title: Effects of warm acupuncture on breast cancer-related chronic lymphedema: a randomized controlled trial.
abstract: BACKGROUND
  Effective treatment for breast cancer-related chronic lymphedema (bcrl) remains a clinical challenge. Acupuncture and moxibustion treatments have been shown to be beneficial and safe for treating bcrl. In the present randomized controlled trial, we compared the effectiveness of combined acupuncture and moxibustion ("warm acupuncture") with that of diosmin in bcrl.
  
  
  METHODS
  Breast cancer patients who met the inclusion and exclusion criteria (n = 30) were randomized to experimental and control groups (15 per group). On alternate days, patients in the experimental group received 30 minutes of acupuncture at 6 acupoints, with 3 of the needles each being topped by a 3-cm moxa stick. The control treatment was diosmin 900 mg 3 times daily. The control and experimental treatments were administered for 30 days. Outcome measures included arm circumferences (index of effectiveness), range of motion [rom (shoulder joint function)], quality of life, clinical safety, and adverse events.
  
  
  RESULTS
  Measured by the index of effectiveness, bcrl improved by 51.46% in the experimental group and by 26.27% in the control group (p < 0.00001). Effects were greatest at 10 cm above the elbow and at the wrist, where the warm needling was provided. Impairments in shoulder joint rom were minimal at baseline in both treatment groups. However, the roms of rear protraction, abduction, intorsion, and extorsion in the experimental group improved significantly; they did not change in the control group. Self-reported quality of life was significantly better with warm acupuncture than with diosmin. No adverse effects were reported during the treatment period, and laboratory examinations for clinical safety fell within the normal ranges.
  
  
  CONCLUSIONS
  Compared with diosmin, warm acupuncture treatment can effectively reduce the degree of bcrl at the specific acupoints treated and can promote quality of life. Warm acupuncture showed good clinical safety, without any adverse effects on blood or the cardiovascular system.
authors.affiliation: Department of Breast Disease, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, P.R.C.;
authors.forename: C
authors.initials: C
authors.lastname: Yao
authors.affiliation: Department of Breast Disease, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, P.R.C.;
authors.forename: Y
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Breast Disease, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, P.R.C.;
authors.forename: L
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Breast Disease, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, P.R.C.;
authors.forename: H
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Hospital of the Catholic University of Daegu, Daegu, South Korea;
authors.forename: C S
authors.initials: CS
authors.lastname: Ki
authors.affiliation: Department of Internal Medicine, College of Korean Medicine, Daegu Haany University, Daegu, South Korea.
authors.forename: J S
authors.initials: JS
authors.lastname: Byun
authors.affiliation: Department of Breast Disease, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, P.R.C.;
authors.forename: W
authors.initials: W
authors.lastname: Bian
keywords: Warm acupuncture; breast cancer–related lymphedema; clinical safety; quality of life; range of motion