中药熏洗联合加味金黄膏穴位贴敷治疗乳腺癌术后上肢淋巴水肿的疗效观察

Observation of curative effect of the treatment of lymphedema of upper limb after breast cancer operation with fumigation and washing of traditional Chinese medicine combined with acupoint application of Jiawei Jinhuang ointment

目的:探讨中药熏洗联合加味金黄膏穴位贴敷治疗乳腺癌术后上肢淋巴水肿的效果及对中医症候积分的影响。方法:选取80例乳腺癌术后上肢淋巴水肿患者,研究时间为2018年02月至2020年02月,按照随机抽样法分为对照组(给予物理疗法)与观察组(给予中药熏洗联合加味金黄膏穴位贴敷治疗),各40例,且对两组患者的中医证候积分、患侧与健侧水肿周径差值、视觉模拟评分法(VAS)、卡氏功能状态评分(KPS)、上肢Constant-Murley评分进行观察及评估。结果:治疗4周后,观察组的上肢水肿、疼痛、肢体麻木、乏力、纳呆、心烦易燥等中医证候积分、患侧与健侧水肿周径差值、VAS评分低于对照组(P均<0.05)。治疗4周后,观察组的KPS评分、上肢Constant-Murley评分高于对照组(P均<0.05)。结论:中药熏洗联合加味金黄膏穴位贴敷治疗,能够有效减轻乳腺癌术后上肢淋巴水肿及改善上肢功能。

Objective:To explore the effect of traditional Chinese medicine fumigation and washing combined with acupoint application of Jiawei Jinhuang ointment in the treatment of upper limb lymphedema after breast cancer surgery and its influence on TCM syndrome score.Methods:80 patients with lymphedema of upper limbs after breast cancer surgery were selected as the study subjects.The study period was from February 2018 to February 2020.According to the random sampling method,they were divided into control group(given physical therapy)and observation group(given Chinese medicine fumigation and washing combined with acupoint application of Jiawei Jinhuang ointment),40 cases in each group,and the scores of TCM syndromes,the difference between the edema circumference of the affected side and the uninfected side,the visual analogue scale(VAS),and the Karnofsky functional status score(KPS),Upper limb Constant-Murley score for observation and evaluation.Results:After 4 weeks of treatment,the observation group's upper limb edema,pain,limb numbness,fatigue,appetite,upset and easy dryness and other traditional Chinese medicine syndromes,the difference between the edema of the affected side and the uninfected side(mild,moderate,important,total)and VAS scores were lower than those of the control group(all P<0.05).After 4 weeks of treatment,the KPS score and upper limb constant-murley score of the observation group were higher than those of the control group(P<0.05).Conclusion:Traditional Chinese medicine fumigation and washing combined with acupoint application of Jiawei Jinhuang ointment can effectively reduce upper limb lymphedema and improve upper limb function after breast cancer surgery.