组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2019, Vol. 15 ›› Issue (6): 408-412.doi: 10.3969/j.issn.1673-0364.2019.06.008

• 论著 • 上一篇    下一篇

远红外线治疗慢性肢体淋巴水肿的疗效观察及机制研究

肖文天，李科，张铮，喜雯婧，刘宁飞，章一新   

  1. 上海交通大学医学院附属第九人民医院整复外科
  • 收稿日期:2019-10-09 修回日期:2019-11-15 出版日期:2019-12-20 发布日期:2019-12-20
  • 作者简介:章一新(E-mail:zhangyixin6688@163.com);刘宁飞(E-mail:liuningfei@126.com)。

Clinical Efficiency and Mechanism Research of Far Infrared Radiation in the Treatment of Chronic Lymphedema of Extremities

XIAO Wentian,LI Ke,ZHANG Zheng,XI Wenjing,LIU Ningfei,ZHANG Yixin   

  1. Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine
  • Received:2019-10-09 Revised:2019-11-15 Online:2019-12-20 Published:2019-12-20
  • Contact: 上海市科学技术委员会优秀技术带头人计划(18XD1423700)；国家自然科学基金面上项目(81772098)；上海交通大学医学院附属第九人民医院临床研究型多学科诊疗团队建设(2017-1-007)；上海交通大学医学院附属第九人民医院临床研究助推计划(JYLJ027)；上海市教委高峰高原计划—“研究型医师”项目(20152227)

摘要： 目的观察远红外线治疗慢性肢体淋巴水肿的临床疗效,并探讨其作用机制。方法选取32例慢性肢体淋巴水肿患者(Ⅱ～Ⅲ期),采用远红外线治疗,分别于治疗前后进行与肢体肿胀相关的临床疗效评估,包括水分检测、肢体周径测量、真皮及皮下组织厚度测量、生活质量评估及不良反应记录;选取其中11例(34%)进行实验室指标检测,包括血清以及患肢组织液内的肿胀相关细胞因子和大分子物质(IL-6、瘦素、透明质酸和总蛋白)的浓度。结果 32例患者接受远红外线治疗后,体内细胞外液减少(0.763±0.259) Kg(P<0.001),患肢水分减少(1.204±0.737) Kg(P<0.001),患肢周径减小(2.0±1.3) cm (P<0.001),患肢真皮厚度降低(0.07±0.10) cm(P<0.001),皮下组织厚度下降(0.32±0.35) cm(P<0.001),生活质量评分提高(1.375±0.942)(P<0.001);实验室指标检测结果显示,治疗后血清中的IL-6浓度升高(13.947±4.436)pg/mL(P<0.05),组织液中的瘦素浓度降低(11456.210±12656.400) pg/mL(P<0.01),患肢与健肢相比组织液中的额外透明质酸和额外总蛋白分别减少(0.267±0.171) g和(0.137±0.083) Kg(P<0.01)。结论远红外线可以通过提高体内IL-6浓度,降低肢体内瘦素浓度等途径,减少肿胀组织内沉积的水分、脂质、蛋白质以及透明质酸,从而有效改善慢性肢体淋巴水肿患者的肢体肿胀症状。

关键词: 淋巴水肿, 远红外线治疗, 疗效, 机制

Abstract: Objective To investigate the therapeutic effect of far infrared radiation in the treatment of chronic lymphedema of extremities and to explore the mechanism. Methods Thirty-two patients with chronic lymphedema of extremities in stage Ⅱ and Ⅲ were treated with far infrared radiation. Before and after the treatment, clinical effects related to extremities swelling were evaluated, including the amount of fluid, the measurement of limb circumference, the thickness of dermis and subcutaneous tissue, the quality of life and the adverse reactions. Eleven patients(34%) went through laboratory index evaluation including cytokines and macromolecules associated with the swelling(IL-6, leptin, hyaluronan and total protein) in serum and tissue fluid of the lymphedema extremities. Results After treatment, the clinical evaluation showed the decrease of extracellular fluid(0.763±0.259) Kg(P<0.001), the decrease of fluid in the extremities(1.204±0.737) Kg(P <0.001), the decrease of circumference of extremities(2.0 ±1.3) cm(P <0.001), the decrease of thickness of skin and subcutaneous tissue(0.07±0.10) cm(P<0.001);(0.32±0.35) cm(P<0.001), and the improvement of quality of life(1.375±0.942)(P<0.001). And the laboratory index evaluation found that the concentration of IL-6 in serum was increased(13.947±4.436) pg/mL(P <0.05), the level of leptin in tissue fluid was decreased(11456.210 ±12656.400) pg/mL(P <0.01), and the ExtraM-Hyaluronan and ExtraM-total protein in affected extremity were both decreased(0.267±0.171) g(P<0.01);(0.137±0.083) Kg(P <0.01). Conclusion Far infrared radiation treatment can effectively reduce the water, lipid, protein and hyaluronan deposited in the swollen tissues and improve limb swelling symptoms by increasing the concentration of IL-6 in the body and reducing the level of leptin in the limbs.

Key words: Lymphedema, Far infrared radiation treatment, Clinical efficacy, Mechanism Research

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