逍遥蒌贝散辨证治疗乳腺癌术后上肢淋巴水肿临床观察  

Clinical Observation of Using Xiaoyao Loubei Powder in the Differentiation and Treatment of Upper Limb Lymphedema after Breast Cancer Surgery

作　　者：陈澄 杨尊敬 CHEN Cheng;YANG Zun(Department of Oncology,the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi Hubei 445000,China)

机构地区：[1]恩施土家族苗族自治州中心医院肿瘤一科,湖北恩施445000

出　　处：《四川中医》2021年第8期156-160,共5页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:观察逍遥蒌贝散辨证治疗乳腺癌术后上肢淋巴水肿的临床疗效。方法:将我院168例乳腺癌术后上肢淋巴水肿患者随机分为观察组与对照组各84例。对照组给予常规治疗(包括西药及上肢功能训练),观察组在对照组基础上加用逍遥蒌贝散辨证治疗,治疗4周,比较两组临床疗效、治疗前后中医症候积分,评估中医证候疗效,并记录其治疗前后上肢淋巴水肿肿胀程度、患臂康复指标[上臂周径差值、上肢淋巴流量、臂、肩、手残疾调查问卷(DASH)评分]及生活质量[乳腺癌患者生命质量测定量表(FACT-B)中文版]变化及治疗期间不良反应发生。结果:治疗后,观察组总有效率为90.48%,对照组为78.57%(P<0.05);治疗4周后,两组患者肢体肿胀、麻木、疼痛、心烦意燥、恶心呕吐的中医症候积分、上臂周径差值、DASH量表评分均下降(P均<0.05),而上肢淋巴流量、FACT-B量表各维度评分均上升(P均<0.05),且观察组上述指标变化幅度更大(P<0.05);治疗4周后,观察组上肢淋巴水肿肿胀程度明显低于对照组(P<0.05);对照组不良反应总发生率为2.38%,观察组治疗后无任何不良反应,两组组间不良反应发生率比较无统计学意义(χ~2=0.506,P>0.05)。结论:逍遥蒌贝散配合物理训练可有效改善乳腺癌术后上肢淋巴水肿患者上肢麻木疼痛等症状,减轻肿胀程度,并有利于上肢功能及生活质量的提升,值得推广。Objective: To observe the clinical efficacy of using Xiaoyao Loubei powder in the differentiation and treatment of upper limb lymphedema after breast cancer surgery. Methods: A total of 168 patients with upper limb lymphedema after breast cancer surgery in our hospital were randomly divided into an observation group(n=84) and a controlled group(n=84). The controlled group was given routine treatment, including western medicine and upper limb function training, and the observation group was additionally treated with Xiaoyao Loubei Powder on this basis, and they were continuously treated for 4 weeks. The scores of TCM syndromes were compared between the two groups before and after treatment, and the swelling degree of upper limb lymphedema, recovery indicators of affected arm [upper arm circumference difference, Disabilities of Arm, Shoulder and Hand(DASH) score] and quality of life [Chinese Version of Functional Assessment of Cancer Therapy-Breast(FACT-B)] before and after treatment and occurrence of adverse reactions during treatment were compared between the two groups. Results: After treatment, the total effective rate was 90.48% in the observation group and was 78.57% in the controlled group(P<0.05). After 4 weeks of treatment, the scores of TCM syndromes of limb swelling, numbness, pain, annoyance and nausea and vomiting, upper arm circumference difference and score of DASH scale of the two groups were significantly decreased(all P<0.05) while the upper limb lymphatic flow and scores of dimensions of FACT-B scale were significantly increased(all P<0.05),and the changes of above indexes were greater in the observation group(P<0.05). After 4 weeks of treatment, the swelling degree of upper limb lymphedema in the observation group was significantly lower than that in the controlled group(P<0.05). The total incidence rate of adverse reactions was 2.38% in the controlled group, and there were no adverse reactions in the observation group after treatment, and there was no statistical significance in the incidence o

关 键 词：乳腺癌根治术 肢体锻炼 上肢淋巴水肿 生活质量 逍遥蒌贝散 

分 类 号：R737.9[医药卫生—肿瘤]