健脾活血解毒方对乳腺癌改良根治术后脾虚湿滞、瘀毒内结型上肢水肿患者的疗效  

Effect of Jianpi Huoxue Jiedu recipe on upper limb edema of spleen deficiency and dampness stagnation,blood stasis and toxin internal knot type after modified radical operation of breast cancer

作　　者：王芳[1] 罗秀清 胡岗[1] 林麟 詹军勇 黄菊英 Wang Fang;Luo Xiuqing;Hu Gang;Lin Lin;Zhan Junyong;Huang Juying(Department of Oncology,Longyan Hospital of Traditional Chinese Medicine Affiliated to Xiamen University,Longyan 364000,China)

机构地区：[1]厦门大学附属龙岩中医院肿瘤科,龙岩364000

出　　处：《中国医师杂志》2023年第5期724-728,共5页Journal of Chinese Physician

基　　金：龙岩市科技计划项目(2020LYF17055)。

摘　　要：目的探讨健脾活血解毒方对乳腺癌改良根治术后脾虚湿滞、瘀毒内结型上肢水肿患者的疗效。方法选取2020年1月至2022年5月厦门大学附属龙岩中医院收治的乳腺癌改良根治术后脾虚湿滞、瘀毒内结型上肢水肿患者60例,按照随机数字表法分成对照组和观察组,每组30例。对照组给予西医常规的综合消肿术,观察组在对照组基础上联合健脾活血解毒方(1剂/d,早晚温服),连续治疗1个月。比较两组患者治疗后的临床疗效,治疗前后的中医证候积分、水肿直径、乳腺癌生命质量测定量表(FACT)、关节活动度。结果治疗1个月后,观察组临床总有效率(93.33%)明显高于对照组(70.00%,P<0.05)。两组患者治疗后中医证候积分(上肢肿胀、疼痛、饱满、束缚感、皮肤角化、瘙痒、沉重、闷胀、疲劳)均较治疗前降低,且观察组低于对照组(均P<0.05)。两组患者治疗后患肢水肿直径显著减小,且观察组腕横纹上10 cm、肘横纹上10 cm直径小于对照组(均P<0.05)。两组患者治疗后FACT评分显著降低,且观察组FACT评分低于对照组(均P<0.05)。两组患者治疗后关节活动度显著增加,且观察组关节活动度大于对照组(均P<0.05)。结论健脾活血解毒方联合西医治疗乳腺癌改良根治术后脾虚湿滞、瘀毒内结型上肢水肿患者的临床疗效优于单纯西医治疗,能显著改善患者临床症状、体征、生活质量及患者上肢关节活动度,减轻上肢水肿。Objective To explore the therapeutic effect of Jianpi Huoxue Jiedu recipe on upper limb edema of spleen deficiency and dampness stagnation,blood stasis and toxin internal knot type after modified radical surgery for breast cancer.Methods From January 2020 to May 2022,a total of 60 patients with upper limb edema of spleen deficiency and dampness stagnation,blood stasis and toxin internal knot type after modified radical surgery for breast cancer were selected and treated in Longyan Hospital of Traditional Chinese Medicine Affiliated to Xiamen University.They were divided into control group and observation group according to random number table,with 30 cases in each group.The control group was treated with routine western medicine comprehensive swelling reduction surgery,while the observation group was treated with a combination of Jianpi Huoxue Jiedu recipe(1 dose/day,warmly-taken in the morning and evening)for one month on the basis of the control group.The clinical efficacy,traditional Chinese medicine(TCM)syndrome score,edema diameter,breast cancer quality of life scale(FACT),and joint range of motion were compared between the two groups after treatment.Results After one month of treatment,the total clinical effective rate of the observation group(93.33%)was significantly higher than that of the control group(70.00%,P<0.05).After treatment,the TCM syndrome scores(upper limb swelling,pain,fullness,sense of restraint,skin keratinization,itching,heaviness,stuffiness,and fatigue)of both groups of patients decreased compared to those before treatment,and the observation group was lower than the control group(all P<0.05).After treatment,the diameter of edema in the affected limbs was significantly reduced in both groups of patients,and the diameter of 10 cm above the wrist and elbow stripes in the observation group was smaller than that in the control group(all P<0.05).After treatment,the FACT scores of the two groups of patients significantly decreased,and the FACT scores of the observation group were lower than tho

关 键 词：乳腺肿瘤 乳房切除术 改良根治性 健脾活血解毒方 乳腺癌淋巴水肿 

分 类 号：R273[医药卫生—中西医结合]