):4282-4284.
[30]俞国红,胡婵娟,汪永坚.耳穴贴压对乳腺癌改良根治术后焦虑和疼痛的影响[J].上海针灸杂志,2014,33(4):332-334.
[31]路艳星,郭智涛,李雪真,等.中医情志疗法在康复期乳腺癌中的运用与体会[J].内蒙古中医药,2017,36(6):100.