活血通络方熏洗联合地奥司明片对乳腺癌术后上肢水肿及生活质量的影响

Effect of Fumigation and Washing with Huoxue Tongluo Prescription Combined with Diosmin Tablets on Upper Limb Edema After Surgery for Breast Cancer and Quality of Life

目的:观察活血通络方熏洗联合地奥司明片治疗乳腺癌术后上肢水肿的临床疗效及其对生活质量的影响。方法:选取88例乳腺癌术后上肢水肿患者,按随机数字表法分为对照组与研究组各44例。对照组给予常规对症治疗,研究组在对照组的基础上加用活血通络方熏洗。2组疗程均为1个月,观察比较2组临床疗效、中医证候积分、患肢周径、患肢功能活动情况及生活质量情况。结果:研究组总有效率为95.45%,对照组为77.27%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候积分较治疗前降低(P<0.05),且研究组中医证候积分低于对照组(P<0.05)。治疗后,2组患肢周径较治疗前显著减少、上肢功能(DASH)评分较治疗前降低(P<0.05),且研究组上述2项指标改善较对照组更显著(P<0.05)。治疗后,2组乳腺癌特异性量表(EORTC QLQ-BR23)中上肢症状、乳腺癌症状、体象、对未来的憧憬、性欲、性功能、治疗不良反应、对脱发的担忧等评分均较治疗前降低(P<0.05);且研究组上肢症状、乳腺癌症状、体象、对未来的憧憬、治疗不良反应、对脱发的担忧等评分均低于对照组(P<0.05),而性欲、性功能评分与对照组比较则差异不明显(P>0.05)。结论:应用活血通络方熏洗可缓解乳腺癌术后患者上肢水肿,改善其患肢功能及生活质量。

Objective: To observe the clinical effect of the therapy of fumigation and washing with Huoxue Tongluo prescription combined with diosmin tablets on upper limb edema after breast cancer operation and its effect on quality of life of patients. Methods:A total of 88 patients with upper limb edema after surgery for breast cancer were selected and divided into the control group and the study group according to the random number table method,with 44 cases in each group. The control group was given routine symptomatic treatment, and the study group was additionally treated with Chinese herbal fumigation and washing with Huoxue Tongluo prescription based on the treatment of the control group.Both groups were treated for one month. The circumference and functional activity condition of affected limbs and quality of life,clinical effects and Chinese medicine syndrome scores in the two groups were observed and compared. Results:The total effective rate was 95.45% in the study group and 77.27% in the control group, the difference being significant(P<0.05). After treatment, the Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and the Chinese medicine syndrome score in the study group was lower than that in the control group(P<0.05). After treatment, the circumference of affected limbs in the two groups was significantly less than that before treatment and the scores of Disabilities of the Arm, Shoulder and Hand(DASH) were significantly decreased(P<0.05);the improvement of the above two indexes in the study group was more significant than that in the control group(P<0.05). After treatment,the scores of upper limb symptoms,breast cancer symptoms, body image, vision for the future, sexual desire, sexual function, adverse reactions to treatment,and concerns about hair loss in the breast cancer specific module(EORTC QLQBR23) in the two groups were decreased when compared with those before treatment(P<0.05);the scores of upper limb symptoms,breast cancer symptoms,body image,vision for the future,adverse reactions to treatment and concerns about hair loss in the study group were lower than those in the control group(P<0.05), and there was no difference being found in the comparison of sexual desire and sexual function between the two group(P>0.05). Conclusion: The application of fumigation and washing with Huoxue Tongluo prescription can significantly relieve the upper limb edema of patients after surgery for breast cancer,and improve the limb function and quality of life.