何晓旭 韩金凤

【摘要】乳腺癌术后上肢水肿为乳癌并发症，中医多归属于“水肿”范畴，如患者上肢存在索状硬物或疼痛则归属于“脉痹”。此并发症严重影响了患者的生活质量，西医目前尚无很好的治疗方法，而中医药治疗本病具有一定优势。文章通过对本病的病因病机、治疗思路以及临床验案进行整理和分析，总结韩金凤教授通过运气辨证结合常规辨证思维使用薯蓣丸治疗乳腺癌术后上肢水肿的临证经验，为治疗本病提供新的诊疗思路，供广大医者参考。

【关键词】五运六气；薯蓣丸；乳腺癌术后；上肢水肿；临证经验

【中图分类号】R249.2/.7【文献标志码】 A【文章编号】1007-8517（2023）10-0096-04

Professor Hanjinfengs Clinical Experience in Treating Upper Limb Edema after Breast Cancer SurgeryHE Xiaoxu1 HAN Jinfeng2△

1.Tianjin University of Traditional Chinese Medicine， Tianjin 301617， China;2.Wuqing Hospital of traditional

Chinese Medicine Affiliated to Tianjin University of Traditional Chinese Medicine， Tianjin 301700， ChinaAbstract：Upper limb edema after breast cancer is a complication of breast cancer， Chinese medicine is mostly ascribed to the category of “edema”， such as patients with upper limb cord like hard objects or pain ascribed to “bi pulse”.This complication seriously affects the quality of life of patients， and Chinese medicine has great advantages in treatment.Through sorting out and analyzing the etiology， pathogenesis， treatment ideas and clinical experience of this disease， this paper summarizes Professor Hanjinfengs clinical experience of using dioscorea pills to treat upper limb edema after breast cancer surgery through by sorting and analyzing the etiology，pathogenesis，treatment and clinical cases of the disease，which provides a new diagnosis and treatment idea for the clinical treatment of this disease for the reference of doctors.

Keywords：Five Circuit Phases and Six Atmospheric Influences Theory;Yam Pills; Breast Cancer Surgery; Upper Limb Edema; Clinical Experience

乳腺癌已成为主要威胁我国女性健康的恶性肿瘤，患病率逐年攀升，并趋向年轻化。乳腺癌多采用手术、放疗、化疗以及内分泌、免疫治疗等，手术治疗为主要治疗措施，但术后并发症发生率较高［1］。西医认为出现此并发症的主要原因为乳腺根治术腋窝淋巴结清扫损伤了上肢的淋巴管网结构，淋巴结受损，使得淋巴液回流受阻［2］，引起胳膊肿胀、疼痛、僵硬甚或功能障碍、活动受限，严重者可并发上肢或肩部蜂窝组织炎、丹毒及感染等，甚至导致残疾。淋巴液回流障碍可使患者的免疫力更加低下、局部炎癥或是纤维化，可进一步加重上肢肿胀，给患者的心理和身体都造成了创伤，严重影响生活质量，也不利于患者术后的康复。西医治疗此并发症采取局部治疗，包括保守治疗，如抬高患肢、避免负重、手法引流、弹力套、加压包扎等。……