Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

Implications for Cancer Survivors

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.

中文翻译：

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淋巴水肿的手动淋巴引流治疗：文献系统回顾。

目的

手动淋巴引流 (MLD) 按摩被广泛接受为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。

方法

使用相关术语检索了电子数据库 Embase、PubMed、CINAHL Complete 和 Cochrane Central Register of Controlled Trials。包括在有淋巴水肿风险或患有淋巴水肿的患者中比较 MLD 与另一种干预或对照的研究。使用 PEDro 量表对研究进行严格评价。

结果

包括 17 项研究，共有 867 名女性和两名男性参与者。仅确定了检查乳腺癌相关淋巴水肿的研究。一些研究报告称，与其他治疗相比，MLD 对体积减少、生活质量和症状相关结果的积极影响，而其他研究报告称，MLD 作为复杂减充血疗法的一个组成部分没有额外的益处。在有风险的患者中，一些研究报告称 MLD 可降低淋巴水肿的发生率，而其他研究则报告没有此类益处。

结论

审查的文章报告了相互矛盾的发现，并且常常受到方法学问题的限制。这篇综述强调了对 MLD 在淋巴水肿中的有效性进行进一步实验研究的必要性。

对癌症幸存者的影响

有证据表明，乳腺癌手术后早期的 MLD 可能有助于防止进展为临床淋巴水肿。MLD 还可以为轻度淋巴水肿的体积减少提供额外的好处。然而，在中度至重度淋巴水肿中，MLD 与复杂的减充血疗法联合使用时可能不会提供额外的益处。