疏肝通络汤结合理疗对乳腺癌术后患者上肢淋巴水肿及皮肤组织TGF-β1、类糜蛋白酶的影响  

Influence of Liver-soothing Collateral-dredging Decoction Combined with Physiotherapy on Breast Cancer-related Lymphedema,TGF-β1 and Chymotrypsin in Skin Tissue

作　　者：高城闻 王维娜 赵海彬 GAO Chengwen;WANG Weina;ZHAO Haibin(Clinical Lab,Zhangjiakou Maternal and Child Health Care Hospital,Zhangjiakou 075000,China)

机构地区：[1]张家口市妇幼保健院检验科,河北张家口075000

出　　处：《西部中医药》2023年第5期98-101,共4页Western Journal of Traditional Chinese Medicine

基　　金：张家口市重点研发计划项目(2121147D)。

摘　　要：目的:探讨疏肝通络汤结合理疗对乳腺癌术后患者上肢淋巴水肿(breast cancer-ralated lymphedema,BCRL)及皮肤组织内转化生长因子β1(transforming growth factor-β1,TGF-β1)、类糜蛋白酶的影响。方法:将女性BCRL患者76例依照随机数字表法分为联合组与对照组各38例,对照组予理疗,联合组予疏肝通络汤联合理疗。观察两组患者治疗前后患侧上肢淋巴流量、水分及脂肪含量,患侧前臂、上臂周径,患侧肩关节活动情况,患侧上肢中医症状积分及皮肤组织TGF-β1、类糜蛋白酶水平,以及不良反应发生情况。结果:治疗后联合组患者患侧上肢淋巴流量大于对照组(P<0.05),水分含量小于对照组(P<0.05),两组患者患侧上肢脂肪含量比较差异无统计学意义(P>0.05);治疗后联合组患者患侧前臂、上臂周径均小于对照组(P<0.05),患侧肩关节内收、外展、前屈、后伸角度均大于对照组(P<0.05);治疗后联合组患者烦躁易怒、情绪抑郁及脘腹胀痛、脉涩、舌黯积分均小于对照组(P<0.05)。两组均未见明显不良反应。结论:疏肝通络汤结合理疗在促进BCRL患者患侧上肢淋巴回流,缓解局部水肿及炎性反应,抑制TGF-β1、类糜蛋白酶生成,提高患肢功能,改善中医症状方面效果优于理疗,且安全可靠。Objective:To discuss the influence of liver-soothing collateral-dredging decoction combined with physiotherapy on breast cancer-related lymphedema(BCRL),TGF-β1 and chymotrypsin in skin tissue.Methods:All 76 female BCRL patients were divided into the combination group and the control group in light of random number table method,with 38 cases in each group,the control group accepted physiotherapy,the combination group liver-soothing collateral-dredging decoction and physiotherapy.To observe lymph flow,water content and fat content of the affected upper limb,cross section diameter of the affected forearm and the upper arm between both groups;the activity of the shoulder joint on the affected side,TCM symptom integrals of the affected upper arm,the levels of TGF-β1 and chymotrypsin in skin tissue,as well as the incidence of adverse reaction.Results:After the treatment,lymph flow of the affected upper limb of the combination group was greater than that of the control group,water content less than that of the control group(P<0.05),and there was no difference in the fat content of the affected upper limb between both groups(P>0.05);after the treatment,the combination group was less than the control group in cross section diameter of the affected forearm and the upper arm(P<0.05);after the treatment,the combination group was larger than the control group in the adduction,abduction,forward flexion and posterior extension angles of the affected shoulder(P<0.05);after the treatment,the combination group was less than the control group in the scores of irritation,depression and abdominal distension pain,uneven pulse and dark tongue(P<0.05).No obvious adverse reaction occurred in both groups.Conclusion:Liver-soothing collateral-dredging decoction combined with physiotherapy could promote lymphatic return of BCRL patients'affected upper limb,relieve local edema and inflammatory reaction,inhibit the generation of TGF-β1 and chymotrypsin,raise the function of the affected limb,and improve TCM symptoms,which is safe and reliab

关 键 词：上肢淋巴水肿 乳腺癌术后 皮肤组织 TGF-Β1 类糜蛋白酶 疏肝通络汤 理疗 

分 类 号：R273[医药卫生—中西医结合]