康复体操护理对乳腺癌术后患者日常生活活动能力的影响

目的观察康复体操护理对乳腺癌术后患者日常生活活动能力影响。方法 64例乳腺癌术后患者接受了康复体操护理,治疗前后评估日常生活活动能力(ADL)。结果 64例乳腺癌术后患者治疗后尿、便、修饰、用厕、吃饭、转移(床-椅)、活动(步行)、穿衣、上楼梯、洗澡等ADL分项评分和ADL总分均明显高于治疗前(P均<0.01～0.05)。结论康复体操护理可以明显改善乳腺癌术后患者日常生活活动能力。

多管腔硅胶管防治乳腺癌术后皮下积液的临床观察

目的探讨应用多管腔硅胶管对预防乳腺癌根治术后皮下积液的临床效果。方法将206例乳腺癌患者按手术时间随机分为两组,观察组104例,应用多管腔硅胶管,在腋下及锁骨下窝置分别多管腔硅胶管各1条,接负压球持续负压吸引,再用弹力绷带加压包扎;对照组102例,在腋下及锁骨下窝置单腔引流管各1条,接负压球持续负压吸引,再用弹力绷带加压包扎。结果观察组术后平均置管时间为(5.62±2.19)d明显少于对照组(9.37±2.85)d(t=2.418,P<0.01);观察组术后发生皮下积液7例(6.73%)明显少于对照组明显少于对照组(38例和37.25%)(χ2=8.930,P<0.01),具有统计学意义。结论多管腔硅胶管可明显缩短乳腺癌根治术后置管时间及减少皮下积液发生。

Study of 160 breast cancer patients with distant metastasis after operation by way of TCM syndromes classification

Objective: To discuss the relationship between the postoperative breast cancer with distant metastasis and the TCM syndromes classification. Methods: 160 postoperative 5-year breast cancer patients from 1995 to 2000 were tracked, summed up and analysized TCM syndromes as stagnation of hepatic qi, deficiency of spleen and pathogenic phlegm reten- tion, blood stasis and toxin stagnation, deficiencies of both blood and qi. Results: (1) For blood stasis and toxin stagnation TCM syndrome, the metastatic rate raised to 45% during 5 years. However, the metastatic rates of other three TCM syn- dromes are 15%, 17.5% and 22.5% respectively. The general distant metastasis rate was 27.5% (P<0.01). (2) Lymph node metastasis, tumor size, Her-2 and its receptor have no obvious relation with TCM syndromes classification (P>0.05). Conclu- sion: (1) TCM syndrome classification has close relation with breast cancer distant metastasis. Distant metastasis have close relationship with blood stasis and toxin stagnation syndrome. (2) Lymph node metastasis, tumor size, Her-2 and its receptor have no obvious relation with TCM syndromes classification, which suggested that metastatic ability has been programmed in the early stage of carcinoma initiation. (3) Significantly enlightening for predict the prognosis under the guide of TCM syn- drome classification and take right therapeutic strategy: attack pathogen and activate blood circulation against cancer.

Clinical experience in treating 78 cases of upper limb edema after breast cancer operation by WenYang HuoXue Washing Prescription

Objective To observe the clinical efficacy and safety of WenYang HuoXue Washing Prescription （WYHX） in the treatment of upper limb edema after breast cancer surgery. Methods： Seventy-eight patients with upper extremity edema after operation of breast cancer with Yin Syndrome were given wet compress with prescription and nursing guidance. The symptom score of affected extremity was observed before and 14 days after treatment, and the total effective rate was evaluated. Results： Twenty-three cases were markedly effective, 41 cases were effective and 14 cases were Invalid. The total effective rate was 82.1%. There was no significant difference between the two groups according to stage I and stage II of edema （P 〉 0.05）. Conclusion： WYHX can effectively improve the discomfort symptoms of upper limb edema and cold after breast cancer surgery, and is worthy of clinical application.

Study of the Relations among Tumor Size and Axillary Lymph Nodes Involvement with the Prognosis of Patients with Breast Cancer Surgery in Shohada Hospital in Tehran, Tajrish

Facts and evidence hold out a steadily increasing prevalence of breast cancer in the mid-1940s. In most cases, the disease is discovered when the disease has reached an advanced stage, therefore, early diagnosis can significantly reduce the burden of disease. Breast cancer has some risk factors, such as tumor size and lymph node involvement. The aim of this study was to evaluate the correlation between tumor size and axillary lymph node involvement and the prognosis for patients with breast cancer has been surgery. The study population consisted of 100 patients with breast cancer surgery at Shohada Hospital of Tajrish during the last 10 years. The results suggest that lymph node involvement was significantly associated with prognosis in patients with breast cancer and in cases where the tumor size was less than 1 cm, it has no impact on the prognosis of breast cancer. Also, a family history of the disease among close relatives is an independent risk factor for poor prognosis, in patients with breast cancer in general it can be said that involvement of lymph nodes in patients with breast cancer is due to an unfavorable prognosis; but the number of lymph nodes involved and the size of the tumor did not have any effect on the prognosis.

