扶阳解毒法联合免疫营养治疗对Ⅲ-Ⅳ期结直肠癌化疗患者癌因性疲乏的疗效观察

Efect of Yang Qi-Reinforcing and Detoxifying Method Combined with Immunonutritional Therapy on Cancer-Related Fatigue in Patients Undergoing Chemotherapy for Stage Ⅲ-Ⅳ Colorectal Cancer

目的观察扶阳解毒法联合免疫营养治疗对Ⅲ-Ⅳ期结直肠癌化疗患者癌因性疲乏(CRF)的疗效。方法采用前瞻性、随机对照的试验设计方法,将60例中晚期结直肠癌化疗的癌因性疲乏患者随机分为观察组、对照组,每组30例。两组均进行姑息性化疗,对照组采用基础营养支持及免疫营养治疗,观察组在基础营养支持及免疫营养治疗的同时联合扶阳解毒法治疗,两组均治疗2个化疗周期。比较两组主要结局指标Piper疲乏量表评分,以及次要结局指标EORTC QLQ-C30生命质量量表及主观全面评定量表(PG-SGA)评分的变化情况。结果(1)组间治疗前后Piper评分差值比较,观察组Piper疲乏量表各维度评分下降均优于对照组(P<0.05)。(2)两组间治疗后比较,观察组在躯体功能、角色功能、情绪功能、认知功能、社会功能、总体健康状况及疲倦、疼痛、恶心呕吐、失眠、食欲丧失方面的改善均优于对照组(P<0.05)。(3)治疗后两组PG-SGA评分均较治疗前下降(P<0.05),且观察组下降较对照组更为显著(P<0.05)。(4)在总体人群中,治疗前后PG-SGA量表总分变化与Piper量表总分变化呈现明显正相关,即随着PG-SGA量表评分的下降,Piper量表评分也随之下降,且具有统计学差异(P<0.05)。结论扶阳解毒法联合免疫营养治疗可有效减轻中晚期结直肠癌化疗患者的CRF,并改善营养状态,提高生活质量。

Objective To observe the effect of yang qi-reinforcing and detoxifying method combined with immunonutritional therapy on cancer-related fatigue in the patients undergoing chemotherapy for stage III–IV colorectal cancer.Methods A prospective,randomized,and controlled trial design was employed.Specifically,60 patients with cancer-related fatigue after chemotherapy for stage III–IV colorectal cancer were randomized into an observation group and a control group,with 30 patients in each group.Both groups received palliative chemotherapy.The control group received basic nutrition support and immunonutritional therapy.The observation group received basic nutrition support and immunonutritional therapy in combination with yang qi-reinforcing and detoxifying therapy.Both groups received two chemotherapy cycles.The Piper Fatigue Scale(PFS)score,European Organization for Research and Treatment of Cancer Quality of Life questionnaire-C30(EORTC QLQ-C30)score,and Patient-Generated Subjective Global Assessment(PG-SGA)score were compared between the two groups.Results①The observation group showed a larger decrease in the PFS score after treatment than the control group(P<0.05).②After treatment,the observation group outperformed the control group in terms of physical functioning,role functioning,emotional functioning,cognitive functioning,social functioning,and global health status and in alleviating fatigue,pain,nausea of vomiting,insomnia,and loss of appetite(P<0.05).③The PG-SGA scores of the two groups decreased after treatment(P<0.05),and the decrease of the observation group was more signifcant than that of the control group(P<0.05).④In the whole population,the total change in PGSGA score before and after treatment was positively correlated with the total change in PFS score.That is,with the decrease in PG-SGA score,the PFS score also decreased(P<0.05).Conclusion Yang qi-reinforcing and detoxifying method combined with immunonutritional therapy can alleviate the cancer-related fatigue and improve the nutritional status and quality of life in the patients undergoing chemotherapy for stage III–IV colorectal cancer.