一例非小细胞肺癌患者癌因性疲乏杵针疗法的循证护理

Evidence-based Nursing Care with Pestle Needle Therapy for Non-small Cell Lung Cancer with Cancer-related Fatigue:Report of One Case

背景癌因性疲乏(CRF)是影响癌症患者生活质量的重要因素,杵针疗法兼具针灸与按摩的双重功效,符合干预CRF的中医理论和思路,但缺乏一线临床的直接证据。目的评价对1例非小细胞肺癌患者的CRF进行杵针护理干预的临床有效性及安全性,为CRF探索新的护理干预措施。方法选取2019-02-25成都中医药大学附属医院收治的非小细胞肺炎患者1例为研究对象,应用循证护理的思路,结合杵针疗法的临床实践经验和患者的个人意愿,提出CRF的杵针护理问题,检索相关文献并对重要文献进行分析,然后制定实施CRF杵针护理干预并评估效果。结果经文献检索及筛选后共纳入7篇重要参考文献,均为杵针护理干预CRF提供了理论支持,但缺乏杵针护理干预CRF的直接病例研究。按照患者的个体化杵针护理干预方案完成治疗并对患者的CRF状况进行评估,结果显示,杵针护理能够有效缓解患者的CRF程度,改善患者的生活质量,但是停止杵针护理后的远期疗效尚不够理想。结论在处理该例非小细胞肺癌患者的CRF问题中,杵针护理干预安全有效,长期实施可能实现CRF的远期缓解,有望成为CRF新的中医护理干预手段。

Background Cancer-related fatigue(CRF)is an important factor that affects the quality of life of cancer patients.Pestle needle therapy has the synthetic efficacy of acupuncture and massage,which is in line with the traditional Chinese medicine theory and idea of CRF intervention,but there is lack of first-hand clinical evidence of this therapy in CRF patients with first-line treatment.Objective To evaluate the clinical effectiveness and safety of pestle needle therapy as a new type of intervention for CRF in a patient with non-small cell lung cancer.Methods A patient with non-small cell cancer admitted to the Affiliated Hospital of Chengdu University of TCM on February 25,2019 was selected as the research object.Based on the idea of evidence-based nursing,clinical experience of pestle needle therapy and this CRF patient's subjective intention of treatment,the problems that may be encountered in pestle needle therapy for CRF were put forward,and were analyzed and addressed by referring to important articles that were retrieved.Then pestle needle therapy for CRF was implemented and the effect was evaluated.Results A total of 7 important articles were included,all provided theoretical support for pestle needle therapy for CRF,but without first-hand studies.The program of pestle needle therapy was completed according to the patient's conditions,and the CRF status of the patient was evaluated.The results showed that,after receiving the pestle needle therapy,the CRF level and quality of life of the patient were effectively improved.However,when the therapy was stopped,the satisfactory effectiveness could not last for long.Conclusion In the treatment of CRF in this patient with non-small cell lung cancer,pestle needle therapy is safe and effective and feasible,and its persistent treatment may achieve long-term remission of CRF,which is expected to become a new TCM nursing intervention for CRF.