Observation of Curative Effect of Surgical Nursing in Patients with Grade III Hand-Foot Syndrome

Objective: To investigate the effect of surgical nursing on grade III Hand-Foot Syndrome (HFS) induced by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery. Method: From January 2019 to December 2019, 10 patients with HFS grade III caused by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery in the Breast Department of Cancer Prevention and Treatment Center of Sun Yat-sen University were selected, and surgical nursing methods were used to intervene and observe the therapeutic effects of the patients. Results: One patient was cured within 7 days, the cure rate was 10% in 7 days, 8 patients were cured within 10 days, the cure rate was 80% in 10 days, 10 patients were cured within 15 days, the cure rate was 100% in 15 days. Conclusion: The surgical nursing method is effective for patients with grade III HFS caused by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery, shortening the treatment time of HFS, and is worthy of clinical promotion.

The Comparative Study on Two Models of Syndrome Differentiation of the Hand, Foot and Mouth Disease: An Investigation Analysis of the Signs and Symptoms on 2325 Cases

Objective To realize the characteristics of "zheng" differentiation-treatment for hand, foot and mouth disease(HFMD), a new methodology of syndrome differentiation for different stages of HFMD has been explored. Methods Total of 2 325 cases with HFMD were recorded by distributing them into exterior syndrome stage, interior syndrome stage, severe syndrome stage and recovered syndrome stage, respectively, and the main symptoms and subsidiary symptoms of different stages of HFMD have been observed. The major and minor pathogenesis of HFMD in different stages were obtained, and compared with the "2010 Guideline for the Diagnosis and Treatment of HFMD". Results It was found that the major pathogenesis of exterior stage was defined as "the invation of the wenevil to the defender of the body with the collaterals got involved ", and the minor as "qi deficiency"; in interior stage, "the fury of Gan-Yang" was the main pathogenesis, and "qi in chaos and qi deficiency" was the minor; in severe syndrome stage, "the damage of heart, liver and lung" was the main pathogenesis, and "qi in chaos" was the minor; and the pathogenesis of recovered stage was "qi-yin deficiency". Compared with the "2010 Guideline for the Diagnosis and Treatment of HFMD", it showed that "the obstruction of the fei-pi qi by the mixture of shi-re evil" and "the mixture of shi-re" in vivo was quite difficult to be explained in completely different context in the general situation; in the severe stage, the TCM clinical characteristics of syndrome differentiation might lose; in the early acute severe cases, the phenomenon that xin-yang and fei-qi almost ran out was difficult to be observed, then, the line between the severe and the acute severe became vague.Conclusions The theory of syndrome differentiation by stages of HFMD was reasonable in the actual situation of clinical description on HFMD which was expected to be further tested and widely applied in the "zheng" differentiation-treatment of HFMD in the future.

Regional characteristics and spatiotemporal differentiation of the prevalence of hand, foot, and mouth disease in Xinjiang, China

In recent years,the number of hand,foot,and mouth disease(HFMD)cases in China has continued to grow,and the disease has become a serious public health issue.Xinjiang Uygur Autonomous Region is located in the arid areas of Northwest China,where the epidemiological trend of HFMD is gradually increasing and characterized by geographical heterogeneity.In this study,based on the HFMD case data in all counties and cities in Xinjiang,we employed statistical and GIS spatial analyses,and geographic probe models to characterize the spatiotemporal differentiation of HFMD epidemics in Xinjiang during the period of 2009–2018,and quantitatively analyzed the factors influencing the spatial differentiation of HFMD epidemics.The results showed that HFMD incidence rate in Xinjiang had non-stationary temporal characteristics on the interannual and monthly scales,and the monthly variation characteristics of HFMD epidemic were quite different in southern and northern Xinjiang.The spatial distribution characteristics of HFMD epidemics showed a north–south spatial differentiation pattern with the Tianshan Mountains as the boundary;cold spot and hot spot of HFMD epidemics in Xinjiang have shifted from scattered to concentrated,and the spatial differentiation pattern had gradually stabilized.Moreover,the dominant factors influencing the spatial differentiation of HFMD epidemics in Xinjiang were socioeconomic factors,such as per capita GDP and urbanization rate,while the basic factors affecting its spatial differentiation were natural environmental factors.The spatial differentiation and evolution patterns of HFMD epidemics differed between northern and southern Xinjiang.Specifically,the leading role of socioeconomic factors is more obvious in southern Xinjiang than in northern Xinjiang,while natural environmental factors(e.g.,dryness and relative humidity)contribute to the prevalence of HFMD epidemics in northern Xinjiang,and the perturbing effect of these factors was more prominent than other factors.The results of this study can provide a scientific basis for the prevention of HFMD epidemics and early warning of HFMD epidemics in Xinjiang.

