穴位按摩联合艾灸治疗乳腺癌术后上肢淋巴水肿临床研究

目的：观察穴位按摩联合艾灸治疗乳腺癌术后上肢淋巴水肿的临床疗效。方法：采用随机数字表法将80例乳腺癌术后上肢淋巴水肿患者分为对照组、治疗组各40例。2组均给予地奥司明片治疗，对照组加用按摩与上肢功能锻炼治疗，治疗组加用穴位按摩联合艾灸治疗，2组连续治疗8周。比较2组临床疗效及治疗前后腺癌淋巴水肿症状体验指数（BCLE-SEI）、淋巴水肿纤维化分级、视觉模拟评分法（VAS） 肿胀、VAS疼痛、乳腺癌患者生命质量测定量表（FACT-B） 评分及上肢活动度。结果：治疗后，治疗组总有效率95.00%，高于对照组80.00%（P＜0.05）。治疗后，2组中医证候积分、BCLE-SEI评分、淋巴水肿纤维化分级评分、VAS肿胀评分、VAS疼痛评分、FACT-B维度（生理、社会/家庭、情感、功能及其他状况） 评分均较治疗前降低（P＜0.05），且治疗组治疗后上述指标均低于对照组（P＜0.05）。治疗后，2组上肢上举、内旋、外旋、水平屈曲及水平伸展活动度均较治疗前增大（P＜0.05），且治疗组治疗后上述5 项活动度高于对照组（P＜0.05）。结论：穴位按摩联合艾灸治疗乳腺癌术后上肢淋巴水肿疗效确切，能够减轻患者患肢水肿和疼痛程度，促进上肢功能恢复，提高生活质量。

Clinical Study on Acupoints Massage Combined with Moxibustion for Upper LimbLymphedema After Surgery of Breast Cancer

Abstract：Objective：To observe the clinical effect of the therapy of acupoints massage combined withmoxibustion for upper limb lymphedema after surgery of breast cancer. Methods：A total of 80 patients withupper limb lymphedema after surgery of breast cancer were divided into the control group and the treatmentgroup according to the random number table method，with 40 cases in each group. The two groups weretreated with Diosmin Tablets， the control group was additionally given massage and exercises of upperlimbs for treatment， and the treatment group was additionally treated with acupoints massage combinedwith moxibustion. The two groups were treated for eight weeks. The clinical effects， and the scores ofBreast Cancer Lymphedema Symptom Experience Index (BCLE-SEI)， fibrosis grading of lymphedema，Visual Analogue Scale (VAS) of swelling and pain， and Functional Assessment of Cancer Therapy-Breast(FACT-B) and the range of motion of upper limbs were compared before and after treatment between thetwo groups. Results：After treatment，the total effective rate was 95.00% in the treatment group，higher than that of 80.00% in the control group (P＜0.05). After treatment，scores of BCLE-SEI，fibrosis gradingof lymphedema，VAS of swelling and pain and FACT-B dimensions (physiology，society/family，emotion，function and others) in the two groups were decreased when compared with those before treatment (P＜0.05). After treatment，the range of motion of elevation，inward and outward rotation，and horizontal flexand extension of upper limb in the two groups were respectively increased (P＜0.05)， and the range ofrotation of above five items in the treatment group was higher than that in the control group (P＜0.05).Conclusion：The therapy of acupoints massage combined with moxibustion has a definite curative effect onupper limb lymphedema after surgery of breast cancer，which can mitigate the edema of affected limbs andthe pain degree，promote the recovery of function of upper limbs and improve the quality of life.