个体化饮食指导结合人文关怀对肺癌合并2型糖尿病患者血糖水水平平、生活质量及化疗依从性的影响  

Effect of individualized dietary guidance combined with humanistic care on blood glucose level, quality of life and adherence to chemotherapy in patients with lung cancer complicated by type 2 diabetes mellitus

作　　者：张甜甜[1] 唐瑶[2] 严伟[3] ZHANG Tiantian;TANG Yao;YAN Wei(Department of Integrated Chinese and Western Medicine,Nanjing Chest Hospital,Nanjing 210029,Jiangsu,China;Department of Internal Medicine,Nanjing Chest Hospital,Nanjing 210029,Jiangsu,China;Department of Respiration,Nanjing Chest Hospital,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京市胸科医院中西医结合科,南京210029 [2]南京市胸科医院内科,南京210029 [3]南京市胸科医院呼吸科,南京2100290

出　　处：《癌症进展》2019年第20期2471-2474,共4页Oncology Progress

摘　　要：目的探讨个体化饮食指导结合人文关怀对肺癌合并2型糖尿病(T2DM)患者血糖水平、生活质量及化疗依从性的影响。方法将82例肺癌合并T2DM患者根据干预方法不同分为对照组和观察组,各41例;对照组给予常规干预,观察组在对照组基础上给予个体化饮食指导结合人文关怀;比较干预前和干预3个月后两组患者的血糖、糖化血红蛋白(HbA1c)水平和生活质量;比较干预3个月后两组患者的化疗依从性和不良反应发生率。结果干预前,两组患者的血糖、HbA1c、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分比较,差异均无统计学意义(P﹥0.05);干预3个月后,观察组患者的空腹血糖(FPG)、餐后2 h血糖(2 h PG)、HbA1c、SAS和SDS评分均低于对照组患者(P﹤0.05)。干预3个月后,观察组患者的化疗依从率97.56%高于对照组患者的78.05%;观察组患者食欲减退、恶心呕吐、腹泻和粒细胞减少的发生率分别为17.07%、19.51%、7.32%和24.39%,均低于对照组患者的36.59%、41.46%、29.27%和51.22%(P﹤0.05)。结论个体化饮食指导结合人文关怀能够明显降低肺癌合并T2DM患者的血糖和HbA1c水平,改善患者心理状态,提高患者化疗依从性,并降低不良反应发生率。Objective To investigate the effects of individualized dietary guidance combined with humanistic care on blood glucose level, quality of life(QOL) and adherence to chemotherapy in patients with lung cancer complicated with type 2 diabetes mellitus(T2 DM). Method 82 cases of lung cancer complicated with T2 DM were divided into control group and study group according to different intervention methods, 41 cases in each group. The control group was given routine nursing interventions, while the study group was administered with individualized dietary guidance combined with humanistic care;the levels of blood glucose and glycosylated hemoglobin(HbA1 c) before and after 3-month intervention were compared between the two groups;besides, the adherence of patients to chemotherapy as well as the incidence of adverse reactions after 3-month intervention were also assessed. Result Before intervention, the blood glucose,HbA1 c, self-rating anxiety scale(SAS) score and self-rating depression scale(SDS) score were similar between the two groups(P>0.05);after 3-month intervention, the fasting plasma glucose(FPG), 2-hour plasma glucose(2 h PG) and HbA1 c, as well as SAS and SDS scores recorded in study group were significantly lower than those of the control group(P<0.05). After intervention for 3 months, the adherence rate for chemotherapy in study group was 97.56%, which was significantly higher than the 78.05% observed in control group;the incidence rates of adverse reactions comprising decreased appetite, nausea and vomiting, diarrhea and granulocytopenia were 17.07%, 19.51%, 7.32% and 24.39%, and were lower compared to the 36.59%, 41.46%, 29.27% and 51.22% in control group patients, respectively(P<0.05).Conclusion Individualized dietary guidance combined with humanistic care can significantly reduce the levels of plasma glucose and HbA1 c, improve the psychological status of patients with lung cancer complicated by T2 DM, and promote their adherence to chemotherapy, with lower incidence of adverse reactions.

关 键 词：个体化饮食指导 人文关怀 肺癌 2型糖尿病 血糖 化疗依从性 

分 类 号：R734.2[医药卫生—肿瘤]