“治气为先”康复治疗对肺癌术后症状的临床疗效和相关因素分析

Analysis of clinical efficacy and related factors of’treating qi first’rehabilitation therapy for postoperative symptoms of lung cancer

目的:分析"治气为先"康复治疗对肺癌术后症状的临床疗效和相关因素。方法:2016年10月至2019年12月于上海5家医院收集的305例肺癌术后患者随机分为治疗组和对照组,其中296例完成治疗,各组148例。治疗组予中药联合肺康复训练,对照组予中药安慰剂联合健康宣教,共治疗12周。观察治疗前后中医证候总分和症状评分,并采用广义线性混合模型和Logistic回归分析治疗组疗效相关因素。结果:治疗组总有效率54.05%(80/148)显著优于对照组47.30%(70/148)(P<0.05),并且治疗组较对照组咳嗽、神疲乏力症状显著改善(P<0.05);治疗组总评分和咳嗽评分在不同时间点差异均有统计学意义(P<0.01),神疲乏力评分在12周时差异具有统计学意义(P<0.05);年龄是治疗组总疗效的独立相关因素(P<0.05)。结论:"治气为先"康复治疗能有效改善肺癌术后症状,且疗效与干预时间长短、年龄相关。

Objective:To analyze the clinical efficacy and related factors of’treating qi first’rehabilitation therapy for postoperative symptoms of lung cancer.Methods:A total of 305 patients after lung cancer surgery from 5 hospitals of Shanghai during October,2016 to December,2019 were collected and randomly divided into a treatment group and a control group,296 cases were included and 148 cases in each group.The treatment group was given traditional Chinese medicine combined with pulmonary rehabilitation training,and the control group was given TCM placebo combined with health education,12 weeks for treatment.The total score and symptom scores of TCM syndrome scores were observed before and after treatment.Generalized linear mixed model and Logistic regression were used to analyze the related factors of the treatment group.Results:The total effective rate of the treatment group was 54.05%(80/148),which was significantly better than the control group of 47.30%(70/148)(P<0.05).Compared with the control group,the treatment group significantly improved cough and mental fatigue(P<0.05).The total effect and cough curative effect of the treatment group were always significant at different time points(P<0.01),while the effect of mental fatigue had significantly difference only at 12 weeks(P<0.05).Age was the independent related factor for the total effect of the treatment group(P<0.05).Conclusion:’Treating qi first’rehabilitation therapy can effectively improve postoperative symptoms of lung cancer,which is related to the duration of intervention and age.