220例肺癌患者胸部放疗结束时的症状负担和症状群研究  

Study of Symptom Burden and Symptom Clusters at the End of Thoracic Radiotherapy in 220 Patients with Lung Cancer

作　　者：宋丽君 刘杰[1] 任似梦 马雪娇 原苏芮 李道睿[1] Song Lijun;Liu jie;Ren Simeng;Ma Xuejiao;Yuan Surui;Li Daorui(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《世界科学技术-中医药现代化》2023年第6期2140-2146,共7页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：中央保健科研课题(2021TB02):中医用药治疗肺小结节疗效评价,负责人:林洪生;北京市科学技术委员会首都临床特色应用研究(Z181100001718175):外用中药预防放射性皮肤损伤的临床研究,负责人:刘杰。

摘　　要：目的调查在胸部放疗结束时肺癌患者的症状负担特征,提取症状群。方法2017年11月—2017年9月期间从中国中医科学院广安门医院等国内20家三甲医院收集了接受胸部放射治疗的肺癌患者,MDASI-TCM量表评估放疗结束时的患者症状,描述性统计及探索性因子分析探讨症状负担及症状群分布。结果放疗结束时,45.1%患者报告了两种及以上中度至重度症状,疲劳是最普遍和最严重的症状;中重度症状发生率从高到低前5位依次为疲劳(31.4%)、咳嗽(30.9%)、咳痰(24.1%)、苦恼(23.2%)和气短(20.9%),中重度症状干扰发生率最高的是生活乐趣(36.4%)。探索性因子分析提取3个症状群,分别命名为热盛阴伤-脾胃不和相关症状群、心脾两虚相关症状群和肺气不利相关症状群,累积方差贡献率为70.1%。结论接受胸部放疗的肺癌患者在放疗结束时存在一定的症状负担,对症状负担和症状群特征的识别有利于促进中医辨证标准化,为今后制定合理有效的中医药干预措施奠定前期基础。Objective To investigate the characteristics of symptom burden and extract symptom clusters in lung cancer patients at the end of thoracic radiotherapy.Methods Lung cancer patients receiving Thoracic Radiotherapy were collected from 20 tertiary hospitals in China,including Guang'anmen Hospital of the Chinese Academy of Traditional Chinese Medicine,during November 2014—September 2017,and the MDASI-TCM scale assessed patient symptoms at the end of radiotherapy,and descriptive statistics and exploratory factor analysis explored symptom burden and the distribution of TCM symptom clusters.Results At the end of radiotherapy,45.1%of patients reported two or more moderate to severe symptoms,with fatigue being the most prevalent and severe symptom.Fatigue(31.4%),cough(30.9%),expectoration(24.1%),distress(23.2%)and shortness of breath(20.9%)were the top five symptoms from the highest to the lowest in the incidence of moderate to severe symptoms.The enjoyment of life(36.4%)had the highest incidence of interference with moderate to severe symptoms.Exploratory Factor analysis extracted three symptom clusters,namely the excessive heat and damaged yin-Spleen and stomach disorders related symptom cluster,the heart and spleen-deficient related symptom cluster,and the lung qi-unfriendly related symptom cluster,with a cumulative variance contribution of 70.1%.Conclusion Lung cancer patients undergoing thoracic radiotherapy have a certain symptom burden at the end of radiotherapy.The identification of symptom burden and symptom group characteristics is conducive to promoting standardization of TCM syndrome differentiation and laying a preliminary foundation for formulating reasonable and effective TCM intervention measures in the future.

关 键 词：胸部放射疗法 肺癌 症状负担 症状群 

分 类 号：R273[医药卫生—中西医结合]