膳食指导在食管癌放疗患者中的应用及对患者免疫功能的影响

Application of dietary guidance in patients undergoing radiotherapy for esophageal cancer and its effect on patients’immune function

目的探讨膳食指导在食管癌放疗患者中的应用及对患者免疫功能的影响。方法选取2022年4月至2024年1月南京医科大学附属淮安第一医院收治的102例食管癌放疗患者,按照随机数字表法将其分为研究组和对照组,各51例。对照组给予常规指导,研究组给予膳食指导。两组均持续干预4周,并于4周后观察分析两组并发症总发生率、生活质量、依从性及干预前后免疫功能指标、体重指数、患者参与的主观全面评定(PG-SGA)评分。结果研究组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。干预前,两组生理机能、生理职能、躯体疼痛、精神健康及总体健康生活质量评分比较,差异无统计学意义(P>0.05);干预后,两组生理机能、生理职能、躯体疼痛、精神健康及总体健康生活质量评分高于干预前,且研究组高于对照组,差异有统计学意义(P<0.05)。两组依从性高于对照组,差异有统计学意义(P<0.05)。干预前,两组CD4^(+)、自然杀伤(NK)细胞、CD8^(+)水平比较,差异无统计学意义(P>0.05);干预后,两组NK细胞、CD4^(+)水平高于干预前,CD8^(+)水平较低于干预前,且研究组NK细胞、CD4^(+)水平高于对照组,CD8^(+)水平低于对照组,差异有统计学意义(P<0.05)。干预前,两组PG-SGA评分比较,差异无统计学意义(P>0.05);干预后,两组PG-SGA评分低于干预前,且研究组低于对照组,差异有统计学意义(P<0.05)。结论在食管癌放疗患者中科学运用膳食指导能起到理想作用,可促进患者营养状况、免疫功能改善,依从性及生活质量均得到显著提升,且并发症发生可能性也进一步降低,可推广使用。

Objective To explore the application of dietary guidance in patients undergoing radiotherapy for esophageal cancer and its effect on patients’immune function.Methods A total of 102 cases of esophageal cancer radiotherapy patients admitted to the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University from April 2022 to January 2024 were selected and they were divided into the study group and the control group according to the random number table method,51 cases each.Routine instructions were given to the control group and dietary instructions were given to the study group.Both groups continued the intervention for four weeks and were observed and analysed at the end of four weeks for the total complication rate,quality of life,compliance,and immune function indicators,body mass index,and scored patient-generated subjective global assessment(PG-SGA)scores before and after the intervention in both groups.Results The total complication rate in the study group was lower than in the control group,and the difference was statistically significant(P<0.05).Before intervention,there was no significant difference in physiological function,physical function,physical pain,mental health,and overall health quality of life scores between the two groups(P>0.05).After intervention,the scores of physiological function,physical function,physical pain,mental health,and overall healthy life quality in both groups were higher than before intervention,and the scores in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).The compliance of the study group was higher than that of the control group,the difference was statistically significant(P<0.05).Before intervention,there was no significant difference in the levels of CD4^(+),natural killer(NK)cells,and CD8^(+)between the two groups(P>0.05).After intervention,the levels of NK cells and CD4^(+)in the two groups were higher than before intervention,and the level of CD8^(+)was lower than before intervention,and the level of NK cells and CD4^(+)in the study group was higher than that in the control group,and the level of CD8^(+)was lower than that in the control group,the differences were statistically significant(P<0.05).Before intervention,there was no significant difference in PG-SGA scores between the two groups(P>0.05).After intervention,the PG-SGA score of the two groups was lower than before intervention,and the study group was lower than that of the control group,the differences were statistically significant(P<0.05).Conclusion The scientific application of dietary guidance in patients with esophageal cancer radiotherapy can play an ideal role,which can promote the improvement of nutritional status and immune function of patients,significantly improve compliance and quality of life,and further reduce the possibility of complications,so it can be widely used.