中药干预对结肠癌化疗患者生活质量影响的动态观察

Longitudinal Observation on Effects of the Chinese Traditional Medicines on Quality of Life and Negative Emotions in Colon Carcinoma Patients During Chemotherapy

目的:研究中药干预对结肠癌化疗期间患者生活质量影响的动态变化。方法:96例结肠癌患者随机分为两组,中药组50例在FOLFOX4化疗基础上,加用益气健脾清热解毒法立方的中药进行辨证治疗,对照组46例仅采用单纯化疗。应用生活质量核心问卷(EORTCQLQ-C30)中文版以及焦虑自评量表(SAS),抑郁自评量表(SDS)在化疗前1天(B1)、化疗第2天(T2)、化疗间歇期第7天(I7)和第14天(I14)进行评定。结果:两组患者生活质量自B1后开始下降,T2降至最低,I7后呈缓慢上升趋势,I14回升至最高,但仍低于B1水平;SAS、SDS则呈反向变化。两组生活质量和SAS、SDS总分在B1、T2点差异无显著性(P>0.05),而在I7、I14点差异有统计学意义(P<0.05)。结论:化疗期间结肠癌患者生活质量呈现先下降后缓慢回升的变化趋势,益气健脾清热解毒中药能部分逆转生活质量的下降,改善焦虑、抑郁负性情绪。

Objective： To explore longitudinal changes on effects of Chinese traditional medicines on negative emotions and quality of life （QLQ） in the colon carcinoma patients during chemotherapy. Methods： 96 colon carcinoma patients receiving adjuvant FOLFOX4 （Oxaliplatin/5-FU/LV） were divided into two groups： the CTM group（n=50） had Chinese traditional medicines of replenishing spleen qi and clearing away heat and removing toxic substances combined with the adjuvant chemotherapy, the control group（n=46） had the adjuvant chemotherapy only. Both the two groups were treated for sixteen days. The level of anxiety and depression as well as QLQ were assessed with European Organization for Research Treatment Of Cancer （EORTC QLQ-C30）, Self-reported Anxiety Scales （SAS） and Depression Scales（SDS） at day 1 prior to the chemotherapy （B1）, day 2 during the chemotherapy （T2）, day 7（I7） and day 14 014） after the chemotherapy, respectively. Results： Both the two groups had experienced the deterioration in QLQ, anxiety and depression since B1, decreased at a low ebb at T2. Following I7, the global QLQ recovered gradually and reached a peak at I14. Compared with the control group, QLQ scores QLQ, anxiety and depression of CTM group showed no differences at B1 and T2（P〉0.05）, but better at I7 and I14 （P〈0.05）. Conclusion： The QLQ, anxiety and depression of colon caner patients experience deterioration at the beginning, and recover gradually during chemotherapy. Chinese traditional medicines of replenishing spleen qi and clearing away heat and removing toxic substances can reverse, to some extent, the deterioration of QLQ and relieve anxiety and depression of colon carcinoma patients during chemotherapy.