正念减压疗法联合化疗对骨髓瘤骨病患者生存质量的影响

Effect of mindfulness-based stress reduction combined with traditional chemotherapy on the quality of life of patients with myeloma bone disease

目的探究正念减压疗法联合化疗对提高骨髓瘤骨病患者的生存质量及疾病缓解率的效果,为改善骨髓瘤骨病患者的生活质量和治疗依从性提供参考。方法选取2018年1月-2020年1月在绵阳市第三人民医院血液科住院治疗的84例骨髓瘤骨病患者为研究对象,采用随机数字表法分为研究组和对照组各42例,两组患者均按BDT(硼替佐米+地塞米松+沙利度胺)化疗方案治疗3~5个周期,研究组在此基础上接受为期8周的正念减压疗法干预。在干预前、干预后第3月、第6月采用卡氏评分表(KPS)评定生存质量,采用疼痛强度数字评分(NRS)评定骨痛程度,按照国际骨髓瘤工作组疗效标准(IMWG标准)进行疗效评估。结果干预后第6个月,研究组和对照组生活质量改善率差异有统计学意义(61.90%vs.33.33%,χ2=6.65,P<0.05)。干预后第3个月及第6个月,研究组NRS评分均低于对照组,差异均有统计学意义(P均<0.05),但两组疾病缓解程度比较差异均无统计学意义(P均>0.05)。结论正念减压疗法联合化疗对改善骨髓瘤骨病患者生存质量、缓解骨痛的效果可能优于单纯传统化疗。

Objective To explore the effect of mindfulness-based stress reduction combined with chemotherapy on improving the quality of life and remission rate of patients with myeloma bone disease,so as to provide references for improving the quality of life and treatment compliance of patients.Methods A total of 84 patients with myeloma bone disease who were hospitalized in the hematology department of The Third Hospital of Mianyang from January 2018 to January 2020 were selected as the research objects,and they were divided into the study group(n=42)and control group(n=42)by random number table method.Both groups were treated with BDT(bortezomib+dexamethasone+thalidomide)chemotherapy for 3 to 5 cycles.Based on this,the study group received mindfulness-based stress reduction therapy for 8 weeks.Before the treatment,3 months and 6 months after intervention,the quality of life was assessed with Karnofsky Performance Status score(KPS),the pain level was assessed with Numerical Rating Scale(NRS),and the efficacy was assessed according to the international working group standard for efficacy of myeloma(IMWG).Results At the 6th month after intervention,the difference of life quality improvement rate between the study group and the control group was statistically significant(61.90%vs.33.33%,χ2=6.65,P<0.05).At the 3rd and 6th month after intervention,NRS scores of the study group were lower than those of the control group,with statistically significant differences(P<0.05).However,there was no statistically significant difference in the degree of disease remission between the two groups(P>0.05).Conclusion Mindfulnessbased stress reduction combined with traditional chemotherapy may improve the quality of life of patients with myeloma bone disease as well as better alleviate bone pain compared with conventional chemotherapy alone.