综合消肿治疗技术联合中药外治法治疗乳腺癌患者术后上肢淋巴水肿临床疗效观察

Clinical Observation of CDT Combined with External Treatment of Traditional Chinese Medicine for Postoperative Upper Limb Lymphedema in Breast Cancer Patients

目的研究综合消肿治疗技术联合中药外治法治疗乳腺癌患者术后上肢淋巴水肿临床疗效观察。方法选取2017年1月—2019年12月收治的乳腺癌术后上肢淋巴水肿患者合计90例,随机分为治疗组和对照组,每组各45例。对照组予综合消肿治疗技术;治疗组予综合消肿治疗技术联合中药外治法进行治疗。治疗两个疗程之后,比较两组患者的总有效率、患侧肢体的周径、肩关节活动度、肢体组织水分比率、肢体功能以及日常生活能力的评分。结果治疗组总有效率82.2%(37/45),对照组总有效率73.3%(33/45),治疗组疗效优于对照组,但差异无统计学意义(P>0.05)。在治疗后,治疗组的手虎口处,腕横纹上5 cm,肘横纹向上及下10 cm及腋窝处的周径,与治疗前相比差异显著(P<0.05)。与对照组相比,两组的差异显著(P<0.05)。两组患肢的周径比较,具有显著性差异(P<0.05);两组患者治疗后,肩关节活动情况均明显改善,治疗组改善情况优于对照组,但差异无统计学意义(P>0.05);两组患者治疗后,组织水分比率均较治疗前明显改善;两组患者Fugl-Meyer及Bathel评分均较治疗前提高,差异有统计学意义(P<0.05),且治疗后的组间差异显著(P<0.05)。结论综合消肿治疗技术联合中药外治法治疗乳腺癌患者术后上肢淋巴水肿具有确切的临床疗效。

Objective To study the clinical efficacy of comprehensive decongestive therapy(CDT)combined with external treatment of traditional Chinese medicine in the treatment of postoperative upper limb lymphedema in breast cancer patients.Methods From January 2017 to December 2019,90 postoperative breast cancer patients with upper limb lymphedema were selected and randomly divided into treatment group and control group,with 45 cases in each group.Patients of the control group were given CDT treatment,and those of the treatment group were given CDT combined with external treatment of traditional Chinese medicine.After two courses of treatment,the total effective rate,circumference of the affected limb,shoulder mobility,water ratio of limb tissue,limb function and ability of daily living scores were compared between the two groups.Results The total effective rate was 82.2%(37/45)in the treatment group and 73.3%(33/45)in the control group.The therapeutic effect of the treatment group was better than that of the control group,while there was no significant difference(P>0.05).In the treatment group,the circumference between thumb and index finger,the circumference of 5 cm above carpal stria,10 cm above and under elbow Stria,and the circumference of armpit had been significantly improved after treatment(P<0.05).The difference between the two groups was significant(P<0.05).The shoulder mobility was significantly improved in both groups,and the improvement in the treatment group was better than that in the control group,while the difference was not statistically significant(P>0.05).The water ratio of limb tissue was significantly improved in both groups.The scores of Fugl-Meyer and Bathel in the two groups were significantly higher than those before treatment(P<0.05),and the difference between the groups was significant after treatment(P<0.05).Conclusion It is effective to treat upper limb lymphedema by CDT combined with external therapy of traditional Chinese medicine in postoperative breast cancer patients.