Clinical Study Of Acupuncture Combined With Rehabilitation Medical Gymnastics In The Treatment Of Shoulder Joint Dysfunction After Breast Cancer Surgery

Purposes:As one of common malignant tumors of women with breast cancer,its incidence rate is increasing year by year.It has even ranked the leading cause of female malignant tumors in some developed cities around the world.The treatment of breast cancer is still based on surgery which is a traumatic treatment.It can easily lead to chest wall malformation,skin flap necrosis,lymphatic leakage,subcutaneous fluid accumulation,upper limb edema,and eventually lead to shoulder joint movement disorder.It seriously affects the quality of life of the patient.At this stage,clinical research at home and abroad has found that TCM acupuncture combined with Western medical rehabilitation medical gymnastics has its unique curative effect in improving postoperative shoulder dysfunction in breast cancer,and has been recognized by more and more clinicians.In this study,we compared the visual analog score(VAS),shoulder mobility(ROM)(including flexion,extension and outreach activities)and Barthel index of daily living activity in patients with postoperative breast cancer before and after treatment with acupuncture combined with rehabilitation medical gymnastics and individual rehabilitation medical gymnastics.Explore its efficacy to provide a scientific basis for clinically optimal treatment options.Method:This study included 40 patients with postoperative shoulder dysfunction who met the criteria for breast cancer,and were randomly divided into treatment group(n=20)and control group(n=20).The treatment group used the acupuncture method combined with rehabilitation medical gymnastics treatment.In the test,look for 3 to 4 tender points around the shoulder joint,and treat it twice a week for 12 weeks.The control group only used rehabilitation medical gymnastics training.Before and after treatment,the visual analog score,shoulder joint activity(ROM),and daily living activity(ADL)scale Barthel index score were tested and analyzed statistically.Result:1.It was found that there was no statistical significance(P>0.05)in age,height and weight between the two groups,which was comparable.2.Visual analog scores,shoulder mobility(ROM)(including flexion,extension and abduction),and activity of daily living(ADL)scale Barthel index were measured at baseline.Their differences were not statistically significant(P>0.05)and were comparable.3.Changes in VAS score:1)The VAS scores of the two groups after the treatment of the acupuncture combined with rehabilitation medical gymnastics and the rehabilitation medical gymnastics were significantly lower than before treatment.And the difference between the two groups was statistically significant(P<0.01);2)The difference between the treatment group and the control group was statistically significant(P<0.05).4.Changes in shoulder mobility(ROM):1)The flexion,extension and abduction activity of the shoulder joint after treatment in the combined treatment group and the simple rehabilitation medical gymnastics treatment group were improved compared with before treatment.And the difference between the two groups was statistically significant(P<0.01);2)The improvement of shoulder mobility was compared between the two groups,and the results were significantly different(P<0.05).5.Change in the Barthel Index of the Activity of Daily Living(ADL)Scale:1)The Barthel index of patients after treatment with acupuncture combined with rehabilitation medical gymnastics or simple rehabilitation medical gymnastics increased significantly.And the difference between the two groups was statistically significant(P<0.01);2)The degree of increase in the index of the combined treatment group and the simple rehabilitation medical gymnastics treatment group,and the results were significantly different(P<0.05).Conclusion:1.Rehabilitation medical gymnastics can alleviate the pain level of shoulder joint dysfunction in postoperative patients with breast cancer.If combined with the acupuncture,the effect is better.2.Acupuncture combined with rehabilitation medical gymnastics or simple rehabilitation medical gymnastics treatment can significantly increase the range of shoulder joint activities of patients with breast cancer after surgery,including flexion,extension and abduction activities.The effect is more obvious when the two are combined.3.In the improvement of postoperative daily life ability of breast cancer patients,the combination of acupuncture and rehabilitation medical gymnastics can more effectively improve the living ability of postoperative patients with breast cancer.