Clinical Study On The Treatment Of Breast Cancer-related Lymphedema With Massage Along The Meridian Combined With Moxibustion

Objective:The purpose of this study was to preliminarily evaluate the clinical efficacy of moxibustion combined with manipulation lymphatic drainage based on traditional Chinese medicine in the treatment of breast cancer-related lymph-edema.Method:40 eligible patients with unilateral upper limb breast cancer-related lymphedema were enrolled in A randomized crossover study and randomly divided into the combined protocol group A and the circulatory drive group B,with 20 patients in each group.The treatment course was 10 weeks in total,divided into two stages,P1 and P2,with 4 weeks for each stage and 2 weeks for the washout period.Patients were treated twice a week for a total of 16 times.The treatment was moxibustion combined with manipulation lymphatic drainage based on traditional Chinese medicine in group A at 4 weeks after P1,followed by air pressure treatment at 4 weeks after P2 after 2 weeks of elution.The treatment order of group B was opposite to that of the combined group A.The patients were followed up after treatment at week 0,2,4,6,8 and 10.The evaluation indexes were the changes of volume value,girth value and swelling sensation score of the affected limb before and after treatment.Results:A total of 40 patients were included in this study,including 20 in group A and 20 in group B,with 5 patients shedding(3 in group A and 2 in group B).There were no statistically significant differences between the two groups in age,height,weight,BMI,history of edema,history of surgery,history of tumor,arm circumference,volume value,swelling value and other baseline indicators(p>0.05).Among them,there was no statistical difference in the "residual effect" and "sequential effect" of the evaluation indexes of arm circumference,volume and swelling sensation of the affected limb(p>0.05).1.The results of volume:(1)Phased test:After the treatment of P1 and P2,there was no statistical difference between groups A and B(p>0.05).After the treatment,the volume of groups A and B was smaller than that before the treatment,showing A statistical difference(p<0.05).(2)The matching test:There was no statistically significant difference between the two treatment regimentation at week 0 and week 2(p>0.05),and the volume reduction effect of TCM comprehensive therapy at week 4 was more significant than that of air pressure therapy(p<0.05).The volume at week 4 was smaller than that at week 0,and the difference was statistically significant(p<0.01).2.The results of arm circumference:(1)Phased test:?The arm circumference of wrist transverse stripes:There was no statistically significant difference between groups A and B in the two stages P1 and P2(p>0.05).?10cm arm circumference above the wrist:In P1 and P2 stages,there was no inter-group difference between groups A and B(p>0.05).In group P1,there was no statistical difference between groups A and B(p>0.05).In comparison with group P2,arm circumference of group A was smaller than that before treatment,with statistical difference(p<0.05),while arm circumference of group B was reduced,but there was no statistical difference(p>0.05).?The arm circumference of elbow transverse stripes:In P1 and P2 stages,there was no difference between groups A and B(p>0.05).In P1,there was no statistical difference between groups A and B(p>0.05).At the stage of P2,the intra-group comparison showed that the arm circumference of group A was smaller than that before treatment,with A statistical difference(p<0.05),and that of group B was on A downward trend,but there was no statistical difference(p>0.05).?10cm arm circumference above the elbow:In P1 and P2 stages,groups A and groups B did not show the difference(p>0.05).P1 within the group comparison,A,B two groups of arm circumference have narrowed,and were statistically significant(p<0.05).P2 within the group,group A of arm circumference is on the decline,but no statistical difference(p>0.05),group B arm circumference is reduced,statistically significant(p<0.05).(2)The sample matching test:There was no statistically significant difference in arm circumference between the two groups at each point at week 0 and week 2(p>0.05),while the reduction in arm circumference was more significant in the TCM comprehensive therapy group at the measurement point of 10cm on the transverse line of the elbow than in the air pressure therapy group at week 4(p<0.05).Compared with week 0 in the group,arm circumference was reduced in both measurement points of 10cm on the elbow transverse grain and 10cm on the elbow transverse grain by TCM comprehensive therapy in week 4(p<0.05),while there was a statistical difference in arm circumference reduction at 10cm on the elbow transverse grain in air pressure therapy(p<0.05).3.The results of VAS:(1)Phased test:In group comparison of P1,VAS scores of both groups A and B showed a decrease(p<0.05).In comparison between groups,group A was superior to group B,with statistical difference(p<0.05).In group comparison of P2,VAS scores of both groups A and B showed a decrease,with A statistical difference(p<0.05).Group B was superior to group A,with statistical difference(p<0.05).(2)The sample matching test:Results show that the two methods of treatment in comparison between 0,2 weeks group were no statistical differences(p>0.05),4 weeks VAS score of TCM comprehensive therapy significantly lower than the air pressure therapy,there are significant differences(p<0.01).Compare two kinds of therapy group,VAS score 4 weeks a week 0 dropped obviously,obvious statistical significance(p<0.01).Conclusions:Manipulation lymphatic drainage based on traditional Chinese medicine combined with moxibustion can effectively reduce BCRL patients' limb volume and reduce the arm circumference to a certain extent,especially for the upper arm(above the elbow transverse line).Manipulation lymphatic drainage based on traditional Chinese medicine combined with moxibustion can significantly improve the sensation of limb swelling in BCRL patients.