Relationship between Self-Care and Hand Foot Syndrome Specific Quality of Life in Cancer Patients

Purpose: The purpose of this study was to describe adherence to self-care for hand-foot syndrome (HFS) and the relationship between self-care and health-related quality of life (QOL). Methods: A cross-sectional study was conducted on 105 consecutive outpatients with HFS. To assess self-care for HFS and QOL, the participants were asked to complete self-care and HFS-14 (hand-foot syndrome specific QOL) questionnaires, respectively. Multiple regression models were used to identify the relationship between self-care and QOL. Results: Adherence to self-care for HFS was low, less than 50% for most of the items. Multivariate analysis revealed that poorer self-care (βs = -0.19;P = 0.03), depressive symptoms (βs = 0.43;P βs = 0.20;P = 0.04) were independent predictors of poorer QOL scores. Conclusions: We have identified a need for further research to develop effective programs of self-care in HFS.

Evaluation of the Preventive Effect of Regional Cooling Nursing on Hand Foot Syndrome Caused by Doxorubicin Hydrochloride Liposome

Purpose: To explore the preventive effect of Regional cooling comprehensive nursing on hand foot syndrome caused by pegylated liposomal doxorubicin (PLD). Method: Adopt overall sampling method. Patients who used the same adjuvant drugs from January to December 2020 were randomly divided into an intervention group and a control group. The patients in the two groups received routine nursing guidance and drug prevention for the use of amygdalin. The patients in the intervention group were required to take protective measures of Regional cooling during chemotherapy. The occurrence of hand foot syndrome during adriamycin liposome administration was compared between the two groups. Results: By comparing the adverse reactions of cases during Adriamycin Administration, the incidence rates of grade I, II and III hand foot syndrome in the control group were 28.8%, 7.6% and 27.5% respectively, and the incidence rates of grade I, II and III hand foot syndrome in the intervention group were 42.1%, 12.3% and 7.0% respectively, with statistical significance (P Conclusion: Regional cooling nursing and preventive behavior guidance can effectively reduce the severity of hand foot syndrome caused by adriamycin.

Pazopanib Induced Hand-Foot Syndrome in a Patient Previously Treated with Sunitinib: A Possible Cumulative Skin Toxicity?

Hand-foot syndrome (HFS), also known as palmar-plantar erythrodysesthesia, is a skin toxicity that could be observed during target therapies such as with tyrosine-kinase inhibitors (TKI). It usually develops within the first 2 - 4 weeks of drug administration. We present a case of HFS induced by Pazopanib after 2 months of treatment, in patients previously treated with Sunitinib, suggesting a possible cumulative toxicity of two drugs. The clinical and therapeutic management of skin adverse reactions during TKI therapy usually requires 25% dose reduction and adequate local treatment. It is important for the clinicians to recognize clinical signs and symptoms of such skin toxicities. Attention should be paid especially when two or more drugs from the same class are used in combined treatment.

Quantitative and Qualitative Investigation of Traditional Chinese Medicine Nursing Protocols for Type 2 Diabetes Mellitus

Objective:To analyze the implementation status of traditional Chinese medicine(TCM)nursing protocols for type 2 diabetes mellitus.Methods:Totally 420 hospitalized patients with type 2 diabetes mellitus were given TCM nursing protocols by syndrome differentiation.A quantitative and qualitative investigation was conducted to patients who received TCM nursing and nurses who performed TCM nursing techniques.Results:According to the self-evaluation outcomes of patients,TCM nursing protocols were effective to relieve polydipsia,polyuria,fatigue and other symptoms.Patients exhibited a high level of compliance with nursing techniques such as auricular point pressing,acupoint massage,Chinese herbal foot-bath and moxibustion.The interview showed that patients could benefit from the TCM nursing protocols,and nurses considered that application of TCM nursing protocols could enhance their awareness of TCM knowledge and practice skills.Conclusion:The application of TCM nursing protocols is effective to relieve clinical symptoms of type 2 diabetes mellitus.It can also improve the knowledge level and practice skills of nurses in TCM hospitals.

