恶性肿瘤患者护理中热敏灸对PD-1抑制剂相关性胃肠道毒性的应用效果  

Application effect of heat-sensitive moxibustion of PD-1 inhibitor-related gastrointestinal toxicity on malignancy tumor patients

作　　者：闵美兰 吴昆[1] 朱伟[1] MIN Meilan;WU Kun;ZHU Wei(Jiangxi Cancer Hospital,Jiangxi,330000)

机构地区：[1]江西省肿瘤医院,江西省南昌市330000

出　　处：《护理实践与研究》2022年第11期1704-1708,共5页Nursing Practice and Research

基　　金：江西省中医药管理局科技计划课题(编号:2020B0203)。

摘　　要：目的 探讨热敏灸在预防恶性肿瘤患者化疗时程序性细胞死亡蛋白-1(PD-1)抑制剂相关性胃肠道毒性中的应用效果。方法 选取2020年8月—2021年8月医院收治的40例恶性肿瘤化疗患者,按组间基本特征具有可比性的原则分为对照组和观察组,各20例。对照组予以PD-1抑制剂治疗,观察组予以PD-1抑制剂+热敏灸治疗,持续至化疗第14天。比较两组胃肠道毒性反应发生情况及严重程度、中医证候积分、安德森症状评估量表(MDASIC)评分、中性淋巴细胞百分比(LY)及乳酸脱氢酶(LDH)变化,并监测肝肾功能异常情况。结果 热敏灸护理干预后,观察组恶心呕吐、腹泻发生率低于对照组,差异有统计学意义(P<0.05);观察组胃肠道毒性反应严重程度分级低于对照组,差异有统计学意义(P<0.05);化疗第14天观察组腹胀、胃脘、胃痛、反酸嘈杂、饮食减少、口干口苦评分和MDASIC评分均低于对照组,LY、LDH也低于对照组,差异有统计学意义(P <0.05)。结论 热敏灸可降低PD-1抑制剂相关性胃肠道毒性反应发生率,减轻胃肠道毒性反应严重程度,加快血清LY、LDH水平复常。Objective To investigate the clinical effect of heat-sensitive moxibustion in prevention and treatment of malignancy patients programmed cell death protein-1(PD-1) inhibitor-related gastrointestinal toxicity. Methods 40 patients with malignant tumors admitted in the hospital from August 2020 to August 2021 were divided into a control group and an observasion group according to the comparability of basic datas between groups, with 20 cases in each group. The control group was treated with PD-1 inhibitors, and the observation group was treated with PD-1 inhibitors + heat-sensitive moxibustion, and lasted until the 14th day of chemotherapy. The occurrence and severity of gastrointestinal toxicity, TCM syndrome score, Anderson Symptom Assessment Scale(MDASIC) score, Neutral Lymphocyte Percentage(LY) and Lactate Dehydrogenase(LDH) changes were compared between the two groups, and the abnormal liver function was monitored. Results The incidence of nausea, vomiting and diarrhea in the observation group was lower than the control group, the difference was statistically significant(P<0.05);the severity of gastrointestinal toxicity in the observation group was lower than the control group,the difference was statistically significant(P<0.05);The scores of TCM syndromes and MDASIC scores of the observation group on the 14th day of chemotherapy were lower than the control group, the difference was statistically significant(P<0.05);the observation group’s LY and LDH were lower than the control group on the 14th day of chemotherapy, the difference was statistically significant(P<0.05);There was no significant difference in the abnormal rate of liver and kidney function between the two groups(P>0.05). Conclusion Heat-sensitive moxibustion could reduce the incidence of PD-1 inhibitor-related gastrointestinal toxicity, reduce the severity of gastrointestinal toxicity, and accelerate the return of serum LY and LDH levels, which is safe and reliable.

关 键 词：恶性肿瘤 化疗 PD-1抑制剂 热敏灸 胃肠道毒性 中性淋巴细胞百分比 乳酸脱氢酶 

分 类 号：R473.73[医药卫生—护理学]