中药外敷治疗乳腺癌相关淋巴水肿的系统评价  

External application of traditional Chinese medicine on treatment of breast cancer related lymphedema:a systematic review

作　　者：马丽芳 刘玉芬[3] 卿雁冰 黄雯琦 李章琪 岳树锦[1] 苏春香[1] Ma Lifang;Liu Yufen;Qing Yanbing;Huang Wenqi;Li Zhangqi;Yue Shujin;Su Chunxiang(School of Nursing,Beijing University of Traditional Chinese Medicine,Beijing 100029,China;Department of Oncology,Beijing Hospital of Traditional Chinese Medicine,Beijing 100010,China;Department of General Surgery,China Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]北京中医药大学护理学院,北京100029 [2]北京中医医院肿瘤科,北京100010 [3]中日友好医院普外科,北京100029

出　　处：《中国实用护理杂志》2022年第28期2234-2240,F0003,共8页Chinese Journal of Practical Nursing

基　　金：中央高校基本科研业务费专项资金(2020-JYB-ZDGG-079)。

摘　　要：目的系统评价中药外敷治疗乳腺癌相关淋巴水肿的疗效与安全性。方法计算机检索中国知网数据库、万方数据库、维普中文科技期刊数据库、中国生物医学文献数据库、The Cochrane Library、PubMed、Web of Science中建库至2020年5月25日的乳腺癌相关淋巴水肿的随机对照试验。由2名研究者独立筛选、评价文献,采用RevMan 5.4分析数据。结果共纳入16篇文献,共计1 315例乳腺癌相关淋巴水肿患者,纳入文献的方法学质量不高。相较于常规治疗,中药外敷联合常规治疗在提高治疗总有效率(P<0.01)及生命质量(P<0.01)、减轻疼痛(P<0.01)、改善上肢功能(P<0.01)方面具有一定优势,且无明显不良反应(P>0.05),但未改善患者的抑郁情况(P>0.05);相较于常规治疗,中药外敷能够更好地提高治疗总有效率(P<0.01);相较于安慰剂贴敷联合常规治疗,中药外敷联合常规治疗可以明显减小臂围(P<0.05)、减轻疼痛(P<0.01),且无明显不良反应发生(P>0.05)。结论现有证据表明,中药外敷可能是治疗乳腺癌相关淋巴水肿的方法之一,但由于纳入文献的方法学质量不高,尚需更多高质量研究加以证实。Objective To systematic review the efficacy and safety of external application of traditional Chinese medicine on treatment of breast cancer related lymphedema.Methods CNKI,Wanfang Data,VIP,Sino-Med,The Cochrane Library,PubMed,Web of Science were searched for related randomized controlled trials,the retrieval time was from inception to May 25,2020.Two researchers independently screened and evaluated the included studies.Meta-analysis was performed by RevMan 5.4 software.Results A total of 16 studies involving 1315 patients with breast cancer related lymphedema were included,and the methodological quality of the included studies was not high.Compared with conventional treatment,external application of traditional Chinese medicine combined with conventional treatment had advantages in improving the total efficiency(P<0.01)and quality of life(P<0.01),reducing pain(P<0.01)and improving upper limb function(P<0.01),without obvious adverse reactions(P>0.05),but there was no improvement in depression(P>0.05).Compared with conventional treatment,external application of traditional Chinese medicine could improve the total efficiency(P<0.01).Compared with placebo sticker combined with conventional treatment,external application of traditional Chinese medicine combined with conventional treatment can reduce circumference(P<0.05)and reduce pain(P<0.01),without obvious adverse reactions(P>0.05).Conclusions Available evidence suggests that external application of traditional Chinese medicine may be a potential treatment method for breast cancer related lymphedema.Due to the poor methodological quality of the included studies,high-quality randomized controlled trials are still needed.

关 键 词：随机对照试验 中药外敷 乳腺癌相关淋巴水肿 

分 类 号：R248.9[医药卫生—中医临床基础]