远红外线治疗下肢慢性淋巴水肿伴发淋巴管炎效果分析

Therapeutic effects of far-infrared ray in treating chronic lower extremity lymphedema with dermatolymphangioadenitis

目的·探究远红外线对妇科肿瘤术后慢性淋巴水肿伴发皮肤淋巴管炎的疗效。方法·下肢淋巴水肿患者入组后,采用远红外线热疗,持续治疗20 d(每周5个工作日)。分别于治疗前及治疗后进行临床评估和实验室检测。临床评估指标包括皮肤淋巴管炎发作频率、临床症状评估表、生活质量评估表、功能评估表及不良反应;实验室检测包括治疗前后分别对血液及局部患肢组织液进行细菌培养,同时检测全身血清及局部患肢组织液内的炎症相关细胞因子。结果·共64例妇科肿瘤术后下肢淋巴水肿伴发皮肤淋巴管炎患者接受远红外线治疗及临床疗效评估,其中11例同时接受实验室检测。临床评估发现:经远红外线治疗后,皮肤淋巴管炎发作频率减少(P=0.000),其中50例(78%)不再出现皮肤淋巴管炎,63例(98%)患者有效率达50%以上;临床症状出现不同程度的改善,包括紧绷感、沉重感、疼痛、坚硬感、痛苦、不适感、发热、肿胀感、刺痛、虚弱感、麻木感(均P<0.05);生活质量评分升高(P=0.000);FACT-G评分升高(P=0.000)。实验室检测发现:远红外线治疗后血清中IL-1β浓度升高(P<0.05),组织液中IL-2、IL-10、IL-18浓度降低(均P<0.05);远红外线治疗前后,血液及组织液细菌培养结果都为阴性。结论·远红外线治疗会降低妇科肿瘤术后下肢慢性淋巴水肿伴发皮肤淋巴管炎患者皮肤淋巴管炎发作频率,改善患者的生活质量、临床症状及功能,同时引起一系列的血清和组织液中的细胞因子浓度变化。

Objective·To explore therapeutic effects of far-infrared radiation(FIR)therapy on chronic lower extremity lymphedema accompanied with dermatolymphangioadenitis(DLA),occurring after gynecological tumor resection.Methods·The enrolled patients received regular sessions using the FIR therapy machine over the 20-day treatment course(five days in each week).Clinical and laboratory outcome measures were carried out before and after treatment.Clinical outcome measures included DLA seizure frequency,patients'subjective feedback,quality of life,and side effects.Laboratory outcome measures included bacterial cultures and concentrations of in?ammatory cytokines,detected in serum and local lymphedema tissue?uid samples.Results·A total of 64 cases completed FIR treatment and clinical curative effect evaluation,including 11 cases at the same time completing the laboratory tests.The frequency of DLA decreased during treatment(P=0.000).The ef?ciency rate was more than 50%for 63(98%)patients receiving treatment.Even 50 patients(78%)did not experience a single episode of DLA recurrence in the whole year after treatment.Patients reported a subjective decrease in lymphedema-related symptoms(all P<0.05),including tightness,heaviness,pain,hardness,soreness,discomfort,heat,fullness,weakness,and numbness.Patients'quality of life was improved after treatment(P=0.000).Laboratory analysis showed an elevation in serum concentration of IL-1βafter FIR therapy(P<0.05)and reduction in local tissue?uid concentrations of IL-2,IL-10 and IL-18(all P<0.05).Bacterial culture results were both negative before and after treatment.Conclusion·FIR therapy provides an effective treatment modality for patients with chronic lymphedema accompanied with DLA that develops secondarily from the treatment of gynecological malignancies,whose therapeutic effects may be due to reduce immune dysfunction within local lymphedema tissues.