中医悦动操对消化道恶性肿瘤患者癌因性疲乏、生存质量及免疫功能的影响

Influence of Chinese medical pleasure gymnastics on cancer- related fatigue, quality of life and immune function in patients with gastrointestinal malignant tumors

目的:观察中医悦动操对消化道恶性肿瘤患者癌因性疲乏(CRF)、生存质量及免疫功能的影响。方法:纳入消化道恶性肿瘤(胃癌或大肠癌)CRF患者80例,随机分为悦动操组和对照组,每组各40例。两组患者均给予恶性肿瘤常规治疗,在此基础上,悦动操组患者进行悦动操锻炼,对照组患者进行慢走锻炼,两组干预时间均为6个月。比较两组患者的Karnofsky功能状态(KPS)评分及变化,分别采用Piper疲乏量表(PFS)、欧洲癌症研究与治疗组织生存质量问卷(EORTC QLQ-C30)评价患者的CRF程度和生存质量,检测并比较两组患者的血清CD3^+、CD4^+、CD8^+ T细胞水平及CD4^+/CD8^+比值。结果:干预后,两组患者的KPS评分均升高(P<0.05,P<0.01),且悦动操组患者的KPS评分高于对照组(P<0.01);干预后,两组患者的KPS评分变化情况比较,差异有统计学意义(P<0.05),悦动操组患者的KPS评分变化情况优于对照组。干预后,两组患者PFS的感觉、认知、情绪、行为评分及总分较干预前均降低(P<0.05),且悦动操组患者的PFS各方面评分及总分均低于对照组(P<0.05)。干预后,两组患者的EORTC QLQ-C30功能领域中躯体功能、角色功能、情绪功能评分及总体健康状况评分均升高(P<0.05),且悦动操组患者的上述各项目评分均高于对照组(P<0.05);两组患者的症状领域及健康状况各项目评分均降低(P<0.05),且悦动操组患者的上述各项目评分均低于对照组(P<0.05)。干预后,悦动操组患者的CD3^+、CD4^+、CD8^+、CD4^+/CD8^+水平均升高(P<0.05),对照组患者干预前后的各免疫指标水平比较,差异均无统计学意义(P>0.05);且悦动操组患者的CD3^+、CD4^+、CD4^+/CD8^+水平均高于对照组(P<0.05)。结论:中医悦动操配合常规治疗能够有效缓解消化道恶性肿瘤患者的CRF,提高其生存质量,改善患者的免疫功能。

Objective:To observe the influence of Chinese medical pleasure gymnastics on cancer-related fatigue(CRF),quality of life and immune function in patients with gastrointestinal malignant tumors.Methods:A total of 80 patients of gastrointestinal malignant tumors(gastric cancer or colorectal cancer)with CRF were included,and randomly divided into the pleasure gymnastics group and control group,40 cases in each group.The patients in both groups were treated with conventional therapy for malignant tumors,on this basis,the patients in the pleasure gymnastics group were treated with pleasure gymnastics training,and the patients in the control group were treated with slow-walking training,with a course of 6 months.The Karnofsky performance status(KPS)score and its change were compared between the two groups,the CRF and the quality of life were assessed by Piper fatigue scale(PFS)and European Organization for Research and Treatment of Cancer-quality of life questionnaire(EORTC QLQ-C30)respectively,and the serum levels of CD3^+,CD4^+,CD8^+T cells and the ratio of CD4^+to CD8^+were detected and compared between the two groups.Results:After intervention,the KPS scores in both groups were increased(P<0.05,P<0.01),and the KPS score in the pleasure gymnastics group was higher than that in the control group(P<0.01).After intervention,there was statistically significant difference on the changes of KPS score between the two groups(P<0.05),and the changes of KPS score in the pleasure gymnastics group were superior to those in the control group.After intervention,the scores of feeling,cognition,emotion and behavior and the total scores of PFS were decreased in both groups compared with before intervention(P<0.05),and the scores of all aspects and the total scores of PFS in the pleasure gymnastics group were lower than those in the control group(P<0.05).After intervention,the scores of physical function,role function and emotional function in the functional area and the overall health status score of EORTC QLQ-C30 were increased in both groups(P<0.05),and the scores of above items in the pleasure gymnastics group were higher than those in the control group(P<0.05);the scores of all items in the symptom area and health status were decreased in both groups(P<0.05),and the scores of above items in the pleasure gymnastics group were lower than those in the control group(P<0.05).After intervention,the levels of CD3^+,CD4^+,CD8^+and CD4^+/CD8^+in the pleasure gymnastics group were increased(P<0.05),and there were no statistically significant differences on the levels of immunological indicators in the control group between before and after intervention(P>0.05);the levels of CD3^+,CD4^+and CD4^+/CD8^+in the pleasure gymnastics group were higher than those in the control group(P<0.05).Conclusion:Chinese medical pleasure gymnastics combined with conventional therapy can effectively alleviate CRF,enhance the quality of life and improve the immune function in patients with gastrointestinal malignant tumors.