量化不同等级步行运动在原发性肺癌化疗患者中的应用

Application of quantitative walking exercise at different levels in patients with primary lung cancer undergoing chemotherapy

目的探讨量化不同等级步行运动对原发性肺癌化疗患者的影响。方法采用便利抽样法,选取于2020年4—12月在郑州大学第一附属医院接受规律化疗的184例肺癌患者为研究对象。按照随机数字表法将患者分为对照组(n=46)、步行低量组(n=46,5000~7499步/d)、步行中量组(n=46,7500~9999步/d)及步行高量组(n=46,10000~12500步/d)。化疗期间,对照组采取常规管理,观察组在对照组基础上采取量化不同等级步行运动管理。采用Piper疲乏修正量表(PFS-R)和安德森症状评估量表(MDASI)比较4组患者癌性疲乏和症状群得分差异。结果184例患者中有5例未完成全部研究,最终对照组44例、步行低量组46例、步行中量组44例、步行高量组45例完成研究,各组平均每日步行运动量分别为(3769.58±541.62)、(6233.05±472.46)、(7934.81±502.49)、(11103.57±384.25)步/d。化疗期间4组患者PFS-R和MDASI得分存在组间、时间以及组间和时间的交互效应(P<0.05)。化疗期间对照组在不同时间点PFS-R和MDASI得分均高于其余3个不同步行量组,差异有统计学意义(P<0.05);第2次化疗期间,步行低、中、高量组PFS-R和MDASI得分比较差异均无统计学意义(P>0.05);第4次化疗期间,步行低量组PFS-R和MDASI得分较步行中、高量组高,差异有统计学意义(P<0.05);第6次化疗期间,步行低、中、高量组PFS-R和MDASI得分比较差异均有统计学意义(P<0.05)。结论步行运动能有效缓解肺癌化疗患者癌性疲乏和症状群,推荐中等步行数量为最宜步行锻炼量。

Objective To explore effects of quantitative different levels of walking exercise on patients with primary lung cancer undergoing chemotherapy.Methods The convenient sampling method was used to select 184 lung cancer patients who received regular chemotherapy in the First Affiliated Hospital of Zhengzhou University from April to December 2020.Patients were divided into the control group(n=46),low-volume walking group(n=46,5000 to 7499 steps per day),medium-volume walking group(n=46,7500 to 9999 steps per day)and high-volume walking group(n=46,10000 to 12500 steps per day)according to random number table method.During chemotherapy,the control group took routine management,while the observation group took quantitative walking exercise management of different levels on the basis of the control group.Piper Fatigue Scale-Revised(PFS-R)and M.D.Anderson Symptom Inventory(MDASI)were used to compare scores of cancer fatigue and symptom clusters among the four groups.Results Among 184 patients,5 patients did not complete the whole study.Finally,44 patients were in the control group,46 in the low-volume walking group,44 in the medium-volume walking group and 45 in the high-volume walking group.The average daily walking amount of every group was respectively(3769.58±541.62),(6233.05±472.46),(7934.81±502.49)and(11103.57±384.25)steps/day.The PFS-R and MDASI scores of the four groups during chemotherapy had interaction effects between groups,time and between groups and time(P<0.05).During chemotherapy,the scores of PFS-R and MDASI in the control group at different time points were higher than those in the three different walking groups,and the differences were statistically significant(P<0.05).There was no statistically significant difference in PFS-R and MDASI scores among low-volume,medium-volume and high-volume walking groups during the second chemotherapy(P>0.05).During the fourth chemotherapy,the PFS-R and MDASI scores of the low-volume walking group were higher than those of the middle-volume and high-volume walking groups,and the differences were statistically significant(P<0.05).During the sixth chemotherapy,the differences in PFS-R and MDASI scores among the low-volume,medium-volume and high-volume walking groups were statistically significant(P<0.05).Conclusions Walking exercise can effectively alleviate cancer fatigue and symptom clusters in patients with lung cancer undergoing chemotherapy.It is recommended that moderate walking amount is the most suitable amount of walking exercise.