精准营养干预方案改善辅助化疗期胃癌和结直肠癌患者毒性反应、营养摄入和生活质量的效果观察

Precision nutrition intervention program improves toxicity,nutritional intake and quality of life of patients with gastric and colorectal cancer during adjuvant chemotherapy

目的探讨辅助化疗期精准营养干预方案对改善胃癌、结直肠癌患者毒性反应、营养摄入和生活质量的影响。方法将150例胃癌、结直肠癌患者随机分为观察组和对照组各75例,观察组在辅助化疗期接受精准化的营养干预方案,对照组在辅助化疗期接受基础营养护理和健康教育,比较两组患者的胃肠道及血液毒性反应、营养状况和生活质量。结果观察组患者在T2周期胃肠道毒性反应中恶心和T3周期胃肠道毒性反应中恶心、呕吐、厌食发生率少于对照组,观察组患者在T3周期血液毒性反应中白细胞减少发生率对照组,两组比较,差异具有统计学意义(均P<0.01)。观察组在T3周期能量、蛋白质、体重改善程度均优于对照组(P<0.05),观察组患者生活质量的生理机能及生理职能维度在T3周期得分高于对照组。结论辅助化疗期精准营养干预方案能一定程度改善胃癌、结直肠癌患者胃肠道及血液毒性、营养摄入、生活质量,有利于提升患者治疗依从性及效果。

Objective To investigate the effect of a precision nutrition intervention program during adjuvant chemotherapy on toxic reactions,nutrition intake,and quality of life of patients with gastric and colorectal cancer. Methods A total of 150 patients with gastric and colorectal cancer were randomly divided equally into the intervention and control groups: in the former group the patients were managed with a precision nutrition intervention program during the adjuvant chemotherapy,and the latter with basic nutrition care and health education during the same period. The two groups were compared in terms of gastrointestinal and hematologic toxic effects,nutritional status,and quality of life. Results In the second cycle of adjuvant chemotherapy,the rate of nausea in the intervention group was lower than that in the control group(P<0.01) and so it was with the rates of gastrointestinal toxicities like nausea,vomiting,anorexia in the third cycle of adjuvant chemotherapy(P<0.01). The rate of leukopenia,the hematologic toxicity was significantly lower than that of the control group in the third cycle(P<0.01). During the third cycle,the intake of energy and protein and body weight in the intervention group were significantly improved as compared with the control group(P<0.05). The two dimensions of quality of life,e.g.,physical functioning and physical functioning in the intervention group were scored significantly higher than in the control during the third cycle( P < 0. 01). Conclusions The precision nutrition intervention program during the adjuvant chemotherapy can alleviate the gastrointestinal and hematological toxic reactions and improve the nutrition intake and quality of life of patients with gastric and colorectal cancer. It is beneficial for improving patient compliance and therapeutic efficacy.