中药熏洗联合徒手淋巴引流对乳腺癌根治术后上肢水肿的影响

Effect of Chinese Herbal Fumigation and Washing Therapy Combined with Manual Lymph Drainage Technique on Upper Limb Edema after Radical Mastectomy

目的对比分析中药熏洗联合徒手淋巴引流与单纯徒手淋巴引流对乳腺癌根治术后上肢水肿的治疗效果。方法选取2017年9月至2019年9月南阳市第一人民医院蒲山医院收治的123例女性乳腺癌根治术后上肢水肿患者作为研究对象,并按照随机数表法将其随机分为观察组62例与对照组61例,观察组患者采用中药熏洗联合徒手淋巴引流治疗,对照组患者单纯采用徒手淋巴引流治疗,对比两组患者消肿效果、臂肩手功能障碍调查表(DASH)及欧洲癌症研究与治疗组织生活质量量表(EORTC QLQ-C30)评分改善情况。结果治疗4周后,观察组患者消肿效果明显优于对照组(Z=-2.525,P=0.012),DASH及EORTC QLQ-C30评分均明显低于对照组(t=10.020、7.911,P均<0.001)。结论与单纯应用徒手淋巴引流相比,中药熏洗联合徒手淋巴引流能够更好地促进乳腺癌根治术后上肢水肿的消退及上肢功能的恢复,提高患者生活质量,临床应用价值较高。

Objective To analyze comparatively the effect of Chinese herbal fumigation and washing therapy combined with manual lymph drainage technique on upper limb edema after radical mastectomy.Methods One hundred and twenty-three female patients with upper limb edema following radical mastectomy,admitted to Nanyang First People’s Hospital from September 2017 to September 2019,were selected as research subjects to be divided,according to the random number table,into an observation group(62 cases)and a control group(61 cases).The patients in the observation group were treated with Chinese herbal fumigation and washing therapy combined with manual lymph drainage technique(MLDT),whereas the patients in the control group with MLDT only.The detumescence effect,disabilities of the arm,shoulder and hand(DASH)score,and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-core 30(EORTC QLQ-C30)score were compared between the two groups.Results After 4 weeks of treatment,the detumescence effect in the observation group was significantly better than that in the control group(Z=-2.525,P=0.012),and the DASH score and EORTC QLQ-C30 score in the observation group were obviously lower than that in the control group(t=10.020,7.911,both P<0.001).Conclusion Compared with MLDT alone,the treatment protocol of Chinese herbal fumigation and washing therapy combined with MLDT is better in promoting the fading away of upper-limb edema and the functional recovery of upper limb after the radical mastectomy,improving the quality of life of such patients.The protocol has a high value of clinical application.