芳香按摩疗法对晚期肺癌患者化疗相关性恶心呕吐干预效果的研究

The effects of aromatherapy for chemotherapy-induced nausea and vomiting in patients with advanced lung cancer

目的探讨芳香按摩疗法对肺癌患者化疗相关性恶心呕吐的干预效果。方法选取天津市肿瘤医院肺癌患者112例作为研究对象，按照随机数字表法分为干预组58例和对照组54例，对照组实施肺癌化疗常规护理，干预组在常规护理基础上采用芳香穴位按摩疗法。最终完成试验的患者2组各47例。采用《中文版胃肠道恶心呕吐分级评价标准》在患者化疗前1d、化疗后48h、化疗后5—7d评估患者恶心呕吐情况。采用呕吐功能性生活指数（FLIE）量表在患者化疗前1d、化疗后第6天、化疗后第11天评估患者生命质量。结果2组肺癌患者化疗后急性恶心呕吐等级比较，急性恶心等级在第1周期（Z=-3．000，P=O．003）、第3周期（Z=-2．547，P=O．011）差异有统计学意义；但在第2周期（Z=-0．715，P=0．474）、第4周期差异无统计学意义（Z=-1．576，P=0．117）；急性呕吐等级只有第1周期差异无统计学意义（Z=-2．830，P=0．777），第2、3、4周期差异有统计学意义（Z=-2．031、-2．291、-3．499，P=0．042、0．022、0．001）。4个周期延迟性恶性呕吐症状控制得到明显改善（Z=-3．475- -2．144，P=0．001—0．032）。干预组与对照组4个周期中FLIE量表总体及恶心、呕吐2个维度之间平均分均差异有统计学意义（t=0．317-3．760，P=0．000-0．038）。结论芳香按摩疗法能明显降低肺癌患者化疗相关性恶心呕吐的发生严重程度，能有效提高患者的生命质量，值得临床推广。

Objective To evaluate the effect of aromatherapy on chemotherapy-induced nausea and vomiting among lung cancer. Methods A total of 112 patient with lung cancer from Tianjin Cancer Hospital were selected and divided into control group （54 patients） and intervention group （58 patients） by random number table. The control group was given routine health care, while the intervention group was given aromatherapy and routine health care. Chinese Version of Gastroenteric Nausea and Vomiting Grading Criteria was adopted to assess chemotherapy-induced nausea and vomiting among before chemotherapy, 48 h and 5 to 7 days after chemotherapy. Functional Living Index-Emesis was used to measure quality of life among the first day, the sixth day and the eleventh day after chemotherapy. Results The study showed that there were statistical differences between two groups for acute nausea in the first（Z=-3.000, P=0.003） and third cycles （Z=-2.547, P=0.011）, while there were no statistical differences in second（Z=-0.715, P=0.474） and fourth cycles （Z=-1.576, P=0.117）. And for acute vomiting, all cycles had statistical significance （Z=-2.031, -2.291, -3.499, P=0.042, 0.022, 0.001） except the first cycle（Z=-2.830, P=0.777）. There were differences among four cycles about delayed nausea and vomiting（Z=-3.475--2.144, P=0.001-0.032）. It had statistical significance between control group and intervention group for quality of life（t=0.317-3.760, P=0.000-0.038）. Conclusions Aromatherapy can obviously reduce extent of chemotherapy-induced nausea and vomiting, improve quality of life, so it is worth using widely in clinic.