Australian Lymphoedema Education, Research & Treatment (ALERT) Program, Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 1, 75 Talavera Road, Sydney, NSW, 2109, Australia.
School of Environmental & Life Sciences, Faculty of Science, The University of Newcastle, Ourimbah, NSW, Australia.
J Cancer Surviv. 2021 Apr;15(2):244-258. doi: 10.1007/s11764-020-00928-1. Epub 2020 Aug 15.
Manual lymphatic drainage (MLD) massage is widely accepted as a conservative treatment for lymphedema. This systematic review aims to examine the methodologies used in recent research and evaluate the effectiveness of MLD for those at-risk of or living with lymphedema.
The electronic databases Embase, PubMed, CINAHL Complete and Cochrane Central Register of Controlled Trials were searched using relevant terms. Studies comparing MLD with another intervention or control in patients at-risk of or with lymphedema were included. Studies were critically appraised with the PEDro scale.
Seventeen studies with a total of 867 female and two male participants were included. Only studies examining breast cancer-related lymphedema were identified. Some studies reported positive effects of MLD on volume reduction, quality of life and symptom-related outcomes compared with other treatments, while other studies reported no additional benefit of MLD as a component of complex decongestive therapy. In patients at-risk, MLD was reported to reduce incidence of lymphedema in some studies, while others reported no such benefits.
The reviewed articles reported conflicting findings and were often limited by methodological issues. This review highlights the need for further experimental studies on the effectiveness of MLD in lymphedema.
There is some evidence that MLD in early stages following breast cancer surgery may help prevent progression to clinical lymphedema. MLD may also provide additional benefits in volume reduction for mild lymphedema. However, in moderate to severe lymphedema, MLD may not provide additional benefit when combined with complex decongestive therapy.
手动淋巴引流 (MLD) 按摩被广泛认为是治疗淋巴水肿的保守治疗方法。本系统评价旨在检查最近研究中使用的方法，并评估 MLD 对有淋巴水肿风险或患有淋巴水肿的人的有效性。
使用相关术语搜索电子数据库 Embase、PubMed、CINAHL Complete 和 Cochrane 对照试验中心注册库。纳入比较 MLD 与有淋巴水肿风险或患有淋巴水肿的患者的另一种干预措施或对照的研究。使用 PEDro 量表对研究进行批判性评估。
共纳入 17 项研究，总计 867 名女性和 2 名男性参与者。仅确定了检查乳腺癌相关淋巴水肿的研究。一些研究报告了 MLD 与其他治疗方法相比在体积减少、生活质量和症状相关结果方面的积极影响，而其他研究报告了 MLD 作为复杂消肿治疗的一部分没有额外益处。在有风险的患者中，一些研究报告 MLD 可降低淋巴水肿的发生率，而其他研究则没有报告这种益处。
综述文章报告了相互矛盾的发现，并且往往受到方法学问题的限制。本综述强调了需要进一步开展关于 MLD 在淋巴水肿中的有效性的实验研究。
有一些证据表明，乳腺癌手术后早期的 MLD 可能有助于预防进展为临床淋巴水肿。MLD 还可能为轻度淋巴水肿的体积减少提供额外益处。然而，在中度至重度淋巴水肿中，当与复杂的消肿治疗结合使用时，MLD 可能不会提供额外的益处。
