本文選題：乳腺癌 + 術(shù)后上肢淋巴水腫��； 參考：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:通過(guò)臨床觀察評(píng)價(jià)溫陽(yáng)利水法治療乳腺癌術(shù)后上肢淋巴水腫的臨床療效及安全性。方法:將符合納入標(biāo)準(zhǔn)的60例屬陽(yáng)虛型乳腺癌術(shù)后上肢淋巴水腫患者,隨機(jī)分為實(shí)驗(yàn)組與對(duì)照組,每組30例,試驗(yàn)組口服實(shí)脾散,每日1劑,水煎2次取汁分早晚口服,配合肢體氣壓治療,對(duì)照組單純予以肢體氣壓治療,每日2次,每次30分鐘。兩組患者在治療期間,均進(jìn)行常規(guī)的日常護(hù)理及上肢功能鍛煉。于服藥十天后統(tǒng)計(jì)結(jié)果并觀察療效。結(jié)果:1、上臂周徑:(1)治療有效率:經(jīng)卡方檢驗(yàn),試驗(yàn)組的有效率分別為腕部73.3%,腕上10cm 66.7%,肘部83.3%,肘上10cm 80%,對(duì)照組的有效率分別為腕部56.7%,腕上10cm50%,肘部50%,肘上10cm 50%,兩組患者各部位組間對(duì)比均有統(tǒng)計(jì)學(xué)差異(P0.05);(2)上臂周徑測(cè)量值:經(jīng)t檢驗(yàn),試驗(yàn)組結(jié)果表明腕部、腕上10cm、肘部、肘上10cm的治療前后對(duì)比有統(tǒng)計(jì)學(xué)差異(P0.05);對(duì)照組除了腕上10cm前后無(wú)統(tǒng)計(jì)學(xué)差異(P=0.137),其余各部位均有意義(P0.05);兩組對(duì)比治療前后的上臂周徑差值具有統(tǒng)計(jì)學(xué)意義(P0.05);綜合以上結(jié)果提示試驗(yàn)組的改善效果優(yōu)于對(duì)照組。2、上肢功能測(cè)評(píng)表:(1)治療有效率:經(jīng)卡方檢驗(yàn),試驗(yàn)組治療前后的有效率為84%,對(duì)照組有效率為47%,兩組對(duì)比有統(tǒng)計(jì)學(xué)差異(P0.05);(2)DASH評(píng)分:經(jīng)t檢驗(yàn),兩組患者治療前后積分組間對(duì)比均無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),對(duì)比兩組治療前后的DASH評(píng)分差值,說(shuō)明試驗(yàn)組的評(píng)分改善結(jié)果優(yōu)于對(duì)照組。3、毒副反應(yīng):兩組患者治療前后的血象、肝腎功能、電解質(zhì)、心電圖等方面無(wú)明顯變化。結(jié)論:通過(guò)運(yùn)用實(shí)脾散以溫陽(yáng)益氣、健脾利水之法,結(jié)合西醫(yī)基礎(chǔ)治療,能有效改善陽(yáng)虛型乳腺癌術(shù)后上肢淋巴水腫患者臨床癥狀,無(wú)明顯毒副反應(yīng),值得臨床推廣。
[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.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.9

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