中医药防治乳腺癌相关淋巴水肿的进展与思考

Advances in prevention and treatment of breast cancer-related lymphedema with traditional Chinese medicine

乳腺癌相关淋巴水肿(BCRL)是一种慢性进行性疾病。中医从"病""症"角度探讨BCRL病机,主要集中在虚、痰、瘀、毒4个方面,且相互交叉、互为因果、互相联系。临床进行针对性治疗时需病症结合、辨证论治。中医药干预方式包括中药内服、中药外用、针灸拔罐、推拿导引等,防治手段呈现多环节、多途径的优势,但存在着辨证标准不统一,临床辨证施治可重复率低,缺乏长期疗效的大规模、多中心研究,以及疗效评价在标准化、客观化、规范化方面尚显不足等问题。

Breast cancer-related lymphedema(BCRL)is a chronic progressive disease.Its pathogenesis was explored in traditional Chinese medicine from the perspective of“disease”and“symptoms”,focused on four aspects:deficiency,phlegm,blood stasis,and toxin.These four aspects have a close and mutually causal relationship.Clinically,when targeted treatment is performed,disease combination and syndrome differentiation are needed.TCM intervention methods include internal administration of TCM,external application of TCM,acupuncture and moxibustion,cupping and massage,etc.TCM prevention and treatment methods show advantages of multiple links and multiple channels.However,there are still some problems,for instance,inconsistent syndrome differentiation standards,low repeatability of clinical syndrome differentiation,lack of large-scale and multi center research on long-term efficacy,and insufficient standardized,objective and standardized efficacy evaluation.