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Article in Chinese | WPRIM | ID: wpr-940669


ObjectiveTo 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. MethodEighty-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. ResultAfter 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, P<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 (Z=-2.061, P<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 (P<0.01) after treatment. Compared with the control group, the observation group could better improve the swelling and fullness(P<0.01),as well as the feeling of pain,heaviness,stuffiness,fatigue,tightness,skin keratosis and pruritus (P<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 (P<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(P<0.05), decreased DASH score and improved range of motion of the upper limb joint (P<0.01) after treatment. ConclusionShipiyin 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.

Article in Chinese | WPRIM | ID: wpr-873197


Objective:To observe clinical effect of Tiaopi Huxin decoction to chronic heart failure (CHF) and to study mechanism of action of anti-inflammatory and anti ventricular remodeling.Method:One hundred and forty patients were randomly divided into control group (70 cases) and observation group (70 cases) by random number table. And during the study, there were four patients for falling off and missing visit, two eliminated patients in control group, and 64 patients finished the study, and there were six patients for falling off and missing visit in observation group, so 64 patients finished the study. Two groups of patients got losartan potassium tablets, 50 mg/time, 1 time/day, metoprolol tablets, 200 mg/time, 1 time/day, spironolactone tablets, 20-40 mg/time, 1 time/day, control group Jingshe Yiqi granule 1 bag/time,3 times/day,flushed with boiling water, patients in observation group added Tiaopi Huxin decoction, 1 dose/day. The courses of treatment were 12 weeks. Before and after treatment, left ventricular ejection fraction (LVEF), left ventricular end diastolic dimension (LVEDd), leftventricular end-stolic diameter (LVEDs), stroke volume (SV), cardiac output (CO) and ratio of peak value of early diastolic velocity of mitral valve and peak velocity of late diastolic mitral valve (E/A) were recorded by echocardiography. And scores of Lee's heart failure, Qi deficiency and blood stasis, Minnesota Heart Failure Quality of life questionnaire (MLHFQ) and 6 minutes' walking test(6 MWT)were graded. And levels of N-terminal B-type natriuretic peptide (NT-proBNP), galactose lectin-3, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-17, transforming growth factor (TGF) - β and matrix metalloproteinase-9 (MMP-9) were detected.Result:After treatment, LVEDd and LVEDs were lower than that in control group (P<0.05). LVEF, SV, CO and E/A were higher than those in control group (P<0.05). And scores of Lee's heart failure, Qi deficiency blood stasis and MLHFQ were lower than those in control group (P<0.01). And 6 MWT was more than that in control group (P<0.01). And levels of NT-proBNP, galactose lectin 3, IL-17, IL-6, TNF-α, TGF-β and MMP-9 were lower than those in control group (P<0.01). Effect of cardiac function was better than that in control group (Z=2.191, P<0.05).Conclusion:On the basis of conventional western medicine treatment and according to theory of heart and spleen, Tiaopi Huxin decoction can improve the clinical symptoms and signs of heart failure, and it had effect of anti-inflammatory, and can improve ventricular remodeling, improve the exercise tolerance and quality of life of patients, improve the prognosis of heart failure, and its clinical effect is better than that of Western medicine alone.