Pain-relief and movement improvement by acupuncture after ablation and axillary lymphadenectomy in patients with mammary cancer.
BACKGROUND
In the traditional Chinese medicine (TCM), pain and movement restrictions are considered as the result of a blocking of the "Jing-Luo-system" or of a disordered flow of the Jing-Qis in the "Jing-Luo-system".


METHODS
In this study 48 patients with mammary cancer after ablation and axillary lymphadenectomy were treated with acupuncture (group I); a control group of 32 patients with the same operation but without acupuncture was compared (group II).


RESULTS
The results showed a significantly higher maximum abduction angle (AA) at the first treatment immediately after acupuncture without pain (59.1 degrees vs. 80.4 degrees, p < 0.001) with respect to maximum tolerable pain barrier (73.6 degrees vs. 92.3 degrees, p < 0.001). Between group I (12.3%) and group II (50%) there was a statistically significant difference (p < 0.01) in the appearance of pain in the operation field in the rest position on the 5th postoperative day, while on the 7th postoperative day 8.3% vs. 12.5%) and at the time of discharge a significant difference could not be seen (p > 0.05). The percentage of patients with pain during arm movements showed a statistically significant difference between group I and group II on the 5th postoperative day (81% vs. 100%, p < 0.01), on the 7th postoperative day (43% vs. 96.9%, p < 0.01) and at time of discharge (27.1% vs. 65.6%, p < 0.001). The differences in the abduction angle between group I and group II were also statistically significant on the 5th postoperative day at indolency (89.3 degrees vs. 74.5 degrees, p < 0.001) with respect to maximum tolerable pain (105.8 degrees vs. 87.4 degrees, p < 0.001). The differences in the abduction angle on the 7th postoperative day at indolency (97.5 degrees vs. 81.2 degrees, p < 0.001) and at maximum tolerable pain (118.5 degrees vs. 93.4 degrees, p < 0.001) were statistically significant. This statistically significant difference in the maximum abduction angle between group I and group II at indolency (116.1 degrees vs. 91.5 degrees) with respect to maximum tolerable pain (129.4 degrees vs. 112.7 degrees, p < 0.001) could be observed until discharge.


CONCLUSIONS
Acupuncture seems to be an effective treatment to relieve pain and improve arm-movements after ablation and axillary lymphadenectomy. The "Xie-technique" is used at the main acupuncture points and the patient's feeling must be particularly considered. The combination of the different main points with the correctly selected additional acupuncture points--referred to the basic state and the pre- und post-operative state of the patient--are very important for a successful application of acupuncture.
He
J P
JP
Department of Obstetrics and Gynecology, University of the Saarland, Homburg, Germany.
Friedrich
M
M
Ertan
A K
AK
Müller
K
K
Schmidt
W
W
D015667:Acupuncture Analgesia; D001132:Arm / Q000502:physiology; D001365:Axilla / Q000601:surgery; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D059408:Pain Management; D016059:Range of Motion, Articular / Q000502:physiology*; D013997:Time Factors