中药与手法、绑扎疗法综合治疗下肢慢性淋巴水肿

Lishi Tongluo Decoction combined with Manipulation And Bandage Therapy on Chronic Lower Limb Lymphedema

目的观察中药利湿通络汤与手法、绑扎疗法综合治疗下肢慢性淋巴水肿的疗效。方法将确诊的80例下肢慢性淋巴水肿患者分为治疗组和对照组各40例。对照组给予手法淋巴引流和绑扎疗法治疗,治疗组在对照组基础上,加用中药利湿通络汤内服外泡患肢。3周为1个疗程,两组均连续治疗2个疗程,2个疗程后评价疗效。两组患者于治疗前后分别测量肢体周径并统计随访1年内患者丹毒发作次数。结果两组患者治疗后疗效比较,治疗组优于对照组,差异有统计学意义(P<0.01)。治疗后两组患肢周径与治疗前比较均明显改善,而治疗组治疗后患肢周径的改善及丹毒发作次数的减少优于对照组。结论中药利湿通络汤内服外用配合手法、绑扎疗法综合治疗下肢慢性淋巴水肿能够提高疗效,其机制可能通过促进组织炎症病变的消退,促进淋巴液的回流以及局部组织液和蛋白质的重吸收等有关。

Objective To observe the therapeutic effect of Lishi Tongluo Decoction combined with manual lymph drainage and bandage method in treatment of chronic lower limb lymphedema.Methods 80 patients of chronic lower limb lymphedema were divided into 2 groups： control group,in which 40 patients were treated with manual lymph drainage and bandage method;treatment group,in which 40 patients were treated with both Chinese herbal decoction Lishi Tongluo Decoction and manual lymph drainage and bandage method,three weeks for one course,treatment lasted for consecutive two courses,after when evaluation was conducted.The mean circumference of the lower limb of lymphedema and attack frequency of erysipelas during one year follow up were examined and recorded.Results The therapeutic effectiveness of treatment group was superior to that of control group（P0.01）.The improvements in the mean circumference of limb of lymphedema and the reduced attack frequency of erysipelas in treatment group were superior to that in control group.Conclusion Lishi Tongluo Decoction with manual lymph drainage and bandage method can improve the therapeutic effectiveness in treatment of limb chronic lymphedema.Its mechanism may be related to promote elimination of inflammation in tissues,reflux of lymph,elevating re-absorption of tissue fluid and protein.