沙利度胺联合醋酸甲地孕酮在晚期恶性肿瘤相关恶病质的应用效果

Application effect of Thalidomide combined with Megestrol Acetate in the treatment of advanced malignant tumor associated cachexia

目的比较沙利度胺联合醋酸甲地孕酮与醋酸甲地孕酮治疗晚期恶性肿瘤相关恶病质的疗效,评价联合治疗在恶病质治疗中的作用。方法选取2018年9月至2021年12月南平市第一医院收治的97例晚期恶性肿瘤患者作为研究对象,采用随机数字表法分为治疗组(49例)和对照组(48例)。治疗组给予沙利度胺联合醋酸甲地孕酮治疗,对照组给予醋酸甲地孕酮治疗。两组患者均配合最佳营养支持治疗。治疗2个月后,分别比较两组患者治疗前后的疲劳程度、体重变化、生活质量(QOL)、握力、体力状态(PS)评分及不良反应,比较两组患者治疗前后的血红蛋白(HGB)、总蛋白(TP)及白蛋白(ALB)水平。结果治疗2个月后,治疗组的QOL及高于对照组,PS评分低于对照组,差异有统计学意义(P<0.05)。治疗2个月后,治疗组的HGB、TP高于对照组,差异有统计学意义(P<0.05)。两组的疲劳程度、体重及握力比较,差异无统计学意义(P>0.05)。治疗组头晕、便秘及口干发生率高于对照组,差异有统计学意义(P<0.05)。两组的嗜睡、水肿及深静脉血栓发生率比较,差异无统计学意义(P>0.05)。结论沙利度胺联合甲地孕酮可改善晚期恶性肿瘤相关恶病质患者的QOL及PS评分,提高HGB、TP及ALB水平,不良反应可耐受。

Objective To compare the efficacy of Thalidomide combined with Megestrol Acetate and Megestrol Acetate alone in the treatment of advanced malignant tumor associated cachexia,and evaluate the effect of combined medication in the treatment of cachexia.Methods A total of 97 patients with advanced malignant tumors admitted to Nanping First Hospital from September 2018 to December 2021 were selected as the study subjects.They were divided into the treatment group(n=49)and the control group by random number table method(n=48).In the treatment group,patients were treated with Thalidomide combined with Megestrol Acetate,while in the control group,Megestrol Acetate alone was used.Both groups of patients were provided with optimal nutritional support.After two months of treatment,the fatigue degree,weight change,quality of life(QOL),grip strength,physical state(PS)scores and adverse reactions of the two groups before and after treatment were compared.The levels of hemoglobin(HGB),total protein(TP)and albumen(ALB)of the two groups before and after treatment were compared.Results After two months of treatment,the QOL of the treatment group was higher than that of the control group,the PS score was lower than that of the control group,with statistically significant differences(P<0.05).After two months of treatment,and the nutritional indicators such as HGB,TP were higher than that of the control group,with statistical significances(P<0.05).There were no significant differences in fatigue degree,weight,or grip strength between the treatment group and the control group before and after treatment(P>0.05).The incidence rates of dizziness,constipation,and dry mouth of the treatment group were higher than those of the control group,with statistically significant differences(P<0.05).There were no differences in the incidence rates lethargy,edema,and deep vein thrombosis between the two groups(P>0.05).Conclusion Thalidomide combined with Megestrol can improve the QOL and PS scores of patients with advanced malignant tumor associated cachexia,and increase the levels of HGB,TP,and ALB.The adverse reactions are tolerable.