王金燕 俞登峰

【摘要】 目的：探讨五皮饮治疗乳腺癌术后上肢淋巴水肿的临床效果。方法：选取2019年1月-2020年6月于本院接受治疗的乳腺癌术后上肢淋巴水肿患者80例的临床资料进行回顾性分析。依据治疗方法不同将其分为对照组（n=36）与试验组（n=44）。对照组使用手法淋巴引流+术后康复功能锻炼治疗。试验组在对照组基础上给予五皮饮内服、患肢外敷治疗。比较两组消肿度、治疗前后上臂周径差值及生活质量。结果：治疗后，两组上臂周径差值均低于治疗前，且试验组低于对照组（P<0.05）。试验组消肿度高于对照组（P<0.05）。治疗后，两组生活质量评分均高于治疗前，且试验组高于对照组（P<0.05）。结论：针对乳腺癌术后上肢淋巴水肿的患者，在常规手法淋巴引流以及康复锻炼的基础上采用五皮饮内服、患肢外敷的治疗方法，有助于加速水肿消退，提升生活质量，具有更深入分析的价值。

【关键词】 五皮饮 乳腺癌 淋巴水肿

[Abstract] Objective： To explore the clinical effect of Wupiyin in the treatment of upper limbs lymphedema after breast cancer surgery. Method： The clinical data of 80 patients with upper limbs lymphedema after breast cancer surgery treated in our hospital from January 2019 to June 2020 were retrospectively analyzed. They were divided into control group （n=36） and experimental group （n=44） according to different treatment methods. The control group was treated with manual lymphatic drainage and postoperative rehabilitation function exercise. On the basis of the control group， the experimental group was treated with Wupiyin oral administration and external application of affected limb. The degree of swelling reduction， the difference of upper limbs circumference and the quality of life before and after treatment were compared between the two groups. Result： After treatment， the difference of upper limbs circumference of both groups were lower than those before treatment， and the experimental group was lower than that of the control group （P<0.05）. The degree of swelling reduction in the experimental group was higher than that in the control group （P<0.05）. After treatment， the quality of life scores of both groups were higher than those before treatment， and the experimental group was higher than that of the control group （P<0.05）. Conclusion： For patients with upper limb lymphedema after breast cancer surgery， on the basis of conventional manual lymphatic drainage and rehabilitation exercises， the use of Wupiyin oral administration and external application of the affected limb will help accelerate the resolution of edema， and enhance quality of life， which has the value of more in-depth analysis.

[Key words] Wupiyin Breast cancer LymphedemaFirst-authors address： Wuwei Tumor Hospital， Wuwei 733000， China

上肢淋巴水肿是乳腺癌腋窝淋巴结清扫术后常见的并发症，乳腺癌腋窝淋巴结清扫手术破坏淋巴网，引起淋巴液回流受阻，积聚在组织间隙内引起上肢肿胀[1-2]。淋巴水肿的形成使患肢活动度受限，产生不同程度的疼痛、肿胀、麻木等不适反应，加重患者恐惧、焦虑、抑郁等情绪反应，不但严重降低了患者的生活质量，也对术后生存期有明显影响[3-5]。乳腺癌术后生存者中继发上肢淋巴水肿的发生率高达10%～30%，上肢淋巴水肿一旦形成，临床上处理较为棘手[6-7]。目前实际工作中所采用的处理方法较多，如手术治疗、药物治疗等，但效果无法满足需求[8]。对于新式治疗方法的探索也从未停止。采用中藥治疗肢体水肿对于我国人群而言接受程度较高，且操作便利，花费较低，本研究选择部分乳腺癌术后上肢淋巴水肿患者的资料进行回顾性分析，初步探讨五皮饮治疗乳腺癌术后上肢淋巴水肿的临床效果，现报道如下。……