黄芪桂枝五物汤合内消丸化裁外敷辅助中医外治手段治疗乳腺癌术后上肢淋巴水肿的疗效

目的 探讨黄芪桂枝五物汤合内消丸化裁外敷辅以中医外治手段治疗乳腺癌术后上肢淋巴水肿的临床疗效。方法 选取我院2017年1月—2019年6月收治乳腺癌术后上肢淋巴水肿患者共138例，以随机数字表法分为对照组（69例）和观察组（69例）；其中对照组给予西医对症干预；观察组则在对照组基础上给予黄芪桂枝五物汤合内消丸化裁外敷辅以中医外治手段治疗；比较两组上肢水肿改善率、生活质量改善率，治疗前后中医症候积分、上肢双侧周径差、不良反应发生情况及随访复发情况。结果 观察组上肢水肿改善效果显著优于对照组（P<0.05）；观察组生活质量改善率显著高于对照组（P<0.05）；观察组治疗后14 d中医证候积分均显著低于对照组及治疗前（P<0.05）；观察组治疗后7d和14d双侧上肢周径差均显著低于对照组和治疗前（P<0.05）；两组治疗过程中均未见严重不良反应。结论 黄芪桂枝五物汤合内消丸化裁外敷辅以中医外治能够有效改善乳腺癌术后上肢淋巴水肿临床症状，促进上肢水肿消退，提高生存质量，且安全性令人满意。

Clinical Effects of Huangqi Guizhi Wuwu Decoction and Neixiao Pill Cutting Assistedn with External Treatment of Traditional Chinese Medicine on Breast Cancer Patients with Postoperative Upper Limb Lymphedema

Objective To investigate the clinical effects of Huangqi Guizhi Wuwu decoction and Neixiao pill cutting assisted with external treatment of traditional Chinese medicine in the treatment of breast cancer patients with postoperative upper limb lymphedema. Methods We selected 138 breast cancer patients with postoperative upper limb lymphedema treated in our hospital from January 2017 to June 2019, and they were randomly divided into two groups: control group (western medicine intervention, n=69) and observation group (Huangqi Guizhi Wuwu decoction and Neixiao pill cutting assisted with external treatment of traditional Chinese medicine on the basis of control group, n=69). The improvement rates of upper limbs edema and quality of life, TCM syndrome score and circumference difference of upper limbs before and after treatment, adverse reactions and recurrence rate between two groups were compared. Results The improvement rate of upper limbs edema and quality of life of observation group were significantly higher than those of control group (both P<0.05). The TCM syndrome score of observation group on the 14th day after treatment were significantly lower than those of control group and before treatment (P<0.05). The circumference difference of upper limbs of observation group on the 7th and 14th days after treatment were significantly lower than those of control group and before treatment (P<0.05). There was no serious adverse reaction during the treatment course in two groups. Conclusion Huangqi Guizhi Wuwu decoction and Neixiao pill cutting assisted with external treatment of traditional Chinese medicine could efficiently improve the clinical symptoms, promote the disappearance of upper limb edema and improve the quality of life of breast cancer patients with postoperative upper limb lymphedema, with satisfactory safety.