乳腺癌患者化疗后癌因性疲乏调查和正念训练干预临床价值研究  

Investigation on cancer-related fatigue in breast cancer patients after chemotherapy and clinical value of mindfulness training intervention

作　　者：章立楠[1] 邵薇娜[1] 赵港美 毛玉山[1] ZHANG Li-Nan;SHAO Wei-Na;ZHAO Gang-Mei(Affiliated Hospital of Medical College of Ningbo University,Ningbo,Zhejiang 315020,China)

机构地区：[1]宁波大学医学院附属医院,浙江宁波315020

出　　处：《中国妇幼保健》2021年第16期3778-3782,共5页Maternal and Child Health Care of China

基　　金：浙江省医药卫生科技计划项目(2018ZH029)。

摘　　要：目的总结乳腺癌患者化疗后癌因性疲乏调查及正念训练干预临床价值。方法选取2017年6月-2019年6月在宁波大学医学院附属医院行乳腺癌化疗后患者275例为研究对象,其中186例出现癌因性疲乏机械症状,将186例患者分成两组各93例,对照组常规干预,研究组加用正念训练干预,观察两组患者干预后在生活质量、相关评分及睡眠质量变化并比较,观察化疗次数和疲乏积分变化情况。结果癌因性疲乏发生率67.64%。(1)乳腺癌化疗后癌因性疲乏临床表现以疲乏感、焦虑、恶心呕吐及压力为主,占100%、87.1%、76.34%及82.8%,以疲乏感最明显,和其他症状比较差异有统计学意义(P<0.05)。(2)两组治疗前HAMA评分、SDS评分、睡眠质量、睡眠时间、入睡时间、睡眠深度及催眠药物评分比较差异无统计学意义(P>0.05),两组完成治疗后HAMA评分、SDS评分、睡眠质量、睡眠时间、入睡时间、睡眠深度及催眠药物评分均显著下降,且研究组显著低于对照组,差异有统计学意义(P<0.05)。(3)两组治疗前生理功能、生理职能、健康状况、社会职能及情感职能评分比较差异无统计学意义(P>0.05),两组完成治疗后生理功能、生理职能、健康状况、社会职能及情感职能均显著升高,且研究组显著高于对照组,差异有统计学意义(P<0.05)。(4)对照组第4次化疗、≥6次化疗在躯体缺乏、认知缺乏、情感缺乏及总缺乏评分上均显著高于第2次化疗;研究组第4次化疗、≥6次化疗在躯体缺乏、认知缺乏、情感缺乏及总缺乏评分则均显著低于第2次化疗,差异有统计学意义(P<0.05),第4次化疗、≥6次化疗研究组评分均显著优于对照组,差异有统计学意义(P<0.05)。结论乳腺癌患者化疗后癌因性疲乏临床症状表现复杂多样,而正念训练干预能降低癌因性疲乏程度,提高生活质量,改善睡眠质量和抑郁焦虑评分。Objective To summarize cancer-related fatigue in breast cancer patients after chemotherapy and clinical value of mindfulness training intervention.Methods From June 2017 to June 2019,275 breast cancer patients after chemotherapy were selected from Affiliated Hospital of Medical College of Ningbo University as study object,cancer-related fatigue was observed in 186 cases,then the 186 cases were divided into two groups,93 cases in each group,the cases in control group were given routine intervention,the cases in study group were given mindfulness training intervention. The changes of life quality,related scores,and sleep quality after intervention in the two groups were observed and compared in the two groups,the times of chemotherapy and change of fatigue score were observed.Results The incidence rate of cancer-related fatigue was 67.64%. After chemotherapy,the main clinical manifestations of cancer-related fatigue were fatigue,anxiety,nausea,vomiting,and pressure,accounting for 100%,87.1%,76.34%,and 82.8%,respectively,compared with other symptoms,there were statistically significant differences(P<0.05). Before treatment,there was no statistically significant difference in HAMA score,SDS score,life quality,sleep time,the time to fall asleep,depth of sleep,and hypnotic drug score between the two groups(P>0.05). After treatment,HAMA scores,SDS scores,life quality,sleep time,the time to fall asleep,depths of sleep,and hypnotic drug scores in the two groups decreased,especially in study group(P<0.05). Before treatment,there was no statistically significant difference in scores of physiological function,role physical,health status,social function,and emotional function between the two groups(P>0.05). After treatment,the scores of physiological function,role physical,health status,social function,and emotional function increased significantly,especially in study group(P<0.05). The scores of body deficiency,cognitive deficiency,emotional deficiency,and the total score of deficiency during the fourth and the sixth chemoth

关 键 词：乳腺癌 化疗 癌因性疲乏 正念训练干预 临床症状 生活质量 睡眠质量 抑郁焦虑评分 

分 类 号：R737.9[医药卫生—肿瘤]