Indicators of sorafenib efficacy in patients with advanced hepatocellular carcinoma

AIM: To determine significant indicators for the efficacy of sorafenib in patients with advanced hepatocellular carcinoma (HCC).

当归饮子加减联合穴位艾灸治疗乳腺癌化疗后手足综合征临床效果探究

目的探究当归饮子加减联合穴位艾灸治疗乳腺癌化疗后手足综合征(hand-foot syndrome,HFS)临床效果。方法选取2022年1月—2023年1月该院收治的115例乳腺癌化疗后HFS作为研究对象,按照治疗方法分为当归饮子组59例及常规治疗组56例,常规治疗组给予维生素B_(6)+尿素软膏常规治疗,当归饮子组常规治疗组基础上加用当归饮子加减方联合穴位艾灸治疗,比较两组患者临床疗效、中医证候积分、疼痛评分[现时疼痛强度(present pain intensity,PPI)]、血清水平[超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)]、生活质量[HFS生活质量量表(HRQL)]。结果治疗后,当归饮子组总有效率94.92%(56/59)高于常规治疗组82.14%(46/56)(P<0.05);治疗后,两组皮肤暗淡、皲裂脱屑、皮肤干燥、疼痛瘙痒评分均有所降低,且当归饮子组低于常规治疗组(P<0.05);治疗后,两组现时疼痛强度PPI评分均有所降低,且当归饮子组低于常规治疗组(P<0.05);治疗后,两组hs-CRP有所降低,且当归饮子组低于常规治疗组(P<0.05);治疗后,两组HRQL生活质量评分均有所降低,且当归饮子组低于常规治疗组(P<0.05)。结论当归饮子加减联合穴位艾灸治疗乳腺癌化疗后HFS能够取得良好的治疗效果,能够有效缓解中医证候,减轻患者现时疼痛,改善患者生活质量。

中医辨证施护在糖尿病高危足病人中的干预效果

目的:观察中医辨证施护应用于糖尿病高危足的效果。方法:选取2021年10月—2022年12月医院收治的100例糖尿病高危足病人作为研究对象,按随机数字表法将其分为对照组、观察组,每组50例,对照组实施常规护理干预,观察组在常规护理的基础上给予中医辨证施护干预,比较两组病人中医证候积分、糖尿病足发生率、心理状态[心理弹性量表(CD-RISC)评分]、自我效能[自我效能量表(CDSES)评分]。结果:干预后观察组病人肢体麻木、蚁行感、肢末刺痛、失眠心烦中医证候积分均低于对照组(P<0.05);观察组病人糖尿病足发生率为6.00%,低于对照组的20.00%(P<0.05);干预后观察组病人CD-RISC量表各维度评分、总分及CDSES量表各维度评分均高于对照组(P<0.05)。结论:中医辨证施护可有效改善糖尿病高危足病人的中医证候积分,调节病人情绪状态,提高病人的自我效能,从而减少糖尿病足发生的风险。

基于文献数据挖掘的糖尿病足中医用药规律研究

目的:探讨中药治疗糖尿病足(Diabetic Foot,DF)内服方剂常用药物的用药特点和组方规律,为中医临床治疗DF提供参考依据。方法:检索数据库近10年中医内治糖尿病足含处方文献,提取处方信息并建立处方数据库,通过统计分析软件对中药治疗DF用药规律进行分析。结果:查阅含中药治疗糖尿病足内治处方文献154篇,可用处方118首,涉及中药199味。经频率分析得出6味高频(≥20%)用药。关联规则分析得出2味中药相关的有6条、3味中药相关的有14条、4味中药相关的有3条。结论:糖尿病足中医内治以“活血、补气、行气、清热、止痛”为基础;针对气阴两虚、脉络瘀阻型糖尿病足中医内治以“行气活血、化瘀止痛”为主。

