袁氏粘连松解法治疗乳腺癌术后上肢功能障碍的临床观察
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摘要
目的:观察袁氏粘连松解法治疗乳腺癌术后上肢功能障碍的临床疗效。方法:纳入640例乳腺癌术后上肢功能障碍患者,随机分为治疗组和对照组,每组各320例。治疗组患者接受袁氏粘连松解法治疗,对照组患者接受传统康复训练,治疗周期为4周。治疗前后,采用Richards方案评价患者的上肢功能障碍情况,采用视觉模拟评分法(VAS)评价局部疼痛和麻木程度,采用超声检测、按Adler半定量法对患者局部的血循环情况进行评价。结果:治疗后,两组患者的上肢功能、疼痛与麻木情况均明显改善(P<0.05),且治疗组患者上肢功能、疼痛与麻木情况的改善优于对照组(P<0.05)。治疗前后,两组患者的局部血循环情况比较,差异均无统计学意义(P>0.05)。结论:袁氏粘连松解法可改善乳腺癌术后上肢功能障碍患者的上肢功能,减轻局部疼痛、麻木症状,值得临床推广。
Objective: To observe the clinical efficacy of Yuan's adhesiolysis manipulation in the treatment of upper limb dysfunction in postoperative patients with breast cancer. Methods: A total of 640 postoperative patients with breast cancer who had upper limb dysfunction were selected and randomly divided into the treatment group and the control group,320 cases in each group. The patients in the treatment group were treated with Yuan's adhesiolysis manipulation and the patients in the control group were treated with traditional rehabilitation training,with a course of 4 weeks. Before and after treatment,the upper limb dysfunction was evaluated by Richards scheme,the local pain and numbness were measured by visual analogue scale(VAS) score,and the local blood circulation was detected by ultrasound and Adler semi-quantitative method. Results: After treatment,the upper limb function,pain and numbness were significantly improved in both groups(P<0.05),and the improvement of the treatment group was better than that of the control group(P<0.05). Before and after treatment,there were no statistically significant differences on the local blood circulation between the two groups(P>0.05). Conclusion: Yuan's adhesiolysis manipulation can improve the upper limb function of postoperative patients with breast cancer who had upper limb dysfunction,and relieve the symptoms of pain and numbness,which is worth popularizing in clinic.
Objective: To observe the clinical efficacy of Yuan's adhesiolysis manipulation in the treatment of upper limb dysfunction in postoperative patients with breast cancer. Methods: A total of 640 postoperative patients with breast cancer who had upper limb dysfunction were selected and randomly divided into the treatment group and the control group,320 cases in each group. The patients in the treatment group were treated with Yuan's adhesiolysis manipulation and the patients in the control group were treated with traditional rehabilitation training,with a course of 4 weeks. Before and after treatment,the upper limb dysfunction was evaluated by Richards scheme,the local pain and numbness were measured by visual analogue scale(VAS) score,and the local blood circulation was detected by ultrasound and Adler semi-quantitative method. Results: After treatment,the upper limb function,pain and numbness were significantly improved in both groups(P<0.05),and the improvement of the treatment group was better than that of the control group(P<0.05). Before and after treatment,there were no statistically significant differences on the local blood circulation between the two groups(P>0.05). Conclusion: Yuan's adhesiolysis manipulation can improve the upper limb function of postoperative patients with breast cancer who had upper limb dysfunction,and relieve the symptoms of pain and numbness,which is worth popularizing in clinic.
引文
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[14] ADLER D D,CARSON P L,RUBIN J M,et al. Doppler ultrasound color flow imaging in the study of breast cancer:preliminary findings[J].Ultrasound Med Biol,1990,16(6):553- 559.
[2] MOLS F,VINGERHOETS A J,COEBERGH J W,et al. Quality of life among long- term breast cancer survivors:a systematic review[J].Eur J Cancer,2005,41(17):2613- 2619.
[3] DEVOOGDT N,VAN KAMPEN M,CHRISTIAENS M R,et al. Short- and long- term recovery of upper limb function after axillary lymph node dissection[J].Eur J Cancer Care (Engl),2011,20(1):77- 86.
[4] RIETMAN J S,DIJKSTRA P U,HOEKSTRA H J,et al. Late morbidity after treatment of breast cancer in relation to daily activities and quality of life:a systematic review[J].Eur J Surg Oncol,2003,29(3):229- 238.
[5] HAYES S C,JOHANSSON K,STOUT N L,et al. Upper-body morbidity after breast cancer:incidence and evidence for evaluation,prevention,and management within a prospective surveillance model of care[J].Cancer,2012,118(8 Suppl):2237- 2249.
[6] STUBBLEFIELD M D,KEOLE N. Upper body pain and functional disorders in patients with breast cancer[J].PM R,2014,6(2):170- 183.
[7] STUBBLEFIELD M D,CUSTODIO C M. Upper-extremity pain disorders in breast cancer[J].Arch Phys Med Rehabil,2006,87(3 Suppl 1):S96- S99.
[8] CHEVILLE A L,TCHOU J. Barriers to rehabilitation following surgery for primary breast cancer[J].J Surg Oncol,2007,95(5):409- 418.
[9] EBAUGH D,SPINELLI B,SCHMITZ K H. Shoulder impairments and their association with symptomatic rotator cuff disease in breast cancer survivors[J].Med Hypotheses,2011,77(4):481- 487.
[10] TORRES LACOMBA M,MAYORAL DEL MORAL O,COPERIAS ZAZO J L,et al. Incidence of myofascial pain syndrome in breast cancer surgery:a prospective study[J].Clin J Pain,2010,26(4):320- 325.
[11] GATELEY C A. Non- tumour morbidity and mortality after modified radical mastectomy[J].Ann R Coll Surg Engl,1993,75(1):69- 70.
[12] RICHARDS R R,AN K N,BIGLIANI L U,et al. A standardized method for the assessment of shoulder function[J].J Shoulder Elbow Surg,1994,3(6):347- 352.
[13] 何铁春,杨莉,金文刚,等. 乳腺癌术后综合运动康复训练对患侧上肢功能的影响[J].中国临床康复,2004,8(14):2730.
[14] ADLER D D,CARSON P L,RUBIN J M,et al. Doppler ultrasound color flow imaging in the study of breast cancer:preliminary findings[J].Ultrasound Med Biol,1990,16(6):553- 559.