Twenty-seven cases of adverse reaction in postoperative chemotherapy of breast cancer treated with acupoint catgut-embedding therapy

Objective To observe the effect of acupoint catgut-embedding therapy on adverse reaction in chemotherapy of breast cancer. Methods Fifty-four cases were randomly divided into a comprehensive acupuncture and moxibustion group and a western medicine group, 27 cases in each group. All the postoperative cases with breast cancer used the CAF chemotherapy regimen. In the comprehensive acupuncture and moxibustion group, acupoint catgut-embedding therapy was applied to Tiānshū （天枢 ST 25）, Wèishū （胃俞 BL 21） and Zúsānlǐ （足三里 ST 36）, etc., and moxibustion was used at Zúsānlǐ （足三里 ST 36）. In the western medicine group, Ondansetron Hydrochloride, Metoclopramide, Metoclopramide and Qianglishengbai Tablets for oral administration were prescribed. A course was 28 days, and the whole treatment included 6 courses. The status of intake, nausea and vomiting were observed, and the leukocyte was detected before and after chemotherapy. Results After treatment, The status of intake in the comprehensive acupuncture and moxibustion group was superior to that in the western medicine group （P〈0.05）. The total effective rate on controlling nausea and vomiting in the comprehensive acupuncture and moxibustion group was 88.9% （24/27）, which was higher than that of 51.8% （14/27） in the western medicine group （P〈0.05）, the improving leukocyte effective rate was 92.6% （25/27） in comprehensive acupuncture and moxibustion group, which was higher than that of 77.8% （21/27） in western medicine group （P〈0.05）. Conclusion Acupoint catgut-embedding therapy can relieve the gastrointestinal reaction and improve patients’ immunity and quality of life during chemotherapy.

Clinical progress on moxibustion in preventing and treating adverse effects of surgery or chemoradiotherapy for breast cancer

Breast cancer has the highest incidence rate among all women＇s malignant tumors worldwide.Surgery,radiotherapy and chemotherapy are three major treatments,while most patients showed adverse effects or complications during or after the treatment,including lymphedema,gastrointestinal reactions and leukopenia,which cause severe impact on patients＇ recovery and quality of life.Moxibustion has been used and certified to alleviate adverse effects of surgery or chemoradiotherapy for breast cancer.We have summarized literatures in recent years and suggest more systematic research in the future for the underlying mechanism.

Efficacy and effect on serum VEGF-C of mild moxibustion plus functional exercise for upper-limb lymphedema after breast cancer surgery

Objective To observe the efficacy of mild moxibustion combined with functional exercise in the treatment of upper-limb lymphedema after breast cancer surgery and its effect on serum vascular endothelial growth factor C(VEGF-C).Methods Seventy-eight patients were divided into a control group and an observation group by the random number table method,with 39 cases in each group.The control group received functional exercise and the observation group received mild moxibustion plus functional exercise.The differences in circumference between the two upper limbs,the lymphatic flow of the affected upper limb,the disability of arm,shoulder and hand(DASH)score,the functional assessment of cancer therapy-breast(FACT-B)score and serum VEGF-C level between the two groups were compared before and after treatment.Efficacy was evaluated after treatment.Results The total effective rate was significantly higher in the observation group than in the control group(P<0.05).The difference in circumference between the two upper limbs of the two groups decreased significantly after treatment(both P<0.05),but it was significantly lower in the observation group than in the control group(P<0.05).The lymphatic flow of the affected upper limb of the two groups increased significantly after treatment(both P<0.05),but it was significantly greater in the observation group than in the control group(P<0.05).The DASH scores of the two groups decreased significantly after treatment(both P<0.05),but it was significantly lower in the observation group than in the control group(P<0.05).The FACT-B scores of the two groups increased significantly after treatment(both P<0.05),but it was significantly higher in the observation group than in the control group(P<0.05).After treatment,the serum VEGF-C level increased significantly in the observation group(P<0.05),whereas the control group did not show significant change(P>0.05).The post-treatment serum VEGF-C level was significantly higher in the observation group than in the control group(P<0.05).Conclusion The efficacy of mild moxibustion combined with functional exercise for upper-limb lymphedema after breast cancer surgery is certain,which can reduce the difference in circumference between the two upper limbs,increase the lymphatic flow of the affected upper limb,improve the limb function and the quality of life,and regulate the serum VEGF-C level.