点穴分筋拨络法治疗乳腺癌术后腋网综合征的疗效观察  

The effectiveness of massage manipulation in the treatment of axillary web syndrome following breast cancer surgery

作　　者：杨棋惠 乔佳 李开庭[1] 孔渝菡[1] 白定群[1] 余和平[1] YANG Qihui;QIAO Jia;LI Kaiting;KONG Yuhan;BAI Dingqun;YU Heping(Department of Rehabilitation Medicine,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Rehabilitation Medicine,the Third Affiliated Hospital,Sun Yat-sen University,Guangdong Guangzhou 510630,China)

机构地区：[1]重庆医科大学附属第一医院康复医学科,重庆400016 [2]中山大学附属第三医院康复医学科,广东广州510630

出　　处：《现代肿瘤医学》2023年第3期463-468,共6页Journal of Modern Oncology

基　　金：国家自然科学基金青年基金项目(编号:82003306);重庆市科卫联合中医药科研项目(编号:2019ZY3408)。

摘　　要：目的:拟采用点穴分筋拨络法治疗乳腺癌术后腋网综合征,运用中医临床理论为该病的认识及防治提供临床依据。方法:将2019年10月至2021年10月我院乳腺外科存在腋网综合征的患者82例随机分为两组,治疗组41例,对照组41例。治疗组由专门从事传统康复的治疗师予以点穴分筋拨络法进行治疗,并提供健康教育;对照组不进行手法治疗,仅给予健康教育,两组患者分别在干预前和干预后3周、6周进行随访,对比两组患者在肩关节活动度、视觉模拟评分(visual analogue scale/score,VAS)、上肢残疾功能评分(disabilities of arm,shoulder and hand scale,DASH)以及Barthel指数方面的改变情况。结果:治疗组患者在3周、6周随访时肩关节外展、前屈活动度,DASH评分与对照组相比均有明显改善,且具有统计学差异(P<0.05);治疗组肩关节后伸、内收以及Barthel指数评分、VAS评分在3周随访时与对照组相比无统计学差异(P>0.05),6周随访时差异具有统计学意义(P<0.05)。结论:点穴分筋拨络法能够改善乳腺癌术后腋网综合征患者肩关节活动受限,缓解患肢疼痛,提高上肢功能及生活自理能力。Objective:To analyze the efficacy of massage manipulation for axillary web syndrome(AWS)and provide evidence for clinical prevention and treatment.Methods:From October 2019 to October 2021,82 patients with AWS in the breast surgery department of our hospital were randomly divided into two groups,41 cases in the treatment group and 41 cases in the control group.The treatment group was provided with massage manipulation by the well-trained traditional rehabilitation therapist and health education.While only health education was provided to the control group.The two groups of patients would be followed-up before the treatment and at 3,6 weeks after the treatment,respectively.The shoulder range of motion(ROM),visual analogue scale(VAS),disabilities of arm,shoulder,and hand scale(DASH)and the Barthel index were recorded and analyzed.Results:At 3 and 6 weeks of follow-up,the shoulder abduction and flexion range of motion,DASH score in the treatment group were significantly improved compared with the control group,the difference was statistically significant(P<0.05).There was no statistical difference(P>0.05)between the two groups about the Barthel index score,the VAS pain and shoulder adduction and extension range of motion at 3 weeks of follow-up,but there was a statistical difference(P<0.05)at 6 weeks of follow-up.Conclusion:The massage manipulation can improve the limitation of shoulder movement,relieve pain in the affected limb,and improve limb function and self-care ability in patients with AWS after breast cancer operation.

关 键 词：推拿手法 乳腺癌 腋网综合征 

分 类 号：R737.9[医药卫生—肿瘤]