地奥司明治疗乳腺癌术后淋巴水肿

Diosmin in treating lymphedema after breast cancer operation

目的观察地奥司明治疗乳腺癌术后上肢淋巴水肿的临床疗效。方法 80例乳腺癌术后淋巴水肿患者随机分为两组,每组40例。两组均于确诊淋巴水肿入院后第2日开始给药,对照组给予氢氯噻嗪25 mg,po,qd;观察组给予地奥司明0.90 g,po,bid;疗程均为14 d,随访3个月。治疗前后评价两组局部疼痛、上臂周径及水肿分级,观察并记录治疗中发生的不良反应。3个月后比较两组临床疗效。结果治疗后,观察组局部疼痛评分显著低于对照组[(3.8±0.4)分vs.(6.4±0.5)分,P<0.01],上臂周径亦显著短于对照组[(20.7±3.4)cm vs.(28.3±3.1)cm,P<0.01],水肿分级优于对照组(P<0.05)。观察组总有效率为98%,对照组总有效率为80%,两组临床疗效有显著差异(P<0.05)。两组均无严重不良反应发生。结论地奥司明治疗乳腺癌术后上肢淋巴水肿有效且安全。

AIM To investigate the clinical effect of diosmin in treating upper extremity lymphedema after breast cancer operation. METHODS A total of 80 patients with lymphedema after breast cancer operation were randomly divided into two groups（control and observation group）, 40 in each group. From the second day after diagnosis of lymphedema, the patients in the control group and observation group were, respectively,treated with hydrochlorothiazide（ 25 mg, po, qd） and diosmin（ 0.90 g, po, bid） for 14 d, and followedwith follow- up for three months. Indexes including local pain, arm circumference, edema level and adverse drug reaction were observed for each group. RESULTS After the treatment, the grade of local pain, and arm circumference in the observation group were lower than those in the control group（ 3.8 ± 0.4 vs. 6.4 ± 0.5,（ 20.7 ± 3.4） cm vs.（ 28.3 ± 3.1） cm, P〈0.01）. The grade of edema improved more significantly in the observation group than that in the control group（P〈0.05）. The total effective rate of the observation group and control group was 98% and 80%. There was significant difference in clinical efficacy between two groups（P〈0.05）. No serious adverse reaction occurred in both groups. CONCLUSION Diosmin is effective and safe in treatment of upper extremity lymphedema after breast cancer operation.