Therapeutic Observation of Shipiyin Combined with Diosmin in Treatment of Lymphedema with Spleen Yang Deficiency Syndrome After Modified Radical Mastectomy

Yudie HU; Xiaoli WANG; Fangmin JIAO; Xuezhen CHEN; Ting XIE; Jinhui HU

doi:10.13422/j.cnki.syfjx.20220195

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Therapeutic Observation of Shipiyin Combined with Diosmin in Treatment of Lymphedema with Spleen Yang Deficiency Syndrome After Modified Radical Mastectomy

更新时间：2022-06-09

- Therapeutic Observation of Shipiyin Combined with Diosmin in Treatment of Lymphedema with Spleen Yang Deficiency Syndrome After Modified Radical Mastectomy
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 28, Issue 13, Pages: 137-144(2022)
- 作者机构：
  
  1.湖南中医药大学，长沙 410208
  2.湖南中医药大学第一附属医院，长沙 410007
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20220195
  CLC： R22;R242;R2-031;R73
- Received：10 June 2021，
  
  Published Online：09 November 2021，
  
  Published：05 July 2022
- 稿件说明：
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胡玉蝶,王晓丽,焦方敏等.实脾饮联合地奥司明治疗乳腺癌改良根治术后淋巴水肿脾阳虚衰证的疗效观察[J].中国实验方剂学杂志,2022,28(13):137-144.

HU Yudie,WANG Xiaoli,JIAO Fangmin,et al.Therapeutic Observation of Shipiyin Combined with Diosmin in Treatment of Lymphedema with Spleen Yang Deficiency Syndrome After Modified Radical Mastectomy[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(13):137-144.
胡玉蝶,王晓丽,焦方敏等.实脾饮联合地奥司明治疗乳腺癌改良根治术后淋巴水肿脾阳虚衰证的疗效观察[J].中国实验方剂学杂志,2022,28(13):137-144. DOI： 10.13422/j.cnki.syfjx.20220195.

HU Yudie,WANG Xiaoli,JIAO Fangmin,et al.Therapeutic Observation of Shipiyin Combined with Diosmin in Treatment of Lymphedema with Spleen Yang Deficiency Syndrome After Modified Radical Mastectomy[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(13):137-144. DOI： 10.13422/j.cnki.syfjx.20220195.

摘要

目的

探讨实脾饮联合地奥司明治疗乳腺癌改良根治术后淋巴水肿脾阳虚衰证的临床疗效及其对患侧肢体功能活动的影响。

方法

湖南中医药大学第一附属医院乳腺科、肿瘤科门诊和住院部收治的82例乳腺癌改良根治术后淋巴水肿脾阳虚衰证患者随机分成观察组与对照组，每组41例。对照组在常规治疗基础上予以地奥司明片（0.9 g/次，2次/d）治疗，观察组在对照组基础上加用实脾饮（1剂/d，分2次服），疗程为14 d。观察实脾饮对临床症状、水肿周径、中医证候评分、乳腺癌生命质量测定量表（FACT-B）评分、上肢功能障碍量表（DASH）评分、关节活动度、中医证候疗效及临床疗效的影响。

结果

治疗14 d后，中医证候疗效观察组总有效率为85.37%（35/41），对照组为63.41%（26/41），观察组明显高于对照组，差异有统计学意义（

=-2.212，

0.05）；临床疗效观察组总有效率为82.93%（34/41），对照组为75.61%（31/41），观察组明显高于对照组，差异有统计学意义（

=-2.061，

0.05）。与本组治疗前比较，两组患者上肢肿胀、疼痛、沉重、闷胀、疲劳、饱满、束缚感、皮肤角化、瘙痒的临床症状评分均显著降低（

0.01）。与对照组治疗后比较，观察组患者上肢肿胀、饱满评分显著降低（

0.01），疼痛、沉重、闷胀、疲劳、束缚感、皮肤角化、瘙痒评分明显降低（

0.05）。与本组治疗前比较，两组患者患肢淋巴水肿周径显著降低，中医证候评分显著降低，FACT-B评分显著升高，DASH评分显著降低，上肢关节活动度显著升高（

0.01）；与对照组治疗后比较，观察组降低肘横纹上10 cm周径明显降低，中医证候评分明显降低，FACT-B评分明显升高（

0.05），DASH评分显著降低，上肢关节活动度显著提高（

0.01）。

结论

实脾饮联合地奥司明治疗乳腺癌改良根治术后淋巴水肿脾阳虚衰证的临床疗效优于单用地奥司明，能更好地改善患者临床症状、体征、生活质量及肢体功能活动，为中西医结合治疗乳腺癌术后淋巴水肿提供了新的临床方案。

Abstract

Objective

To investigate the clinical effect of Shipiyin combined with diosmin in the treatment of lymphedema with spleen Yang deficiency syndrome（SYDS）after modified radical mastectomy and the specific effect on the function of the affected limb.

Method

Eighty-two patients with lymphedema with SYDS after modified radical mastectomy from outpatient and inpatient department of breast department and oncology department of the First Affiliated Hospital of Hunan University of Chinese Medicine were randomly divided into an observation group（41 cases） and a control group（41 cases）. The control group was given diosmin tablets（0.9 g per time， two times per day）on the basis of conventional treatment，and the observation group was given Shipiyin（one dose per day）on the basis of the control group. The course of treatment was 14 days. The clinical symptoms were observed and the limb circumference，traditional Chinese medicine（TCM） syndrome score，functional assessment of cancer therapy-breast cancer（FACT-B） score，disability of arm， shoulder and hand questionnaire（DASH） score，and joint range of motion were measured to analyze the TCM syndrome therapeutic effect and clinical efficacy.

Result

After 14 days of treatment， the total effective rate of the observation group was 85.37% （35/41） and that of the control group was 63.41% （26/41） in the TCM symptoms， showing a statistically significant difference

（Z

=-2.212，

0.05）. In terms of the clinical efficacy， the total effective rate in the observation group was 82.93% （34/41） and that in the control group was 75.61% （31/41）， indicating a statistically significant difference （

=-2.061，

0.05）. Compared with the situations before treatment， the scores of clinical symptoms such as the swelling of the upper limb， pain， sense of heaviness， stuffiness， fatigue， fullness， tightness， and skin keratosis and pruritus in the two groups were significantly lowered （

0.01） after treatment. Compared with the control group， the observation group could better improve the swelling and fullness（

0.01），as well as the feeling of pain，heaviness，stuffiness，fatigue，tightness，skin keratosis and pruritus （

0.05）of the upper limbs of patients. The affected limb circumference， TCM syndrome score， and DASH score decreased significantly， while the FACT-B score and upper limb joint range of motion increased significantly in the two groups after treatment （

0.01）. Compared with the control group， the observation group showed significantly reduced limb circumference at 10 cm proximal to the elbow striae， lowered TCM syndrome score， elevated FACT-B score（

0.05）， decreased DASH score and improved range of motion of the upper limb joint （

0.01） after treatment.

Conclusion

Shipiyin combined with diosmin has better clinical efficacy in the treatment of lymphedema with SYDS after modified radical mastectomy than diosmin alone，which can better improve the clinical symptoms，signs，quality of life and limb functional activity of patients. This provides a new clinical program for the treatment of lymphedema after breast cancer surgery with integrated Chinese and western medicine.

关键词

Keywords

references

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