CDTM模式应用于肿瘤营养规范化治疗的随机对照研究  

Randomized controlled study of CDTM mode for tumor nutritional standardized treatment

作　　者：吴炜[1] 梁海[1] 杨淼[1] 程刚[2] 陈方[2] 冯翠影 蒋祥德[2] WU Wei;LIANG Hai;YANG Miao;CHENG Gang;CHEN Fang;FENG Cui-ying;JIANG Xiang-de(Department of Pharmacy,Municipal People's Hospital,Anhui Bozhou 236800,China;Department of Oncology,Municipal People's Hospital,Anhui Bozhou 236800,China)

机构地区：[1]亳州市人民医院药学部,安徽亳州236800 [2]亳州市人民医院肿瘤内科,安徽亳州236800

出　　处：《中国医院药学杂志》2021年第17期1785-1790,共6页Chinese Journal of Hospital Pharmacy

基　　金：亳州市人民医院院级科研项目(编号:By202014);亳州市人民医院三新项目(编号:2020YB-58)。

摘　　要：目的:评价合作药物治疗管理(CDTM)模式在肿瘤营养规范化治疗中的临床应用效果。方法:取亳州市人民医院肿瘤营养不良患者90例,随机分为2组,每组45例。对照组采用五阶梯营养治疗法,干预组在对照组的治疗基础上联合CDTM模式干预。比较2组肿瘤患者综合营养(PG-SGA)评分、总热量及蛋白质摄入量、生活质量(QOL)评分、不良反应发生率、住院时间以及营养治疗成本。结果:治疗后,2组PG-SGA评分均较治疗前减少(P<0.01),且干预组PG-SGA评分低于对照组(P<0.01);2组首日总热量及蛋白质摄入量比较差异无统计学意义(P>0.05),但干预组蛋白质摄入量高于对照组(P<0.05);治疗后,2组QOL评分均显著高于治疗前(P<0.01),且干预组高于对照组(P<0.01);治疗后干预组恶心、呕吐、腹胀、腹泻不良反应发生率均低于对照组(P<0.05),头晕、乏力、皮疹、感染不良反应发生率2组差异无统计学意义(P>0.05);住院天数、住院总费用、检查费用、总药物费用2组差异均无统计学意义(P>0.05)。结论:CDTM模式应用于肿瘤营养规范化治疗有助于改善患者的营养状态,提高患者生活质量,降低不良反应发生率和住院成本,在肿瘤营养规范化治疗药学服务过程中发挥积极的作用。OBJECTIVE To evaluate the clinical effect of collaborative drug therapy management(CDTM)model in the standardized treatment of tumor nutrition.METHODS A total of 90 tumor patients with malnutrition were randomly divided into two groups of intervention and control(n=45 each).The control group received five-step nutritional therapy while the intervention group additional CDTM mode intervention.Patient-generated subjective global assessment(PG-SGA)score,total calorie and protein intake,quality-of-life(QOL)score,incidence of adverse reactions,hospital stay and cost of nutritional therapy were compared between two groups.RESULTS After therapy,PG-SGA score declined in both groups compared with that pre-therapy(P<0.01)and PG-SGA score was lower in intervention group than that in control group(P<0.01).No significant inter-group difference existed in total calorie or protein intake at Day 1(P>0.05).However,protein intake of intervention group was higher than that of control group(P<0.05).After therapy,QOL scores of both groups were significantly higher than those pre-therapy(P<0.01)and intervention group was higher than control group(P<0.01).After therapy,the incidence of adverse reactions such as nausea,vomiting,abdominal distension and diarrhea was lower in intervention group than that in control group(P<0.05).Yet the incidence of adverse reactions such as dizziness,fatigue,rash and infection showed no statistically significant inter-group difference(P>0.05).Hospital stay,hospitalization expense and examination/drug cost showed no statistically significant inter-group difference(P>0.05).CONCLUSION For standardized treatment of tumor nutrition,application of CDTM model can maintain the nutritional status,improve the quality-of-life of patients and lower the incidence of adverse reactions and hospitalization expense.CDTM model plays an active role in the pharmaceutical care process of standardized treatment of tumor nutrition.

关 键 词：合作药物治疗管理 肿瘤 营养规范化治疗 临床药学服务 

分 类 号：R730.5[医药卫生—肿瘤]