围手术期针药联合改善乳腺癌术后上肢功能随机对照研究  

A Randomized Controlled Trial Evaluating the Efficacy of Perioperative Acupuncture Com⁃bined with Traditional Chinese Medicine for Enhancing Upper Limb Functionality after Breast Cancer Surgery

作　　者：帕提古丽·加帕尔 江科[1] 袁敏佳 李晓菲 董梦婷 盛佳钰[1] PATIGULI Jiapaer;JIANG Ke;YUAN Minjia;LI Xiaofei;DONG Mengting;SHENG Jiayu(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Urumqi Friendship Hospital,Urumqi,Xinjiang 830047,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]乌鲁木齐市友谊医院,新疆乌鲁木齐830047

出　　处：《康复学报》2025年第1期22-29,共8页Rehabilitation Medicine

基　　金：国家自然科学基金项目(82104952);上海市科学技术委员会项目(21Y11923600);上海市卫生健康委员会面上项目(202140172)。

摘　　要：目的 探讨芪术方联合电针治疗对围手术期乳腺癌患者术后疼痛和上肢功能障碍的影响。方法选取2022年1—12月于上海中医药大学附属岳阳中西医结合医院乳腺病科行乳腺癌根治术的患者90例作为研究对象,采用随机数字表法分为常规药物组和针药联合组,每组45例。2组均接受常规术后治疗并口服中药芪术方,常规药物组接受假电针治疗,针药联合组接受电针治疗。采用McGill疼痛问卷简表(SFMPQ)评价2组治疗前后疼痛程度;采用肩关节活动度(ROM)、上肢功能障碍(DASH)简式评分表、上肢握力值评价2组上肢功能;采用乳腺癌生命质量测定量表(FACT-B)比较2组生活质量。结果 与治疗前比较,治疗后2组SF-MPQ量表中PRI评分、VAS评分和PPI指数均明显下降(P<0.05);与常规药物组比较,针药联合组治疗后PRI评分、VAS评分和PPI指数均明显下降(P<0.05)。术后1个月时,与常规药物组比较,针药联合组肩外展、前屈及后伸ROM明显增加(P<0.05);术后3个月时,与常规药物组比较,针药联合组肩外展、前屈ROM明显增加(P<0.05);术后6个月时,与常规药物组比较,针药联合组肩外展明显增加(P<0.05)。术后1个月时,在外展、前屈及后伸活动中比较,2组在预期值中占比最高的是针药联合组外展ROM,达75.17%(P<0.05);术后3、6个月时,2组不同ROM的预期值占比比较,差异均无统计学意义(P>0.05)。术后1、3个月时,与常规药物组比较,针药联合组DASH简式评分表评分下降(P<0.05);与术后1个月比较,2组术后3、6个月时DASH简式评分表评分均下降(P<0.05);术后1、3个月时,与常规药物组比较,针药联合组上肢握力值均明显增高(P<0.05);与术后1个月比较,2组术后3、6个月时上肢握力值均升高(P<0.05)。术后1个月时,与常规药物组比较,针药联合组生理状况、功能状况及附加关注得分均升高(P<0.05)。结论 在乳腺癌围手术期口服芪术方的基础上配合电�Objective To explore the effect of oral Qi-Zhu Formula combined with electroacupuncture on postoperative pain and upper limb dysfunction in patients with breast cancer during the perioperative period.Methods A total of 90 patients who underwent radical mastectomy in the department of breast diseases of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine between January 2022 and December 2022 were randomly assigned to either a conventional medicine group or a combined electroacupuncture and medicine group,with 45 cases in each group.Both groups received standard postoperative treatment and took the traditional Chinese medicine Qi-Zhu Formula orally.The conventional medicine group received sham electroacupuncture treatment,while the combined electroacupuncture and medicine group received electroacupuncture treatment.Pain levels were assessed before and after treatment using the Short Form McGill Pain Questionnaire(SF-MPQ)in the two groups;Upper limb functions were evaluated by shoulder joint range of motion(ROM),quick disabilities of the arm,Shoulder and Hand(DASH)questionnaire,and grip strength measurement.Quality of life was compared between the two groups using the Functional Assessment of Cancer Therapy-Breast(FACT-B)scale.Results Compared with that before treatment,the PRI score,VAS score and PPI index of SF-MPQ scale in the two groups significantly decreased after treatment(P<0.05).Compared with the conventional medicine group,the PRI score,VAS score and PPI index were significantly lower in the combined electroacupuncture and medicine group(P<0.05).At one month post-surgery,compared with the conventional medicine group,the abduction,flexion,and extension ROM in the shoulder joint were significantly higher in the combined electroacupuncture and medicine group(P<0.05).At three months post-surgery,compared with the conventional medicine group,the abduction and flexion ROM were significantly higher in the combined electroacupun

关 键 词：乳腺癌 围手术期 芪术方 电针 肩关节活动度 上肢功能 

分 类 号：R737.9[医药卫生—肿瘤]