添加精氨酸的个体化营养支持对同步放化疗鼻咽癌营养不良患者的影响

The effect of adding arginine in the individual nutrition support on patients with nasopharyngeal carcinoma

目的探讨添加精氨酸(Arg)的个体化营养支持对同步放化疗鼻咽癌患者的影响及临床意义。方法选择存在营养不良的同步放化疗鼻咽癌患者86例,随机分为对照组和试验组,各43例。试验组患者进行添加Arg的个体化营养支持,对照组患者实施常规个体化营养支持。比较放化疗前和最后一次放疗后两组营养指标、放化疗不良反应及放化疗中断率和完成率的情况。结果两组患者治疗后血清前白蛋白无明显下降,治疗后试验组患者的血红蛋白、淋巴细胞计数和体重等指标下降比对照组少(P<0.05);试验组口腔黏膜损伤发生率较低(P<0.05);试验组治疗中断率较低,完成率较高(P<0.05)。结论添加Arg的个体化营养支持能有效地改善同步放化疗鼻咽癌患者的营养状况,减轻放化疗不良反应并降低同步放化疗中断率,提高完成率。

Objective To investigate the effect of adding arginine in the individual nutrition support on the patients with nasopharyngeal carcinoma. Methods 86 patients were randomly divided into two groups, with 43 cases in each group. The control group received individualized nutrition support and the test group was given arginine plus the same treatment as the control group. The nutritional indexes, adverse reactions, and the rates of chemoradiothera- py discontinuation and completion were compared between the two groups before and after the ehemoradiotherapy. Re- sults After the treatment, there was no significant difference in the decline of serum prealbumin between the two groups, and the declines in hemoglobin, lymphocyte count and bodyweight were gentler, and the incidences of oral mucositis and chemoradiotherapy discontinuation were lower and the completion rate was elevated in the test group than those in the control group （P 〈 0.05）. Conclusion Adding arginine can effectively improve the nutritional sta- tus individually and reduce the adverse reactions and chemoradiotherapy discontinuation rates for the patients with na- sopharyngeal carcinoma.