多柔比星脂质体诱发手足综合征的研究进展

尽管多柔比星脂质体是一种有效的抗癌药物,但其引发的手足综合征(HFS)对患者的生活质量和治疗依从性构成了显著影响。近年来,关于其机制的深入研究和新的管理策略的开发为改善患者的治疗体验提供了新的希望。本研究旨在探讨多柔比星脂质体诱发HFS的机制、治疗方法以及未来研究方向的最新进展。

手足综合征的中西医防治概况

手足综合征是肿瘤患者接受化疗或分子靶向治疗后出现的特异性皮肤毒性反应,以手足皮肤红肿、疼痛、脱屑、溃疡,伴麻木、疼痛等感觉异常为特点。手足综合征的中医疗法以口服汤药、中药浸洗为主,辅以针灸等非药物手段;西医疗法则以药物对症处理为主,如控制炎症、改善血供,同时配合健康宣教、剂量控制等综合措施。研究发现,中西医防治手足综合征存在相似的作用机制,中西医联合治疗手足综合征有望成为一种可靠选择。参考文献69篇。

国医大师王晞星教授从“脏腑气血”论治手足综合征经验

手足综合征是肿瘤患者经化学药物或靶向药物治疗后导致的药毒反应,王晞星教授认为其主要病位责之于肺、脾、肾三脏,与脏腑虚损、气血不足密切相关,提出“辨其脏腑,和其气血”的治疗原则,临床诊疗中效如桴鼓。对王晞星教授辨治手足综合征的临证经验进行总结,以供同道参考。

不同温度的间断性手足低温疗法对乳腺癌化疗致外周神经毒性的干预效果

目的:探讨不同温度的间断性手足低温疗法对乳腺癌病人紫杉类药物诱导的外周神经毒性(CIPN)、手足综合征(HFS)和生活质量的干预效果。方法:选取2022年8月—2023年5月在唐山市某三级甲等医院收治的72例乳腺癌病人作为研究对象,随机分为试验1组和试验2组,每组36例。两组化疗期间均给予间断性手足低温疗法,每次输注紫杉类药物前后15 min,试验1组与试验2组分别佩戴-10~0℃与-30~-20℃冷冻手套和脚套,于干预前、干预2、4、6个周期后测评CIPN、HFS和生活质量的差异性及低温疗法的耐受性和安全性。结果:试验2组在干预4、6个周期后CIPN和HFS发生率及严重程度均低于试验1组,躯体功能、情绪功能、社交功能、总体健康状况、疲劳、失眠评分差值均低于试验1组,差异均有统计学意义(均P<0.05)。两组病人均无因不能耐受而退出试验者。结论:温度较低的间断性手足低温疗法更能有效预防CIPN和HFS发生及严重程度,提高病人生活质量。

手足皮肤不良反应的中医辨治思路探析

手足皮肤不良反应(HFS/HFSR)是抗肿瘤药物常见的皮肤毒性反应,影响患者抗肿瘤治疗进程和日常生活质量。中医学认为手足皮肤不良反应属于“窩疮”“浸淫疮”“血痹”等范畴,通过临床观察及查阅古籍、医案,手足皮肤不良反应根据不同的临床症状辨证,可分为气滞血瘀、热毒瘀积、血虚风燥、阳虚血瘀四个证型。论述手足皮肤不良反应的中医病因病机及辨治思路,予内服外治治疗,可取得较好的疗效。

