蠲饮方内服合逐水方外用治疗乳腺癌术后上肢水肿的临床观察  

Clinical Observation on Treatment of Upper Extremity Edema after Breast Cancer Surgery with Juanyin Recipe(蠲饮方)Orally and Zhushui Recipe(逐水方)for External Use

作　　者：徐静[1] 朱为康[1] 陈旻[1] 郭鹏[1] 陆俊骏[1] 滕文静[1] 郑诗芸 XU Jing;ZHU Weikang;CHEN Min;GUO Peng;LU Junjun;TENG Wenjing;ZHENG Shiyun(Shanghai Hospital of Traditional Chinese Medicine,Shanghai 200092,China)

机构地区：[1]上海市中医医院,上海200092

出　　处：《中华中医药学刊》2023年第5期86-89,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家中医药管理局中医药行业科研专项(201507001-10);上海市“科技创新行动计划”医学创新研究专项(20210618)。

摘　　要：目的探讨蠲饮方内服合逐水方外用治疗乳腺癌术后上肢淋巴水肿(BCRL)的临床疗效。方法选择医院于2019年10月—2021年10月BCRL患者120例,依据随机数字表法分为观察组60例与对照组60例。对照组口服迈之灵,观察组在对照组基础上采用蠲饮方内服合逐水方外用治疗。两组疗程4周。比较两组临床疗效,治疗前后上臂周径差值、上肢功能指数评定量表(upper limb function index,UEFI)评分、卡氏(Karnofsky performance status,KPS)评分、主要证候评分、炎性因子[C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(tumor necrosis factor,TNF-α)和白细胞介素-6(interleukin-6,IL-6)]变化。结果观察组BCRL患者总有效率(95.00%,57/60)高于对照组(80.00%,48/60)(P<0.05)。两组治疗后BCRL患者上臂周径差值较治疗前降低(P<0.05);观察组治疗后BCRL患者上臂周径差值低于对照组(P<0.05)。两组治疗后BCRL患者UEFI评分较治疗前增加(P<0.05);观察组治疗后BCRL患者UEFI评分高于对照组(P<0.05)。两组治疗后BCRL患者KPS评分较治疗前增加(P<0.05);观察组治疗后BCRL患者KPS评分高于对照组(P<0.05)。两组治疗后BCRL患者肢体麻木、疼痛和上肢水肿评分较治疗前降低(P<0.05);观察组治疗后BCRL患者肢体麻木、疼痛和上肢水肿评分低于对照组(P<0.05)。两组治疗后BCRL患者血清CRP、TNF-α和IL-6水平较治疗前降低(P<0.05);观察组治疗后BCRL患者血清CRP、TNF-α和IL-6水平低于对照组(P<0.05)。结论蠲饮方内服合逐水方外用治疗BCRL患者疗效良好,可改善患者上肢功能和生存质量,及减轻患者炎性反应。Objective To investigate the clinical efficacy of Recipe(蠲饮方)for oral administration and Zhushui Recipe(逐水方)for external use in the treatment of upper limb lymphedema(BCRL)after breast cancer surgery.Methods A total of 120 patients with BCRL in the hospital from October 2019 to October 2021 were selected and divided into an observation group(60 cases)and a control group(60 cases)according to the random number table method.The control group was given Maizhiling(迈之灵)(orally),and the observation group was treated with Juanyin Recipe orally and Zhushui Recipe on the basis of the control group.The course of treatment in the two groups was 4 weeks.The clinical curative effects of the two groups were compared,and the difference in upper arm circumference and upper extremity function index before and after treatment were compared.Rating Scale(UEFI)score,Karnofsky(KPS)score,major symptom score,inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)]of two groups were compared.Results The observation group’s total effective rate(95.00%,57/60)was higher than that(80.00%,48/60)of the control group(P<0.05).After treatment,upper arm circumference of the two groups was lower than that before treatment(P<0.05)and the upper arm circumference of the observation group was lower than that of the control group(P<0.05).After treatment,the UEFI scores of two groups were higher than those before treatment(P<0.05)and the score of the observation group was higher than that of the control group(P<0.05).After treatment,the KPS scores of two groups were higher than those before treatment(P<0.05)and the score of the observation group was higher than that of the control group(P<0.05).After treatment,the scores of limb numbness,pain and upper extremity edema of two groups were lower than those before treatment(P<0.05)and the scores of the observation group were lower than those of the control group(P<0.05).After treatment,the serum levels of CRP,TNF-αand IL-6 of two groups were l

关 键 词：蠲饮方 逐水方 乳腺癌 术后上肢水肿 

分 类 号：R273.379[医药卫生—中西医结合]