临床药师参与胃癌新辅助化疗患者营养治疗的研究

Roles of clinical pharmacists in nutritional therapy for gastric cancer patients treated with neoadjuvant chemotherapy

目的探讨临床药师参与胃癌患者营养治疗和药学服务的作用。方法拟行新辅助化疗的胃癌患者60例,随机分为干预组和常规治疗组,常规治疗组行常规化疗,干预组在常规化疗的基础上,临床药师对其营养状况进行全程干预,两组化疗方案均为XELOX方案(卡培他滨+奥沙利铂),每组各30例,观察治疗结束后两组营养指标、不良反应发生率和治疗完成率。结果干预组患者化疗结束后各项营养指标均优于常规治疗组(均P<0.05)。严重骨髓抑制发生率低于常规治疗组(P<0.05)。干预组全部按计划完成治疗,常规治疗组6例患者暂停或终止化疗(P<0.05)。结论临床药师参与胃癌化疗患者营养治疗可以改善患者营养状况,降低药物不良反应发生率,提高抗肿瘤治疗顺应性和耐受性。

Objective To assess the roles of clinical pharmacists in nutritional therapy and pharmaceutical care of gastric cancer patients receiving neoadjuvant chemotherapy. Methods Sixty gastric cancer patients receiving neoadjuvant chemotherapy were randomly divided into the intervention group and routine treatment group with 30 cases in each group.The routine treatment group underwent conventional chemotherapy,while the intervention group received nutrition intervention from clinical pharmacists,in addition to conventional chemotherapy. Both groups underwent XELOX chemotherapy regime（ capecitabine ＋ oxaliplatin）. After treatment,the nutritional status,incidence of adverse reactions and completion rates of therapy were evaluated in both groups. Results After treatment,all nutritional parameters were significantly improved for the intervention group compared with the routine treatment group（ P〈 0. 05）. The incidence of severe myelotoxicity was also lower in the intervention group than that in the routine treatment group（ P〈 0. 05）. Moreover,all the patients in the intervention group completed the treatment plan,whereas 6 patients in the routine treatment group had to delay or stop the chemotherapy（ P〈 0. 05）. Conclusion The involvement of clinical pharmacists in nutritional therapy can improve the nutritional status,reduce the incidence of adverse reactions,and enhance the compliance and tolerance of anti-tumor treatment for gastric cancer patients undergoing chemotherapy.