| Objective: Breast cancer-associated lymphedema is currently the most common complication after breast cancer surgery,and it is also a difficult complication that seriously affects the quality of life of patients.This subject is to apply the self-made Tongluo Xiaozhong Recipe combined with air waves to treat upper extremity lymphedema after breast cancer surgery,observe its clinical therapeutic effect,and explore the therapeutic advantages of Chinese medicine combined with traditional Chinese medicine and western medicine to provide theoretical support for clinical practice.Methods: The study selected patients with breast cancer-related upper extremity lymphedema in our clinic and hospitalized from January 2018 to December 2019,and randomly divided them into a control group and an observation group of Tongluo swelling combined with air wave treatment.There were 40 patients in each group.Mainly perform arm circumference measurement and TCM symptom score evaluation,laboratory indicators CRP、IL-6、Ig A、Ig G、 Ig M、CD3+ T cells,CD4+ T cells and CD4+/CD8+ T cells、 NK cells and the expression of VEGF、MMP-2、MMP-9 levels,and evaluate safety indicators and efficacy.Results:(1)There were no statistically significant differences between the two groups in gender、age、course of disease and risk factors including surgical methods、postoperative radiotherapy and postoperative lymph node staging(P>0.05);(2)compared with before treatment,the difference between the upper limb circumference of the affected side of the two groups was significantly reduced,and the upper limb circumference of the observation group of Tongluoxiaozhong decoction combined with intermittent pneumatic compression pump theapy(IPC)was significantly smaller than the control group(P<0.05);Compared with the same group before treatment,the total symptom score of the two group after treatment was significantly lower(P<0.05);and compared with the control group after treatment,the total symptom score of the observation group after treatment was significantly lower(P < 0.05);compared with the same group before treatment,there was no obvious improvement in tiredness,fatigue,lack of food,stickiness in the mouth,poor stool,dry stool symptoms in the control group(P>0.05),while all symptoms of the observation group were significantly improved compared with the previous ones(P<0.05);Tiredness,fatigue,lack of food,stickiness in the mouth,poor stool,dry stool symptoms were significantly improved compared with the control group after treatment(P<0.05).(3)Compared with the same group before and after treatment,the levels of inflammation indicators CRP and IL-6 in the observation group were significantly lower than before treatment(P<0.05),and after treatment comparison,the levels of CRP and IL-6 in the observation group were also significantly lower than the control group(P<0.05);compared with the same group before and after treatment,the levels of Ig A、Ig G and Ig M in the control group were significantly lower than before treatment(P<0.05),and the levels of Ig A、Ig G and Ig M in the observation group after treatment was significantly higher than control group after treatment(P<0.05);compared with the same group before and after treatment,the ratio of CD3+、CD4+、CD4+/CD8+ T cells and NK cells in the control group were significantly lower than before treatment(P < 0.05);while after treatment,the ratios of CD3+、CD4+、CD4+/CD8+ T cells and NK cells in the observation group were significantly higher than those in the control group(P < 0.05).The levels of VEGF 、 MMP-2 and MMP-9 in the two groups before treatment were significantly lower than those before treatment(P<0.05);after treatment,the levels of VEGF、MMP-2 and MMP-9 in the observation group were significantly lower than those in the control group(P<0.05).(4)Safety monitoring of blood routine、 liver function、electrolyte、stool routine + occult blood、electrocardiogram and other indicators for the results showed no significant difference between the two groups.(5)Control group cured 2 cases(5.0%)、markedly effective of 8 cases(20.0%)、 effective of 18 cases(45.0%)、ineffective of 12 cases(30.0%),the total effective rate was 70.0%;observation group cured 10 cases(25.0 %)、Markedly effective of 18 cases(45.0%)、effective of 10 cases(25.0%)、ineffective of 2 cases(5.0%),the total effective rate was 95.0%,and the total effective rate of the observation group was significantly higher than the control group with statistics Difference(P<0.05).Conclusion: The self-made Tongluoxiaozhong decoction combined with intermittent pneumatic compression pump theapy(ICP)can significantly reduce the upper limb edema of the affected side,can effectively improve the clinical symptoms of the patient,and has high safety.The mechanism may be that it can reduce the inflammation response,adjust the patient’s humoral and cellular immune functions,and further reduce its ability of tumor invasion and metastasis to play a role in improving the quality of life of patients is a simple,safe,economical and effective treatment method of BCRL,suitable for clinical application and promotion. |
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