健脾活血解毒汤与温针灸联合常规疗法治疗乳腺癌术后上肢水肿临床研究

Clinical Study on Jianpi Huoxue Jiedu Tang and Warming Acupuncture and Moxibustion Combined with Routine Therapy for the Upper Limb Edema after Breast Cancer Surgery

目的:观察在常规疗法基础上加用健脾活血解毒汤与温针灸治疗乳腺癌术后上肢水肿的临床效果。方法:将104例乳腺癌术后上肢水肿患者纳入研究,采用随机数字表法分成2组,每组52例。2组均采用常规对症治疗,试验组联合健脾活血解毒汤与温针灸治疗,2组均治疗4周。对比2组的疗效,治疗前后测定患者的上肢臂围计算出有效指数,以评定上肢水肿情况,并应用视觉模拟评分法(VAS)评测患肢的疼痛程度,以Karnofsky评分法评测患者的功能状态。结果:治疗后,试验组总有效率96.16%,高于常规组的82.69%(P<0.05)。2组有效指数和Karnofsky评分均较治疗前增加,VAS评分均较治疗前下降,差异均有统计学意义(P<0.01)。试验组VAS评分低于常规组,有效指数、Karnofsky评分均高于常规组,差异均有统计学意义(P<0.01)。结论:在常规疗法基础上加用健脾活血解毒汤和温针灸治疗乳腺癌术后上肢水肿,能有效改善患肢症状和减轻疼痛,提高临床疗效,促进肢体功能恢复,且操作便捷。

Objective:To observe the clinical effect of the additional application of Jianpi Huoxue Jiedu tang and warming acupuncture and moxibustion on the basis of routine therapy for the upper limb edema after breast cancer surgery.Methods:Enrolled 104 cases of patients with the upper limb edema after breast cancer surgery into the study and divided them into two groups according to the random number table,with 52 cases in each group.Both groups received the routine symptomatic treatment,while the experiment group was additionally treated with the combination of Jianpi Huoxue Jiedu tang and warming acupuncture and moxibustion.Both groups were treated for four weeks.Compared the curative effect in the two groups,measured the upper limb circumference of the patients before and after treatment and calculated the effective indexes to evaluate the edema of the upper limb,and evaluated the pain degree of the affected limb by the visual analogue scale(VAS)and evaluated the functional status of the patients by the Karnofsky scoring method.Results:After treatment,the total effective rate in the experiment group was 96.16%,being higher than that of 82.69%in the routine group(P<0.05).The effective indexes and Karnofsky scores in the two groups were increased when compared with those before treatment and the VAS scores were decreased when compared with those before treatment,differences being significant(P<0.01).VAS scores in the experiment group were lower than those in the routine group,the effective indexes and Karnofsky scores were higher than those in the routine group,differences being significant(P<0.01).Conclusion:The additional application of Jianpi Huoxue Jiedu tang combined with warming acupuncture and moxibustion on the basis of routine therapy for the upper limb edema after breast cancer surgery can effectively improve the symptoms of affected limb and relieve the pain,enhance the clinical effect,promote the recovery of limb function,and the operation is convenient.