加味金黄膏穴位贴敷联合中药喷雾治疗乳腺癌术后上肢淋巴水肿疗效观察

目的:观察加味金黄膏硬膏穴位贴敷联合中药喷雾治疗乳腺癌术后上肢淋巴水肿的临床效果。方法:选取符合标准的80例乳腺癌术后上肢淋巴水肿患者,随机分为治疗组和对照组各40例。两组患者均给予肢体锻炼联合空气波压力循环治疗,治疗组给予中药硬膏贴敷天泉、曲池、太渊穴,并联合使用温经活络方中药喷雾,对照组给予安慰剂贴敷上述穴位,并联合安慰剂喷雾。通过对比两组患者治疗前后总有效率、中医症候积分(水肿、肢体麻木、疼痛、心烦易怒、乏力、纳呆)、显效时间、KPS评分情况及不良反应等,对其疗效及安全性进行评价。结果:治疗组总有效率高于对照组,差异存在统计学意义(P0.05);两组在中医症候评分、显效时间及KPS评分等方面较治疗前均有下降,且治疗组下降幅度明显优于对照组(P0.05),治疗组患者在疼痛评分及纳呆两方面比治疗前亦有所改善,差异有统计学意义(P0.05),对照组患者上述两方面治疗前后差异无统计学意义(P 0.05)。不良反应率治疗组12.5%,对照组7.5%,两组比较差异无统计学意义(P0.05)。结论:运用加味金黄膏硬膏穴位贴敷联合中药喷雾治疗乳腺癌术后上肢淋巴水肿临床疗效良好,操作简便,安全性高,不良反应少。

Clinical Study on Treatment of Postoperative Upper Limb Lymphedema with Modified Jinhuang Plaster Acupoint Application Combined with Traditional Chinese Medicine Spray

Objective:To observe the clinical effect of modified Jinhuang plaster acupoint application combined with traditional Chinese medicine spray in the treatment of upper limb lymphedema after breast cancer surgery. Methods:80 cases of upper limb lymphedema after breast cancer surgery were randomly divided into the treatment group(40 cases) and the control group(40 cases). Patients in the two groups were given physical therapy of limbs combined with air wave pressure circulation therapy. The treatment group was given traditional Chinese medicine plaster applied to Tianquan(PC 2),Quchi(LI 11),Taiyuan(LU 9) acupoints,and combined application of Chinese traditional medicine spray. And the control group was given placebo plaster applied to the same acupoints as the treatment group combined with placebo spray. The efficacy and safety of the two groups were evaluated by comparing the effects and TCM syndrome integral(edema,limb numbness,pain,upset irritability,fatigue,dementia),onset time,KPS score and adverse reaction before and after the treatment. Results:The effect of the treatment group was better than that of the control group,and the difference was statistically significant(P<0.05). TCM syndrome score,onset time and KPS score of the two groups decreased. The decrease of the treatment group was significantly greater than that of the control group(P<0.05). Patients in the treatment group also showed improvement in pain scores and retention compared with those before and after treat ment,which was with statistically sig nificant differences(P<0.05),but there was no statistically significant difference in the pain scores and dementia for the patients in control group before and after treatment(P> 0.05). The adverse reaction rate was12.5% in the treatment group and 7.5% in the control group. There was no statistically significant difference between the two groups(P> 0.05). Conclusions:Modified Jinhuang(plus) plaster acupoint application combined with traditional Chinese medicine spray has good clinical efficacy in the treatment of upper limb lymphedema after breast cancer surgery. It's easy for operation,of high safety and few adverse reactions,and it should be well promoted in the clinic.