基于加速康复外科理念的早期康复训练联合八段锦前四式在乳腺癌改良根治术后患者中的应用效果研究

摘要 目的：研究基于加速康复外科（ERAS）理念的早期康复训练联合八段锦前四式在乳腺癌改良根治术后患者中的应用效果。方法：选择2019年9月~2022年5月期间在湖南中医药大学第一附属医院行乳腺癌改良根治术的128例乳腺癌患者。按照随机数字表法将患者分为对照组（基于ERAS理念的早期康复训练，n=64）和研究组（对照组的基础上接受八段锦前四式干预，n=64）。对比两组抑郁自评量表（SDS）评分、健康调查简表（SF-36）、焦虑自评量表（SAS）评分、Constant-Murley肩关节功能评分、疼痛视觉模拟评分（VAS）和肩关节活动度。结果：与对照组相比，研究组干预后SDS、SAS评分更低（P<0.05）。与对照组相比，研究组情感/生理职能、躯体疼痛、社会/生理功能、活力、总体/精神健康评分更高（P<0.05）。与对照组相比，研究组干预后VAS评分更低，Constant-Murley肩关节功能评分更高（P<0.05）。与对照组相比，研究组干预后前屈、后伸、外展关节活动度更大（P<0.05）。结论：基于ERAS的早期康复训练联合八段锦前四式应用于乳腺癌改良根治术后患者，可提高患者的生活质量，可能与缓解焦虑、抑郁情绪，减轻术后疼痛，促进肩关节功能恢复有关。

Study on the Application Effect of Early Rehabilitation Training Based on the Concept of Enhanced Recovery after Surgery Combined with the First Four Types of Baduanjin in Patients after Modified Radical Mastectomy for Breast Cancer

ABSTRACT Objective: To study the application effect of early rehabilitation training based on the concept of enhanced recovery after surgery (ERAS) combined with the first four types of Baduanjin in patients after modified radical mastectomy for breast cancer. Methods: 128 breast cancer patients who underwent modified radical mastectomy in the The First Affiliated Hospital of Hunan University of Chinese Medicine from September 2019 to May 2022 were selected. Patients were divided into control group (early rehabilitation training based on the ERAS concept, n=64) and study group (control group received the first four types of Baduanjin intervention on the basis of control group, n=64) according to the random number table method. The self-rating depression scale (SDS) score, health survey summary (SF-36), self-rating anxiety scale (SAS) score, Constant-Murley shoulder function score, pain visual analogue score (VAS) and shoulder joint activity were compared between two groups. Results: Compared with control group, the SDS and SAS scores in study group were lower after intervention (P<0.05). Compared with control group, the emotional/physiological function, physical pain, social/physiological function, vitality, overall/mental health scores in study group were higher (P<0.05). Compared with control group, the VAS score was lower and the Constant-Murley shoulder function score was higher in study group after intervention (P<0.05). Compared with control group, anteflexion, extension, and abduction joint activity in study group was greater after intervention (P<0.05). Conclusion: The application of early rehabilitation training based on ERAS combined with the first four types of Baduanjin in patients after modified radical mastectomy for breast cancer can improve the quality of life of patients, which may be relate to alleviating anxiety and depression, reducing postoperative pain and promoting the recovery of shoulder joint function.