温阳利水法治疗阳虚型乳腺癌术后上肢淋巴水肿的临床观察

发布时间：2018-05-15 10:50

本文选题：乳腺癌 + 术后上肢淋巴水肿　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:通过临床观察评价温阳利水法治疗乳腺癌术后上肢淋巴水肿的临床疗效及安全性。方法:将符合纳入标准的60例属阳虚型乳腺癌术后上肢淋巴水肿患者,随机分为实验组与对照组,每组30例,试验组口服实脾散,每日1剂,水煎2次取汁分早晚口服,配合肢体气压治疗,对照组单纯予以肢体气压治疗,每日2次,每次30分钟。两组患者在治疗期间,均进行常规的日常护理及上肢功能锻炼。于服药十天后统计结果并观察疗效。结果:1、上臂周径:(1)治疗有效率:经卡方检验,试验组的有效率分别为腕部73.3%,腕上10cm 66.7%,肘部83.3%,肘上10cm 80%,对照组的有效率分别为腕部56.7%,腕上10cm50%,肘部50%,肘上10cm 50%,两组患者各部位组间对比均有统计学差异(P0.05);(2)上臂周径测量值:经t检验,试验组结果表明腕部、腕上10cm、肘部、肘上10cm的治疗前后对比有统计学差异(P0.05);对照组除了腕上10cm前后无统计学差异(P=0.137),其余各部位均有意义(P0.05);两组对比治疗前后的上臂周径差值具有统计学意义(P0.05);综合以上结果提示试验组的改善效果优于对照组。2、上肢功能测评表:(1)治疗有效率:经卡方检验,试验组治疗前后的有效率为84%,对照组有效率为47%,两组对比有统计学差异(P0.05);(2)DASH评分:经t检验,两组患者治疗前后积分组间对比均无统计学差异(P0.05),对比两组治疗前后的DASH评分差值,说明试验组的评分改善结果优于对照组。3、毒副反应:两组患者治疗前后的血象、肝肾功能、电解质、心电图等方面无明显变化。结论:通过运用实脾散以温阳益气、健脾利水之法,结合西医基础治疗,能有效改善阳虚型乳腺癌术后上肢淋巴水肿患者临床症状,无明显毒副反应,值得临床推广。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of warming yang and water therapy in the treatment of upper limb lymphedema after breast cancer operation. Methods: sixty patients with upper limb lymphedema were randomly divided into experimental group and control group, 30 cases in each group. Combined with limb barometric therapy, the control group was treated with limb barometric therapy twice a day for 30 minutes. The patients in both groups were treated with routine daily nursing and upper limb exercise. After taking the medicine for ten days, the results were counted and the curative effect was observed. Results: 1, circumference of upper arm: 1) effective rate of treatment: chi-square test, The effective rates of the test group were 73.3% of wrist, 66.7% of 10cm on wrist, 83.3% of elbow and 80% of 10cm on elbow. The effective rates of control group were 56.7%, 10 cm on wrist, 50 cm on elbow, and 50 cm on elbow, respectively. Measured value: through t test, The results of the test group showed that the wrist, upper wrist 10 cm, elbow, There was significant difference in 10cm on elbow before and after treatment (P 0.05); in the control group, there was no significant difference before and after treatment with 10cm on wrist (P < 0. 137), but there was no significant difference in other parts (P 0. 05); the difference in the circumference diameter of upper arm between the two groups before and after treatment was statistically significant (P 0. 05); in the control group, there was no significant difference before and after treatment (P 0. 05). The above results suggest that the improvement effect of the experimental group is better than that of the control group (0.2, upper limb function evaluation table: 1) the effective rate of treatment is: chi-square test, The effective rate before and after treatment in the trial group was 84 and the effective rate in the control group was 47. There was a statistical difference between the two groups in the scores of P0.05 and 2DASH: after t test, there was no statistical difference between the two groups before and after treatment, and the difference of DASH score between the two groups before and after treatment was compared. The results showed that the score improvement of the test group was better than that of the control group. The toxic and side effects: there were no significant changes in blood picture, liver and kidney function, electrolyte and electrocardiogram before and after treatment in the two groups. Conclusion: the clinical symptoms of upper limb lymphedema of breast cancer patients with yang deficiency type can be effectively improved by using the method of warming yang and benefiting qi and invigorating spleen and promoting water and combining with the basic treatment of western medicine. There is no obvious toxicity and side effect, so it is worth popularizing in clinic.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

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