| Objective: The aim of this study is to evaluate the clinical efficacy of the combination of functional exercise plus Diosmin tablets with the external application of Fangji Huangqi variation formula in the treatment of Breast cancer-related Lymphedema(BCRL)after breast cancer surgery.Methods: Sixty-four patients with BCRL who attended the outpatient clinic of the Department of Surgery,Quanzhou Hospital of Traditional Chinese Medicine between February 2022 and December 2022 were prospectively included.They were divided into treatment group and a control group by random number table,with 32 cases in each group.The control group was treated with conventional functional exercise plus oral diosmin tablets,while the treatment group was treated with external application of Fangji Huangqi variation on top of the control group.After 2 weeks of treatment,the circumference of the transverse wrist,transverse elbow,10 cm above transverse wrist(forearm)and 10 cm above the elbow(upper arm)was observed and recorded on days 1 and 15 of treatment and the effective index were calculated,and the clinical efficacy of the improvement in oedema was determined by the effective index.The Visual Analogue Score(VAS)and Disabilities of the arm,shoulder and hand(DASH)scores were recorded before and after treatment to assess and compare the degree of reduction in swelling and improvement in upper limb function between the two groups.Results:1.64 patients were included in this study;1 case was dislodged in the treatment group and 31 cases were completed,2 cases were excluded from the control group and 30 cases were completed.There was no significant difference between the control group and the treatment group in terms of age,body mass index(BMI),time of onset of oedema,stage of oedema,severity of oedema,and whether the affected limb was the dominant hand before treatment(P>0.05).2.Before treatment,compared to the control group,the affected side had a transverse wrist(21.51 ± 1.93 vs.21.35 ± 1.47),transverse elbow(29.17 ± 2.29 vs.29.23 ± 1.94),10 cm above the transverse wrist(forearm)(26.12 ± 2.49 vs.25.77 ± 1.78),and 10 cm above the transverse elbow(upper arm)arm circumference(34.35 ± 2.32 vs.34.84 ± 1.94),were not significantly different(P>0.05).3.After treatment,there was a significant increase in the difference in circumference of the upper 10 cm of the elbow in the treatment group compared to the control group(1.98(1.30,2.42)vs.0.93(0.15,1.90),P<0.05).There was a significant increase in the transverse wrist circumference difference(1.43 ± 0.58 vs.0.87 ± 0.51,P<0.05),elbow circumference difference(2.15 ± 0.84 vs.1.46 ± 0.98)and forearm circumference difference(1.84±0.84 vs.0.80±0.56)(P<0.05).4.Analysis of the effectiveness index rating criteria showed that the total effective was17(56.67%)in the control group and 24(77.42%)in the treatment group,and after treatment,the total effective rate was more significant in the treatment group compared to the control group(P<0.05).5.Visual analogue score analysis of VAS swelling sensation showed that the swelling sensation of upper limb was reduced in both groups after treatment(P<0.05),but the reduction of swelling sensation was more significant in the treatment group compared with the control group after treatment(2(1,2)vs.3(2,4),P<0.05).6.Analysis of the DASH upper limb function score showed that the upper limb function improved in both groups after treatment(P<0.05),but there was no significant difference in the degree of improvement between the two groups compared after treatment(21.5(20.00,23.55)vs.24.08(20.00,26.30),P>0.05).Conclusion:Combination of external application of Fangji Huangqi variation with functional exercise plus oral Diosmin tablets significantly improved lymphoedema of the upper limbs and reduced the feeling of swelling in the upper limbs after breast cancer surgery due to Qi deficiency and blood stasis. |
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