中医外治法在乳腺癌术后患侧肢体功能康复中的应用研究  

Application of Traditional Chinese Medicine External Therapy in Promoting Functional Rehabilitation of Affected Limb in the Patients After Breast Cancer Surgery

作　　者：周坚[1] 刘艳君[1] 吕小红[1] 崔方圆 王小俊[1] ZHOU Jian;LIU Yan-Jun;LYU Xiao-Hong;CUI Fang-Yuan;WANG Xiao-Jun(The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2021年第7期1357-1363,共7页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】观察应用中医外治法治疗乳腺癌术后患侧上肢功能障碍的临床疗效。【方法】将76例乳腺癌术后患侧上肢功能障碍患者随机分为试验组和对照组,每组各38例。对照组患者给予常规功能康复训练,试验组患者在常规功能康复训练的基础上给予中医外治法(松筋理络法联合双柏散中药外敷)治疗,隔天实施1次,连续治疗3次,治疗时间为1周。2组患者分别于治疗前和治疗后采用肩关节功能评价量表和肩关节Constant-Murley评分(CMS)评价患肢的功能障碍程度,采用ID pain量表评估患肢的疼痛程度,采用数字分级法评估患肢的麻木程度,采用红外线体温计测量患肢的局部温度。【结果】(1)研究过程中,试验组脱落2例,对照组无脱落病例,最终试验组纳入36例,对照组纳入38例。(2)治疗后,2组患者的肩关节功能评价量表评分及肩关节CMS评分均较治疗前明显提高(P<0.01),且试验组的提高作用尤其是对肩关节活动范围(或主动活动范围)评分和日常生活活动能力评分的提高作用均明显优于对照组,差异均有统计学意义(P<0.05或P<0.01);而在疼痛、肌力及关节局部形态方面,2组比较,差异均无统计学意义(P>0.05)。(3)治疗后,试验组的患肢疼痛ID pain量表评分和麻木程度评分均较治疗前明显降低(P<0.01),而对照组均无明显改变(P>0.05);组间比较,差异均无统计学意义(P>0.05)。(4)无论治疗前还是治疗后,2组患者的胸壁伤口中部、腋窝中部、肘窝中部及手心温度比较,差异均无统计学意义(P>0.05)。【结论】中医外治法治疗乳腺癌术后上肢功能障碍患者疗效确切,可有效改善患肢功能,减轻局部疼痛和麻木症状。Objective To observe the clinical efficacy of traditional Chinese medicine(TCM)external therapy for the treatment of affected upper limb dysfunction in the patients after breast cancer surgery.Methods Seventy-six patients with affected upper limb dysfunction after breast cancer operation were randomly divided into trial group and control group,and each group had 38 cases.The control group was given conventional functional rehabilitation training,and the trial group was given TCM external therapy combined with the conventional functional rehabilitation training.The TCM external therapy consisted of manipulations for loosening tendons and unblocking collaterals together with external application of Chinese medicine of Shuangbo Powder,and the therapy was performed once every other day and lasted for 3 times,covering one week.Before and after treatment,the shoulder function assessment scores and the Constant-Murley scores were used for the evaluation of the degree of shoulder dysfunction,ID pain rating scale was used to assess the pain degree of the affected limb,numerical rating scale was adopted for the evaluation of the numbness degree of the affected limb,and infrared thermometer was used for the measurement of the focal temperature of the affected limb.Results(1)During the trial,2 cases from the trial group dropped out while no case from the control group quitted the trial,and a total of 36 cases in the trial group and all of the 38 cases in the control group completed the trial.(2)After treatment,the shoulder function assessment scores and the Constant-Murley scores in the two groups were obviously increased in comparison with those before treatment(P<0.01),and the trial group had stronger effect on increasing the scores in particular the scores of range of movement and activities of daily life than the control group,the difference being statistically significant(P<0.05 or P<0.01).The differences of the scores of pain,muscle strength,and focal morphology between the two groups were not significant(P>0.05).(3)Af

关 键 词：乳腺癌 术后患肢功能障碍 中医外治法 松筋理络法 双柏散 

分 类 号：R273.379[医药卫生—中西医结合]