改良综合消肿疗法对肿瘤相关下肢淋巴水肿的临床疗效研究-现代医学

改良综合消肿疗法对肿瘤相关下肢淋巴水肿的临床疗效研究

单位：南京大学医学院附属鼓楼医院康复医学科, 江苏南京 210008

分类号：R730.6

出版年·卷·期（页码）：2026·54·第三期（483-492）

摘要：

目的：评估改良综合消肿疗法(mCDT)对肿瘤相关单侧下肢淋巴水肿(LLL)的临床疗效。方法：选取89例肿瘤相关单侧LLL患者，随机分为对照组[45例，采用常规综合消肿疗法(CDT)]与试验组[44例，以三维旋进式振动疗法(CVT)替代CDT中的手法淋巴引流(MLD)，其余方案一致]，对比两组疗效。结果：两组基线资料比较差异无统计学意义(P＞0.05)。治疗2周后，试验组与对照组水肿减少率差值的均数为0.20(95%CI 0.08～0.32)，95%CI下限0.08>-0.15，非劣效成立，且试验组在患肢体积缩减、主观症状改善方面均优于对照组(P＜0.05)。结论：mCDT 治疗肿瘤相关单侧 LLL 的疗效非劣效于传统 CDT，具有潜在临床应用价值。

Objective: To evaluate the clinical efficacy of modified complete decongestive therapy(mCDT) for cancer-related unilateral lower limb lymphedema.Methods: A total of 89 patients were randomly assigned to a control group(n=45) receiving conventional complete decongestive therapy(CDT) or an experimental group(n=44) receiving modified CDT(mCDT), which involved cycloid vibration therapy instead of manual lymph drainage. The therapeutic efficacy of the two groups was compared.Results: The baseline characteristics were comparable between the groups(P>0.05). After 2 weeks of treatment, the mean difference in the edema reduction rate between the experimental and control groups was 0.20(95% CI 0.08-0.32). Non-inferiority was established as the lower limit of this confidence interval(0.08) exceeded the pre-specified non-inferiority margin of -0.15. Furthermore, the experimental group outperformed the control group in terms of volume reduction in the affected limb and improvements insubjective symptoms(P<0.05). Conclusion: For cancer-related unilateral lower limb lymphedema, mCDT is non-inferior to conventional CDT, indicating its potential value for clinical application.

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