乳腺癌术后淋巴水肿的中医研究进展
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摘要
乳腺癌术后淋巴水肿(lymphedema)是由于术后淋巴液回流障碍引起的局限性软组织非凹陷性水肿,以质地坚硬与表皮增生为主要特征。其发生的原因主要是术后淋巴通路被切断,侧支循环的破坏和难建立。在以往的治疗中,通常采用以西药或手术的方法,但因不良反应明显和二次创伤风险大,近几年临床运用较少。本文笔者搜索了近5年关于"乳腺癌术后上肢淋巴水肿治疗"的相关文献,对乳腺癌术后上肢淋巴水肿治疗的中医研究进展进行整理归纳,探讨了其最前沿的治疗措施。
Postoperative lymph node edema(lymphedema) is a localized soft tissue non-recessed edema causedby postoperative lymphatic drainage disorder. It is characterized by hard texture and epidermal hyperplasia. The mainreason for this is that the postoperative lymphatic pathway is severed, and the destruction of the collateral circulationis difficult to establish. In the past treatment, Western medicine or surgery was usually used, but the adverse reactionswere obvious and the risk of secondary trauma was large. In recent years, clinical use was less. In this paper, the authorsearched the relevant literature on "treatment of upper limb lymphedema after breast cancer surgery" for nearly 5 years,and summarized the progress of traditional Chinese medicine research on upper limb lymphedema after breast canceroperation, and discussed its most advanced treatment measures.
Postoperative lymph node edema(lymphedema) is a localized soft tissue non-recessed edema causedby postoperative lymphatic drainage disorder. It is characterized by hard texture and epidermal hyperplasia. The mainreason for this is that the postoperative lymphatic pathway is severed, and the destruction of the collateral circulationis difficult to establish. In the past treatment, Western medicine or surgery was usually used, but the adverse reactionswere obvious and the risk of secondary trauma was large. In recent years, clinical use was less. In this paper, the authorsearched the relevant literature on "treatment of upper limb lymphedema after breast cancer surgery" for nearly 5 years,and summarized the progress of traditional Chinese medicine research on upper limb lymphedema after breast canceroperation, and discussed its most advanced treatment measures.
引文
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[8]闫京涛.活血散结方治疗乳腺癌术后淋巴水肿41例[J]光明中医2016,31(7):952
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[11]黄箭娜,吴政龙.四妙勇安汤加味治疗乳腺癌术后上肢水肿30例[J].河南中医,2014,34(12):2398-2399.
[12]高建,王荚民,杨国旺,等.疏肝通络中药配合理疗治疗乳腺癌术后上肢淋巴水肿疗效观察[J].中国中医药信息杂志,2011,18(8):63-64.
[13]付培亭.防己黄芪汤加减治疗乳腺癌术后患肢水肿的临床疗效观察[D].南京:南京中医药大学,2014.
[14]张微微,江科,陈洁,等.“通阳刺水方”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(2):33-35.
[15]程思,彭爽,陈皎皎,等.逐水散联合微波艾灸治疗乳腺癌术后上肢淋巴水肿的临床研究[J].中国中医急症,2018,27(03):442-445.
[16]张萍联合加味补阳还五汤及艾灸复合护理干预在乳腺癌术后淋巴水肿的应用[J].临床医学专集2016:388-389.
[17]金璐怡,赵虹,楼丽华.中药联合威利坦治疗乳腺癌术后上肢水肿60例[J].陕西中医学院学报,2014(1):4647.
[18]赵静,邓新娜,王泽阳,等.补气化瘀通络利水法治疗乳腺癌术后或放疗后上肢淋巴水肿的临床研究[J].解放军医药杂志,2015,27(12):47-50.
[19]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.
[20]李珍,刘永存,钟小玲.双柏散外敷治疗乳腺癌术后上肢淋巴水肿临床观察[J].辽宁中医药大学学报,2009(1):86-87.
[21]张咏梅,计芬琴,杜晶晶,等.清热消肿汤为主治疗乳腺癌术后上肢淋巴水肿观察[J].浙江中医杂志,2013,48(1):48.
[22]崔梦迪.香附四子散热熨治疗乳腺癌术后上肢水肿的临床研究[D].北京:北京中医药大学,2014.
[23]樊杜英,张洁文,罗溢昌,张华中药硬膏穴位贴敷联合中药喷雾治疗乳腺癌术后淋巴水肿疗效观察[J]湖南中医药大学学报2018,38(1):73-76
[24]王玥姣,贾立群,朱世杰.乳脉通络洗剂治疗乳腺癌相关性上肢淋巴水肿临床观察[J].中日友好医院学报,2014,28(3):171-172.
[25]李思蒙.艾灸疗法防治乳腺癌术后化疗期患肢水肿的临床研究[D].杭州:浙江中医药大学,2012.
[26]娄秀娟,娄国喜,杨良权.艾灸治疗用于乳腺癌术后患肢淋巴水肿的疗效观察[J].世界中医药,2013,8(3):327-328.
[27]陈灵.温针灸改善乳腺癌术后上肢水肿的疗效观察[D].南京:南京中医药大学,2014.
[28]赵辉,王启堂,于永政.乳腺癌术后上肢淋巴水肿针灸治疗疗效观察[J].中国临床研究,2012,25(9):918-919.
[29]孙小虎,付均如,曹旭晨.刺络放血结合走罐疗法治疗乳腺癌术后上肢重度淋巴水肿的临床观察[J].中国中西医结合外科杂志,2017,23(02):167-170.
[30]安红丽,陈红根,陈华.中药熏洗联合推拿按摩治疗乳腺癌术后或放疗后上肢淋巴水肿35例临床观察[J].江苏中医药,2016,48(12):59-60+62.
