中医中药

疏肝通络中药配合理疗治疗乳腺癌术后上肢淋巴水肿的临床分析

裴晓峰

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【摘要】  【摘要】目的 探讨疏肝通络中药配合理疗治疗乳腺癌术后上肢淋巴水肿的临床效果。方法 选取2016年3月至2017年3月在我院接受治疗的84例乳腺癌术后上肢淋巴水肿患者,由计算机编号,按照单双数法分为观察组(n=42)与对照组(n=42),对照组仅采用理疗治疗,观察组在对照组基础上采用疏肝通络中药治疗,比较两组患者治疗效果。

【关键字】  乳腺癌术后上肢淋巴水肿,疏肝通络中药,理疗,生命质量评分,中医症候积分

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[Abstract]Objective To investigate the clinical effect of Shugan Tongluo traditional Chinese medicine combined with reasonable treatment for upper limb lymphedema after breast cancer operation. Methods Eighty-six patients with upper extremity lymphedema after breast cancer surgery from March 2016 to March 2017 were enrolled in our hospital. The numbers were divided into observation group (n=42) and control group according to single and double numbers (n=42), the control group was only treated with physiotherapy, and the observation group was treated with Shugan Tongluo Chinese medicine on the basis of the control group, and the therapeutic effects of the two groups were compared. Results The total effective rate of the observation group was 97.62%, which was significantly higher than that of the control group (85.71%) (P<0.05). The quality of life scores of the observation group were significantly lower than the control group (P<0.05). The scores were significantly lower than the control group (P<0.05). Conclusion The use of Shugan Tongluo traditional Chinese medicine combined with reasonable treatment for upper limb lymphedema after breast cancer surgery can significantly improve the patient's condition and improve the quality of life of patients.

乳腺癌属于女性中常见恶性疾病,近年来,随着人们生活习惯以及环境的改变,我国乳腺癌发病率呈现出逐年上升趋势,手术治疗方式已成为临床治疗该病的首选方案,通过切除病灶实现疾病治疗目的[1]。但手术作为一种侵入式操作,易导致术后产生多种并发症。乳腺癌术后上肢淋巴水肿即属于一类病情严重术后并发症,预后不佳[2]。以往常采用物理治疗法进行治疗,但适用范围较小,仅在早期水肿病情中发挥一定疗效,且维持时间短。目前,已有学者证明采用中医治疗可有效改善乳腺癌患者术后上肢淋巴循环,对巨噬细胞活性产生抑制作用,在上肢淋巴水肿治疗中发挥较好效果。本文主要探讨疏肝通络中药配合理疗治疗乳腺癌术后上肢淋巴水肿的临床效果,现报道如下。 1 资料与方法 1.1 一般资料:选取2016年3月至2017年3月在我院接受治疗的84例乳腺癌术后上肢淋巴水肿患者,由计算机编号,按照单双数法分为观察组(n=42)与对照组(n=42)。对照组42例,年龄19~68岁,平均年龄(43.56±9.14)岁,病程2个月~3年,平均(1.56±0.32)年。观察组42例,年龄21~69岁,平均年龄(44.02±9.37)岁,病程6个月~3年,平均(1.62±0.35)年。两组一般资料对比均保持同质性(P>0.05)。纳入标准:所有患者经诊断均符合乳腺癌术后上肢淋巴水肿诊断标准;乳腺癌术后患肢周径>健侧2 cm;无其他恶性肿瘤患者;所有患者及其家属均知情并签署知情同意书。排除标准:合并心肝肾等脏器严重功能障碍患者;处于哺乳或妊娠期妇女;患肢皮肤溃烂或存在淋巴结、血管疾病患者;存在精神或认知障碍无法正常沟通患者。 1.2 方法:对照组仅采用理疗治疗,选取日本杨木日东工器株式会社生产的MEDOMER MB-2000A型号气压泵治疗机治疗,每日1次,每次维持15 min。观察组在对照组基础上采用疏肝通络中药治疗,疏肝通络中药药方组成:柴胡10 g、路路通10 g、当归15 g、海风藤30 g、鸡血藤30 g、络石藤30 g、桂枝10 g、郁金10 g车前草15 g、车前子15 g、水蛭3 g,加水煎熬至400 mL,每天1剂,分别于早晚各服用200 mL,连续4周为1疗程。 1.3 观察指标:①两组患者临床疗效。疗效判定标准:显效:优:治疗后患肢与健侧差值减少>75%;良:治疗后患肢与健侧差值减少在50%~75%;可:治疗后患肢与健侧差值减少在25%~50%;差:治疗后患肢与健侧差值减少<25%。②两组患者中医症状积分。依据《中药新药临床研究指导原则》[3]对本文患者典型症状恢复情况进行评价,考虑症状有肢体肿胀感、肢体沉重感、肢体疼痛、肢体麻木、乏力等,共分为无、轻、中、重4个等级,依次对应分0~3分,得分越低,说明症状恢复越好。③两组患者生活质量评分。采用乳腺癌生命质量量表(FACT-B)[4]对本文患者生命质量进行评价,该量表包括生理状况(0~28分)、社会职能(0~28分)、情感状况(0~24分)、功能状况(0~28分)、附加关注(0~36分)等5项,评分越高,生活质量越差。

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