温针灸改善乳癌术后慢性淋巴水肿随机对照临床研究  

Effects of Warm Acupuncture on Chronic Breast Cancer Related Lymphedema in a Randomized Controlled Trial

作　　者：陈佳静[1] 叶小舟[1] 张媞[1] 顾铭[1] 姚昶[2] 

机构地区：[1]南京中医药大学,江苏南京210029 [2]南京中医药大学附属医院,江苏南京210029

出　　处：《辽宁中医药大学学报》2016年第10期133-136,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：江苏省领军人才项目(LJ2009002);江苏省高校优势学科建设项目II期(012062003010);江苏省中医院高峰学术人才培养项目(y2014cr06)

摘　　要：目的:观察温针灸对于乳腺癌相关的慢性淋巴水肿(BCRL)疗效,为临床广泛应用温针灸治疗乳腺癌术后患侧上肢水肿提供临床依据。方法:将30例来自江苏省中医院乳腺病科门诊BCRL患者随机分为实验组与对照组各15例,对照组每日口服地奥司明片3次,0.9 g/次,14 d为1个疗程,观察2个疗程。实验组隔日进行温针灸治疗28 d,温针灸治疗采用局部取穴为主,结合辨证配合远端选穴,取穴进针后以"平补平泻"手法行针,针灸30 min,予长度为3 cm艾条悬灸。28 d为1个疗程,整个疗程结束后评价疗效。实验组和对照组分别于治疗前及治疗第7、14、21、28天测量病人的患侧上肢臂围、肩关节活动度(ROM)并评估生活质量,分别计算有效指数及肩关节治疗前后活动度均值,以此两项指标及生活质量评估两组疗效。结果:(1)温针灸可以明显提高BCRL治疗有效指数,其对腕部及肘关节上10 cm部位效果较其余部位好(P<0.05)。(2)温针灸对肩关节活动度改善地奥司明片疗效相当,但其可以更早拓展肩关节功能。(3)温针灸可以提高BCRL患者生活质量,实验组自述后生活质量较对照组明显提高(P<0.05)。(4)在治疗期间没有不良反应报告,实验室检查临床安全显示正常的范围。结论:温针灸治疗可以有效地改善患者BCRL的程度、更早拓展肩关节活动度、提高术后生活质量,并具有良好的安全性。Obgective：To evaluated the effectiveness of warm acupuncture,and provide clinical basis for the treatment of BCRL. Methods：30 breast cancer patients who met the inclusion/exclusion criteria were randomized to the experimental and control groups（n=15/group）. On alternate days,patients in the experimental group received 30 minutes of acupuncture at 6 acupoints,3 of which were accompanied with 3 cm long moxa stick（warm acupuncture）. The control treatment was 900 mg Diosmin tablets three times per day. Control and experimental treatments lasted 30 days. Outcomes measured included arm circumference measures（effective index）,range of motion（ROM）of shoulder joint function,quality of life and clinical safety and adverse events. Results：（1）Warm acupuncture treatment can positively reduce the volume of upper limb lyrnphedema and ameliorating activity of the shoulder joint. As compared to the general effective index,the results at the wrist and above elbow increased much high than the results on other locations,which may mean that the effects of acupuncture at the wrist and above elbow are better than those of other locations（P〈0.05）.（2）Warm acupuncture treatment on improving joint mobility did not show significant differences compared with Diosmin. But it can expand the function of shoulder joint earlier.（3）The subjects in the group of warm acupuncture feel much happier than those in the control group（P〈0.05）.（4）All the subjects received twice of the tests of routine blood,electrocardiogram,hepatic and renal functions with normal value,which means that for 1 month is clinical safety. Conclusions：Warm acupuncture treatment can effectively reduce the degree of BCRL at the particular positions of acupoints located and expand the function of shoulder joint earlier,also promote the qualities of life compared to Diosmin. Warm acupuncture showed good clinical safety without any adverse influence on blood and cardiovascular system.

关 键 词：温针灸 乳腺癌相关淋巴水肿 肩关节活动度 生活质量 临床安全 

分 类 号：R737.9[医药卫生—肿瘤]