认知催眠疗法减轻胃癌化疗患者癌因性疲乏的疗效观察

Effect of cognitive-behavioral therapy plus hypnosis in controlling cancer-related fatigue in gastric cancer patients receiving chemotherapy

目的探讨认知催眠疗法在减轻胃癌患者化疗所致癌因性疲乏中的应用效果。方法将60例符合标准的胃癌化疗患者随机分为观察组和对照组,每组30例。2组患者均施行FOLFOX4方案化疗。于化疗第1天开始观察组给予认知催眠疗法,对照组给予常规健康教育,1次/d,每个化疗周期2次。于每周期化疗前、化疗结束后第5天和全部化疗结束后2个月分别评价2组患者的FACIT-F得分及TNF-α、IL-1β、IL-6水平。结果化疗前2组患者疲乏程度相当,FACIT-F评分无统计学差异(P>0.05)。化疗后2组FACIT-F评分呈下降趋势,对照组下降更明显,差异有统计学意义(P<0.01);2组TNF-α、IL-1β、IL-6水平呈增加趋势,对照组增加更明显,差异有统计学意义(P<0.01)。化疗结束后2个月观察组FACIT-F评分及TNF-α、IL-1β、IL-6水平仍高于对照组,差异具有统计学意义(P<0.05)。结论认知催眠疗法能够降低TNF-α、IL-1β、IL-6水平,明显改善胃癌化疗患者癌性疲劳,有望成为化疗所致癌因性疲乏的一种新的辅助治疗手段。

Objective To explore the effect of cognitive-behavioral therapy plus hypnosis to reduce cancer-related fatigue（ CRF） in gastric cancer patients undergoing chemotherapy. Methods A total of 60 gastric cancer patients undergoing chemotherapy were randomly assigned to 2 groups： observation group（ n = 30） and control group（ n = 30）. All patients adopted FOLFOX4 chemotherapy scheme. On day 1 of the treatment,the observation group underwent cognitive-behavioral therapy plus hypnosis,while the control group was provided with routine health education. The intervention was performed once a day,twice in each chemotherapy cycle. The score of FACIT-F,levels of TNF-α,IL-1β and IL-6 were measured at baseline,5 days and 2 months after chemotherapy. Results There were no differences between the 2 groups in fatigue and FACIT-F score before chemotherapy（ P 〈0. 05）. After chemotherapy,the FACIT-F scores of both groups decreased,and the control group had larger margin of decrease（ P 〈0. 01）; the levels of TNF-α,IL-1βand IL-6 in both groups increased,and the control group had a larger margin of increase（ P 〈0. 05）. Two months after chemotherapy,the observation group had higher FACIT-F score and higher levels of TNF-α,IL-1β and IL-6 than the control group（ P 〈0. 01）. Conclusion Cognitive-behavioral therapy plus hypnosis is able to reduce TNF-α,IL-1βand IL-6 levels,and control fatigue in patients undergoing chemotherapy for gastric cancer. Therefore,it may serve as a promising auxiliary treatment for chemotherapy.