中药熏蒸配合穴位按摩治疗乳腺癌术后上肢淋巴水肿的疗效观察

Observation on the Effects of Chinese Medicine Fumigation Combined with Acupoint Massage for Upper Limb Lymphedema after Breast Cancer Operation

目的探讨中药熏蒸配合穴位按摩治疗乳腺癌术后上肢淋巴水肿的疗效。方法回顾性收集2014年5月—2018年1月我院收治的乳腺癌术后上肢淋巴水肿患者172例为研究对象,根据治疗方法的不同分为观察组(n=100)和对照组(n=72)。对照组给予穴位按摩治疗,观察组在对照组的基础上给予自拟中药熏蒸治疗,疗程4周,观察两组患者的预后。结果观察组总有效率(95.0%)显著高于对照组(70.8%)(P<0.05)。观察组治疗前后患侧上肢五点周径比较,差异均无统计学意义(P>0.05);对照组治疗后腕横纹周径与虎口掌径均高于治疗前(P<0.05),且显著高于观察组(P<0.05)。治疗后观察组肩关节活动优良率(99.0%)显著高于对照组(88.9%)(P<0.05)。治疗后两组患者LBCQ评分均显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05)。结论中药熏蒸配合穴位按摩治疗乳腺癌术后上肢淋巴水肿能促进患者肩关节功能改善,缓解临床症状,且不会改变患侧上肢五点周径,可提高治疗效果。

Objective To investigate the effects of traditional Chinese medicine fumigation combined with acupoint massage on upper limb lymphedema after breast cancer operation. Methods A retrospective study was conducted on 172 patients who suffered with upper limb lymphedema after breast cancer surgery and were enrolled in our hospital between May 2014 and January 2018. According to their different treatments, they were divided into the observation group(n=100) and the control group(n=72). Patients in control group received acupoint massage treatment, and those in observation group were given the self-made Chinese medicine fumigation based on the treatment of the control group. Both groups had treatment of 4 weeks, and the effective rate, circumferences at 5 points of the upper limbs, activity of shoulder joint, scores of lymphedema and breast cancer questionnaire(LBCQ) were recorded and compared between the two groups. Results The total effective rates of the observation group(95.0%) was higher than that of the control group(70.8%)(P<0.05). There were no statistical differences in the circumference at 5 points of the upper limbs of the observation group between before and after treatment(P>0.05). But after treatment, the circumferences at the transverse wrist crease and the first web space of hand of the control group were bigger than those before treatment(P<0.05), and they were also bigger than those of the observation group(P<0.05). After treatment, the rates of excellent and good activity of shoulder joint were significantly higher in observation group(99.0%) than in control group(88.9%)(P<0.05). Both groups had significantly lower LBCQ scores after treatment than before treatment(P<0.05). And the LBCQ scores of observation group were also lower than those of control group(P<0.05). Conclusion Chinese medicine fumigation combined with acupoint massage could enhance the therapeutic effects on patients with upper limb lymphedema after breast cancer surgery. It could improve the function of shoulder joint, and relieve the clinical symptoms, but not change the 5-point circumference of the upper limb of the affected side.