腹针联合上肢功能锻炼治疗乳腺癌术后上肢淋巴水肿的临床观察

摘要

目的 分析腹针联合上肢功能锻炼治疗乳腺癌术后上肢淋巴水肿的疗效.方法 选择浙江省中医药大学附属温州中医院外科2014年12月至2016年12月收治的60例临床诊断符合乳腺癌术后上肢淋巴水肿的患者,随机分为实验组和对照组,各组30例,实验组给予腹针联合上肢功能锻炼治疗,对照组给予单纯上肢功能锻炼治疗.治疗2周为1个疗程,2个疗程后评价疗效.结果 两组患者治疗前双侧上肢周径差值比较无显著性差异(t=0.359,P>0.05),治疗后两组患者双侧上肢周径差值均较治疗前显著降低(t值分别为2.219、4.003,均P<0.05),而治疗后实验组患者双侧上肢周径差值较对照组改变更为显著(t=4.149,P<0.05).水肿程度分级方面,两组治疗前无显著性差异(χ2=0.278,P>0.05),治疗后两组患者水肿程度分级均显著减轻(χ2值分别为5.043、16.258,均P<0.05),且实验组较对照组显著改善(χ2=6.652,P<0.05).实验组疗效评价显著优于对照组(χ2=7.231,P<0.05).两组患者治疗前VAS评分比较无显著性差异(t=0.442,P>0.05),治疗后两组患者VAS评分均较治疗前显著降低(t值分别为2.367、3.974,均P<0.05),而治疗后实验组患者VAS评分较对照组降低更为显著(t=4.375,P<0.05).疼痛程度分级方面,两组治疗前无显著性差异(χ2=0.069,P>0.05),治疗后两组患者疼痛程度分级均显著减轻(χ2值分别为11.501、9.587,均P<0.05),且实验组疗效更为显著(χ2=6.007,P<0.05).结论 腹针联合上肢功能锻炼对于消除水肿、改善患肢疼痛疗效更佳,值得推广.%Objective To observe the curative effect of abdominal acupuncture combined with upper limb functional exercise on breast cancer-related upper limb lymphedema.Methods Totally 60 cases with breast cancer-related upper limb lymphedema during December 2014 and December 2016 in the Affiliated Wenzhou TCM Hospital of Zhejiang TCM University were selected and were randomly divided into experimental group and control group with 30 cases in each group.The patients in the experimental group were treated by abdominal acupuncture combined with upper limb functional exercise, while those in the control group were treated by upper limb functional exercise therapy alone.Each course of treatment lasted two weeks.The curative effect was evaluated after two courses.Results Before treatment, there was no significant difference in the diameter of bilateral upper limbs between two groups (t=0.359, P>0.05).After treatment, the difference in diameter of bilateral upper limbs was significant compared to that before treatment in both groups (t value was 2.219 and 4.003, both P<0.05).Compared to the control group, the difference in the diameter of bilateral upper in the experimental group was more significant after treatment (t=4.149, P<0.05).There was no significant difference in grading of edema degree before treatment between two groups (χ2=0.278,P>0.05).After treatment, the grading of edema degree was significantly lower in two groups (χ2 value was 5.043 and 16.258, respectively, both P<0.05).Compared to the control group, the grading of edema degree in the experimental group was significantly improved (χ2=6.652, P<0.05).Moreover, the curative effect evaluation in the experimental group was significantly better than that in the control group (χ2=7.231, P<0.05).There was no significant difference in VAS scores before treatment (t=0.442, P>0.05), but after treatment, the VAS scores were significantly lower in two groups (t value was 2.367 and 3.974, respectively, both P<0.05).After treatment, the decline of VAS scores in the experimental group was more significant compared to the control group (t=4.375,P<0.05).There was no significant difference in grading of pain degree before treatment (χ2=0.069, P>0.05).After treatment, the grading of pain degree was significantly improved in two groups (χ2 value was 11.501 and 9.587, respectively, both P<0.05).The improvement of grading of pain degree in the experimental group was more significant (χ2=6.007, P<0.05).Conclusion Abdominal acupuncture combined with upper limb functional exercise is of better curative effect in eliminating edema and improving pain in phantom, which is worthy of promotion.