温和灸治疗乳腺癌相关性淋巴水肿的临床疗效观察

发布时间：2018-04-11 07:09

本文选题：乳腺癌相关性淋巴水肿 + 温和灸　；参考：《北京中医药大学》2017年硕士论文

【摘要】：研究目的:本研究旨在观察温和灸疗法对乳腺癌相关性淋巴水肿的治疗效果,为温和灸治疗乳腺癌相关性淋巴水肿患者提供有效的临床证据。研究方法:将纳入研究的48例乳腺癌相关性淋巴水肿患者随机分为试验组和对照组。试验组24例患者采用温和灸治疗,对照组24例患者采用气压循环驱动治疗,以4周为一个疗程,每周进行2次治疗。每周测量并记录患肢臂围,患肢自觉肿胀程度和患肢肌力,并在疗程开始和结束时分别记录患者生活质量评分及疲乏评分。将结果进行统计分析,观察两组治疗前后的臂围平均值及差值、肿胀感、肌力分级,生活质量评分及疲乏评分。所有研究数据采用SPSS 20.0统计软件进行统计分析,若P0.05则认为差异有统计学意义。研究结果:通过4周的临床观察,两组患者患肢臂围均较治疗前缩小,组间及组内前后比较P0.05,差异具有统计学意义。试验组与对照组臂围分别减小1.13cm和0.61cm,试验组疗效优于对照组;组间效应方差分析,从第一次访视开始P0.05,具有统汁学差异,治疗一周后试验组的疗效开始优于对照组;治疗后两组患者在肘横纹及肘横纹上1Ocm处组间比较具有统计学差异,试验组在此两点处臂围改善较对照组明显;自觉肿胀感评分组内前后比较P0.05,两组患者治疗后肿胀感均较治疗前减轻,组间比较P0.05,试验组优于对照组;患者生活质量总评分组间比较P0.05,差异具有统计学意义,试验组优于对照组,生活质量的条目改善具体表现在"疲乏"、"对治疗的态度"、"治疗的副作用"三个方面;患者疲乏感评分方面,治疗后两组之间在总体评分及各维度评分上无显著统计学差异;组内前后比较,在"行为"、"情绪"、"感觉","认知"四个维度评分及疲乏总评分上P0.05,统计学差异显著,试验组效果明显。安全性评价上,一例患者因温和灸治疗导致患肢上臂出现潮红、瘙痒皮肤过敏反应。研究结论:分析研究结果表明,两种疗法均能有效的改善上肢淋巴水肿。温和灸治疗相比气压循环驱动治疗在缩减患肢臂围上更明显;温和灸能使上肢淋巴水肿的治疗更快起效,并对上肢淋巴水肿引起的肢体肿胀感缓解更明显;温和灸可以提高患者的生活质量,从多维度减轻患者疲乏感同时具有相对较高的安全性。温和灸疗效确切,操作相对简便、成本低廉,患者接受程度高,是一种值得在临床上推广的治疗乳腺癌相关性淋巴水肿的方案。
[Abstract]:Objective: to observe the therapeutic effect of mild moxibustion on breast cancer associated lymphedema and to provide effective clinical evidence for mild moxibustion in the treatment of breast cancer associated lymphedema.Methods: 48 patients with breast cancer associated lymphedema were randomly divided into trial group and control group.The experimental group (n = 24) was treated with mild moxibustion, while the control group (n = 24) was treated with pneumatic circulatory drive therapy for 4 weeks as a course of treatment, twice a week.The circumference of the affected arm, the degree of swelling and muscle strength of the affected limb were measured and recorded weekly. The quality of life score and fatigue score were recorded at the beginning and the end of the course of treatment.The average value and difference of arm circumference, swelling feeling, muscle strength grading, quality of life score and fatigue score were observed before and after treatment.All the data were analyzed by SPSS 20.0 statistical software. If P0.05, the difference was statistically significant.Results: after 4 weeks of clinical observation, the arm circumference of the two groups was smaller than that before treatment, and the difference between the two groups was statistically significant (P 0.05).The arm circumference of experimental group and control group decreased 1.13cm and 0.61cm respectively, the curative effect of test group was better than that of control group, the variance analysis of effect between groups, P0.05 from the first visit, had the difference of juicing, and the curative effect of test group was better than that of control group after one week of treatment.After treatment, there were significant differences between the two groups in the 1Ocm of the cubital stria and on the cubital stria, and the improvement of the arm circumference at these two points in the trial group was more obvious than that in the control group.The scores of subjective swelling were significantly lower in both groups than before and after treatment (P 0.05), and were better in the test group than in the control group, and the difference was statistically significant in the total score of patients' quality of life (P0.05), the difference between the two groups was statistically significant (P 0.05), and that between the two groups was significantly higher than that in the control group (P 0.05).The improvement of quality of life items in the trial group was better than that in the control group in three aspects: "fatigue", "attitude towards treatment", "side effects of treatment", and scores of patients' fatigue.After treatment, there was no significant difference between the two groups in the total score and the score of each dimension, the difference was significant in the scores of "behavior", "emotion", "feeling", "cognition" and the total score of fatigue between the two groups before and after treatment (P 0.05).The effect of test group was obvious.In safety evaluation, one patient suffered from redness and pruritus skin allergic reaction due to mild moxibustion treatment.Conclusion: the results show that both treatments can effectively improve upper limb lymphedema.Mild moxibustion treatment was more obvious than pneumatic circulatory drive therapy in reducing the circumference of the affected limb, mild moxibustion could make the treatment of upper limb lymphedema more effective, and relieve the swelling of upper limb caused by lymphedema more obviously.Mild moxibustion can improve the quality of life of patients.Mild moxibustion has the advantages of accurate curative effect, relatively simple operation, low cost and high acceptance of patients. It is worth popularizing in clinical treatment of breast cancer associated lymphedema.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.5

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