肺康复教育与运动指导对肺癌化疗患者生活质量和疲劳的影响研究

关键词：肺癌  肺康复教育  运动  化疗  疲劳  生活质量

Keywords:lung cancer  pulmonary rehabilitation education  exercise  chemotherapy  fatigue  quality of life

摘要：

      摘要 目的：研究肺康复教育与运动指导对化疗肺癌患者生活质量和疲劳的影响，同时观察患者情绪的变化。 方法：采用前瞻性对照试验，将74例患者分为干预组（34例）和对照组（40例）。对照组患者使用常规治疗，干预组患者在常规治疗基础上进行肺康复教育（包括戒烟戒酒、饮食、心理指导等宣教）及运动指导。在基线、3周和6周时对患者进行量表评估，使用量表包括欧洲癌症研究治疗组织核心生活质量问卷及肺癌特异量表（EORTC QLQ-C30、EORTC QLQ-LC13）、多维疲劳量表（MFI-20）、抑郁自评量表（SDS）和焦虑自评量表（SAS）。对两组患者3周与基线的差值，6周与基线的差值进行比较。 结果：通过对两组3周与基线的差值分析比较发现，两组在QLQ-C30和QLQ-LC13中失眠、恶心呕吐、便秘、腹泻得分差值及MFI-20中综合疲劳、体力疲劳、活动减少得分差值具有显著性差异（P<0.05），对两组6周与基线的差值分析比较发现，两组QLQ-C30和QLQ-LC13中躯体功能、失眠、恶心呕吐、便秘、腹泻得分差值及MFI-20中体力疲劳和活动减少得分差值有显著性差异（P<0.05）。 结论：肺康复教育及运动指导对肺癌化疗患者生活质量和疲劳有一定影响，患者部分症状有好转或减缓恶化的现象，具有推广价值，但仍需进一步扩大样本量并延长评估和观察时间。

Abstract:

      Abstract Objective： To study the effects of pulmonary rehabilitation education (PRE) and exercise guidance on the quality of life， fatigue， anxiety and depression levels of lung cancer patients who were undergoing chemotherapy. Method： Seventy-four patients were divided into intervention group (34 cases) and control group (40 cases) in a prospective controlled trial. The control group received routine treatment， while the intervention group received PRE (including smoking and drinking cessation， diet and psychological education) and exercise guidance on the basis of routine treatment. Participants were assessed at baseline， 3 weeks and 6 weeks throughout the whole study. The measure questionnaires included the European Organization for Research and Treatment of Cancer Quality of Life， Core 30 and Lung cancer module (EORTC QLQ-C30， EORTC QLQ-LC13)， Multidimensional Fatigue Inventory-20 (MFI-20)， Self-rating Depression Scale (SDS)， Self-rating Anxiety Scale (SAS). Statistical analysis was conducted between the two groups on the score difference between 3 weeks and baseline as well as the difference between 6 weeks and baseline. Result： By comparing the difference between the two groups at 3 weeks and the baseline， it was found that the difference between the scores of insomnia， nausea， vomiting， constipation and diarrhea in QLQ-C30 and QLQ-LC13， and the difference between the scores of comprehensive fatigue， physical fatigue and activity reduction in MFI-20 were statistically significant(P<0.05). The difference analysis between the two groups at 6 weeks and baseline showed that the difference between the scores of body function， insomnia， nausea， vomiting， constipation and diarrhea in QLQ-C30 and QLQ-LC13 and the difference between the scores of physical fatigue and activity reduction in MFI-20 were statistically significant (P<0.05). Conclusion： PRE and exercise guidance have a certain impact on the quality of life and fatigue of patients with undergoing chemotherapy for lung cancer， and some of the symptoms of patients have improved or slowed down the phenomenon of the deterioration， which has the promotion value. But it still needs to further expand the sample size and extend the evaluation and observation time.