赛肤润在抗肿瘤靶向药物所致手足综合征表皮损伤防护中的应用

目的:探讨赛肤润在抗肿瘤靶向药物所致手足综合征(Hand-foot syndrome,HFS)表皮损伤中的应用效果及其对美观性的影响。方法:按照随机数字表法将2021年6月-2022年12月笔者医院收治的90例抗肿瘤靶向药物所致HFS患者分为对照组与观察组,每组45例。对照组患者采用尿素软膏进行治疗,观察组采用赛肤润进行治疗,两组均连续治疗14 d。比较两组手足综合征相关症状评分(HFS评分)、疼痛视觉模拟评分(Visual analogue scale,VAS)、卡氏功能状态评分(Karnofsky performance stat,KPS)、皮肤病生活质量量表指数(Dermatology life quality index,DLQI)、CD3^(+)及CD4^(+)比例、美观满意度、不良反应。结果:治疗后,观察组KPS评分明显高于对照组(P<0.05),HFS评分、VAS疼痛评分、DLQI评分均明显低于对照组(P<0.05);观察组美观满意度明显高于对照组(P<0.05)。结论:赛肤润在抗肿瘤靶向药物所致HFS表皮损伤中应用效果明显,能有效改善相关症状,缓解疼痛,提高患者生活质量及美观满意度,安全性好。

手足综合征中医研究进展

手足综合征(HFS)是恶性肿瘤治疗中常见的不良反应之一,随着抗肿瘤药物的广泛使用,其发病率逐渐升高。HFS严重影响患者日常社交、生活,甚至导致药物减量或提前停药,延误治疗。现代医学对其病因及发病机制认识尚未完全明确,疗效评价缺乏统一标准,且针对性系统治疗方法效果较差。中医学将HFS归属于“血痹”范畴,认为其病位在手足,以虚为主,本虚标实,虚实夹杂,治疗具有显著优势。现梳理近年来中医药治疗HFS相关文献,从病因病机和辨证论治方面总结中医药治疗现状,中医药临床将其分为内治法、外治法和内外合治法,以期为今后中医药治疗HFS提供临床依据和参考。

手足口病与相似疾病鉴别模型构建研究

目的/意义建立手足口病与相似疾病鉴别模型总体架构,有效促进传染病防控并推动智慧公共卫生体系建设。方法/过程通过查阅文献资料确定需与手足口病进行鉴别的疾病及其鉴别要点,通过Meta分析对某一症状与疾病的特异性关联程度赋值,构建基于相似度算法的鉴别模型。结果/结论实现对手足口病的早期和大规模监测预警,为进一步提升手足口病的智能化识别、诊断、预警水平提供帮助。

甘露消毒丹联合苦黄散治疗手足口病肺脾湿热蕴毒证的临床效果

目的观察甘露消毒丹联合苦黄散治疗手足口病肺脾湿热蕴毒证的临床效果。方法选取2022年1月—2023年12月广西中医药大学附属梧州市中医医院儿科住院及门诊诊断为手足口病肺脾湿热蕴毒证患儿200例,采用随机数字表法分为研究组和对照组,各100例。对照组予常规西医治疗,研究组在对照组基础上予甘露消毒丹联合苦黄散治疗,2组疗程均为5~7 d。比较2组临床效果、体温恢复正常时间、皮疹消退时间,治疗前后肝功能指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBil)]、肾功能指标[尿素氮(BUN)、肌酐(Cr)]、空腹血糖(FPG)、心肌酶[肌酸激酶(CK)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBD)、肌酸激酶同工酶(CK-MB)]水平及血常规[白细胞计数(WBC)、淋巴细胞绝对值(LYM)、中性粒细胞绝对值(GRAN)、血小板(PLT)]。结果研究组总有效率为86.00%,高于对照组的74.00%(χ^(2)=4.500,P=0.034);研究组体温恢复正常时间及皮疹消退时间均短于对照组(P<0.01)。治疗5~7 d后,2组ALT、AST、TBil水平低于治疗前,且研究组ALT、AST水平低于对照组(P<0.05或P<0.01),2组TBil水平比较差异无统计学意义(P>0.05)。治疗前后,2组BUN、Cr、FPG水平组内、组间比较差异均无统计学意义(P>0.05)。治疗5~7 d后,2组CK及WBC水平低于治疗前,且研究组低于对照组(P<0.01);2组LDH、α-HBD、CK-MB及LYM、GRAN、PLT组内、组间比较差异均无统计学意义(P>0.05)。结论甘露消毒丹联合苦黄散应用于手足口病肺脾湿热蕴毒证治疗中可提高疗效,缩短患儿体温恢复正常时间、皮疹消退时间,改善患儿肝功能。