基于中医养生理论的早期护理干预对晚期肺癌使用靶向药物不良反应的影响

Effect of Early Nursing Intervention on the Untoward Effect of Targeted Drugs used on Patients with Advanced Lung Cancer Based on TCM Health Preserving Theory

目的:研究并探讨基于中医养生理论的早期护理干预对晚期肺癌患者使用靶向药物治疗后不良反应的影响。方法:入选2014年5月~2015年11月收治的52例晚期肺癌患者为研究对象,据电脑随机数字分为研究组和对照组,各26人,对照组给予吉非替尼、厄洛替尼等晚期肺癌靶向药物进行治疗,研究组则先早期进行护理干预,之后再给予靶向药物进行治疗,治疗过程中观察两组患者服用晚期肺癌靶向药物后的不良反应情况,并进行比较和临床结果评定。结果:靶向药物治疗后的不良反应主要表现为恶心呕吐、腹泻等消化系统症状、皮疹、间质性肺炎、转氨酶升高、骨髓抑制、神经毒性等。据研究观察对比可得出研究组患者服用靶向药物治疗后不良反应的发生率明显低于对照组,差异具有统计学意义(P<0.05)。并且发生的不良反应的严重程度明显比对照组轻,即研究组出现I-II度和III-IV度不良反应明显低于对照组,差异具有统计学意义(P<0.05)。研究组QLQ-C30问卷中各项不良反应评分均低于对照组,差异均有统计学意义(P<0.05,P<0.01)。结论:晚期肺癌患者使用靶向药物治疗后不良反应是无法避免的,但在应用靶向药物治疗前进行基于中医养生理论的早期护理干预可显著降低靶向药物治疗不良反应的发生率和不良反应的严重程度。

Objective： To study the effect of early nursing intervention on the untoward effect of targeted drugs used on patients with advanced lung cancer based on TCM health preserving theory. Methods： 52 patients admitted to our hospital from May 2014 to November 2015 for treating advanced lung cancer were selected as research object, and were divided into a study group and a control group evenly and randomly. The control group was treated with targeted drugs for advanced lung cancer, such as gefitinib and erlotinib, while the study group received early nursing intervention based on TCM health preserving theory at first, and then was treated with targeted drugs. During the treatment, untoward effects of taking targeted drugs in the two groups were observed, compared, and the clinical results were evaluated. Results ： The main untoward effects of taking targeted drugs were digestive symptoms, such as nausea, vomiting, diarrhea and rash, interstitial pneumonia, elevated aminotransferase, bone marrow suppression, neurotoxicity and so on. According to the observation and comparison, the incidence and severity of untoward effects in the study group were significantly lower than those in the control group, and the difference was statistically significant （ P 〈 0.05 ）. The untoward effect of I - II degree and III- IV was significantly lower in the study group than in the control group, with statistically signifi- cant difference （ P 〈 0.05 ）. In QLQ - c30 questionnaire of the study group, all scores of untoward effects were lower than those in the control group, and the difference was statistically significant （P 〈 0.05, P 〈 0.01 ）. Conclusion： The untoward effects of targeted drugs used on patients with advanced lung cancer are unavoidable. However, measures can be taken to reduce the incidence of untoward effects and lower its severity. Ac- cording to this study, before the application of targeted drug, early nursing intervention on the untoward effect of targeted drugs used on patients with advanced lung cancer based on traditional Chinese medicine health care theory can significantly reduce the incidence and severity of untoward effects.