[31]方丹萍,陈亮.经络按摩联合中医外治法治疗乳腺癌术后淋巴水肿的护理体会[J].中国医药指南,2017,15(14):270.
[32]李珍,刘永存,钟小玲.双柏散外敷治疗乳腺癌术后上肢淋巴水肿临床观察[J].辽宁中医药大学学报忉,2009,11(1):86.
[2]Hamner JB,Fleming MD.Lymphedema therapy reduces thevolume of edema and pain in patients with breast cancer[J].Ann Surg Oncol,2007,14(6):1904-1908.
[3]徐根强,冀会学,吕峰.乳腺癌术后患侧上肢淋巴水肿原因及防治探讨[J].现代肿瘤医学,2006(07):825-826.
[4]Wang B.Ni D,Zhu LP.Ipsilateral upper limb swelling fo r b r e a s t c an c e r a f t e r r a s c al m a s t e c t o my:a clinical analysis of 94 cases[J].Journal of Xinjiang Medical University,2008,31(7):834-835.DOI:10.3969/j.issn.1009-5551.2008.07.021.
[5]吴冉冉,齐向华.齐向华教授凭脉从情志论治淋巴水肿[J].母婴世界,2016(8).
[6]郭勇.恶性肿瘤并发症治疗[M].北京:人民卫生出版社,201l.
[7]吴建萍.崔公让教授经验方治疗下肢淋巴水肿60例[J].光明中医,2014,29(02):243-244.
[8]闫京涛.活血散结方治疗乳腺癌术后淋巴水肿41例[J]光明中医2016,31(7):952
[9]许正国,刘加升,张立光,等.血府逐瘀汤加减治疗乳腺癌术后上肢水肿的临床观察[J].光明中医,2011,26(2):253-255.
[10]余小勇.四妙丸加减防治乳腺癌术后上肢淋巴水肿的临床研究[D].南京:南京中医药大学,2013.
[11]黄箭娜,吴政龙.四妙勇安汤加味治疗乳腺癌术后上肢水肿30例[J].河南中医,2014,34(12):2398-2399.
[12]高建,王荚民,杨国旺,等.疏肝通络中药配合理疗治疗乳腺癌术后上肢淋巴水肿疗效观察[J].中国中医药信息杂志,2011,18(8):63-64.
[13]付培亭.防己黄芪汤加减治疗乳腺癌术后患肢水肿的临床疗效观察[D].南京:南京中医药大学,2014.
[14]张微微,江科,陈洁,等.“通阳刺水方”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(2):33-35.
[15]程思,彭爽,陈皎皎,等.逐水散联合微波艾灸治疗乳腺癌术后上肢淋巴水肿的临床研究[J].中国中医急症,2018,27(03):442-445.
[16]张萍联合加味补阳还五汤及艾灸复合护理干预在乳腺癌术后淋巴水肿的应用[J].临床医学专集2016:388-389.
[17]金璐怡,赵虹,楼丽华.中药联合威利坦治疗乳腺癌术后上肢水肿60例[J].陕西中医学院学报,2014(1):4647.
[18]赵静,邓新娜,王泽阳,等.补气化瘀通络利水法治疗乳腺癌术后或放疗后上肢淋巴水肿的临床研究[J].解放军医药杂志,2015,27(12):47-50.
[19]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.
[20]李珍,刘永存,钟小玲.双柏散外敷治疗乳腺癌术后上肢淋巴水肿临床观察[J].辽宁中医药大学学报,2009(1):86-87.
[21]张咏梅,计芬琴,杜晶晶,等.清热消肿汤为主治疗乳腺癌术后上肢淋巴水肿观察[J].浙江中医杂志,2013,48(1):48.
[22]崔梦迪.香附四子散热熨治疗乳腺癌术后上肢水肿的临床研究[D].北京:北京中医药大学,2014.
[23]樊杜英,张洁文,罗溢昌,张华中药硬膏穴位贴敷联合中药喷雾治疗乳腺癌术后淋巴水肿疗效观察[J]湖南中医药大学学报2018,38(1):73-76
[24]王玥姣,贾立群,朱世杰.乳脉通络洗剂治疗乳腺癌相关性上肢淋巴水肿临床观察[J].中日友好医院学报,2014,28(3):171-172.
[25]李思蒙.艾灸疗法防治乳腺癌术后化疗期患肢水肿的临床研究[D].杭州:浙江中医药大学,2012.
[26]娄秀娟,娄国喜,杨良权.艾灸治疗用于乳腺癌术后患肢淋巴水肿的疗效观察[J].世界中医药,2013,8(3):327-328.
[27]陈灵.温针灸改善乳腺癌术后上肢水肿的疗效观察[D].南京:南京中医药大学,2014.
[28]赵辉,王启堂,于永政.乳腺癌术后上肢淋巴水肿针灸治疗疗效观察[J].中国临床研究,2012,25(9):918-919.
[29]孙小虎,付均如,曹旭晨.刺络放血结合走罐疗法治疗乳腺癌术后上肢重度淋巴水肿的临床观察[J].中国中西医结合外科杂志,2017,23(02):167-170.
[30]安红丽,陈红根,陈华.中药熏洗联合推拿按摩治疗乳腺癌术后或放疗后上肢淋巴水肿35例临床观察[J].江苏中医药,2016,48(12):59-60+62.
[31]方丹萍,陈亮.经络按摩联合中医外治法治疗乳腺癌术后淋巴水肿的护理体会[J].中国医药指南,2017,15(14):270.
[32]李珍,刘永存,钟小玲.双柏散外敷治疗乳腺癌术后上肢淋巴水肿临床观察[J].辽宁中医药大学学报忉,2009,11(1):86.