八段锦锻炼对乳腺癌蒽环类药物化疗患者心功能及生活质量的影响  被引量:5

Effects of Baduanjin Exercises on Cardiac Function and Quality of Life ofBreast Cancer Patients Treated with Chemotherapy of Anthracyclines

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作  者:王薇 钟碧莹 丁懿宁 李良 潘光明 WANG Wei;ZHONG Bi-Ying;DING Yi-Ning;LI Liang;PAN Guang-Ming(Dept.of Ultrasound Imaging,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120 Guangdong,China;The Second Clinical Medical School,Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Breast Dept.,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120 Guangdong,China;Dept.of Cardiovascular Diseases,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120 Guangdong,China)

机构地区:[1]广州中医药大学第二附属医院超声影像科,广东广州510120 [2]广州中医药大学第二临床医学院,广东广州510405 [3]广州中医药大学第二附属医院乳腺科,广东广州510120 [4]广州中医药大学第二附属医院心血管科,广东广州510120

出  处:《广州中医药大学学报》2023年第6期1448-1454,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基  金:广东省中医药局面上项目(编号:20211190)。

摘  要:【目的】探究八段锦锻炼对乳腺癌蒽环类药物化疗患者心功能及生活质量的影响。【方法】将2021年7月至2022年1月期间在广东省中医院乳腺科住院的乳腺癌术后拟接受蒽环类药物化疗的80例女性患者随机分为对照组和试验组,每组各40例。2组患者术后均接受蒽环类药物化疗(表柔比星+环磷酰胺)。化疗期间,对照组患者仅给予常规护理,包括患侧上肢功能锻炼、均衡饮食以及心理疏导等;试验组在对照组的基础上进行规范的八段锦锻炼,每天2次,每次30 min。21 d为1个化疗周期,共观察4个化疗周期。观察2组患者化疗前(T0)、化疗第1周期(T1)、第3周期(T3)、第4周期(T4)结束后超声心动图参数、血清B型脑利钠肽(BNP)和肌钙蛋白(cTnT)水平及生活质量健康调查简表12项(SF-12)评分的变化情况。【结果】(1)超声心动图参数方面,化疗后,随着化疗药物剂量的积累,2组患者的左室射血分数(LVEF)值均下降,其中,对照组LVEF值在T3及T4时均较T0时明显降低(P<0.01),试验组LVEF值仅在T4时较T0时明显降低(P<0.01),且其降低幅度较对照组小;对照组二尖瓣口舒张早期峰值流速与舒张末期峰值流速比值(E/A)值在T4时较T0时明显降低(P<0.01),而试验组E/A值在化疗过程中未见明显改变(P>0.05);试验组和对照组的舒张早期二尖瓣口峰值流速与舒张早期二尖瓣环运动峰值速度比值(E/e’)值在T4时均较T0时明显升高(P<0.01);但超声心动图各参数在各时点两组间比较,差异均无统计学意义(P>0.05)。(2)心肌损伤标志物方面,化疗后,与T0相比,2组患者血清BNP、cTnT水平在T1、T3时未见明显改变(P>0.05),在T4时均明显升高(P<0.01),但试验组血清cTnT水平的升高幅度明显低于对照组(P<0.05)。(3)生活质量方面,化疗后,2组患者SF-12的生理评分和心理评分均随着化疗周期的增加而逐渐升高,在T1、T3、T4时均较T0明显升高(P<0.01),且试验组各观察时Objective To investigate the effects of Baduanjin exercises on cardiac function and quality of life of breast cancer patients treated with chemotherapy of anthracyclines.Methods Eighty female inpatients with breast cancer planning to receive chemotherapy of anthracyclines after surgery who were admitted to the Breast Department of Guangdong Provincial Hospital of Traditional Chinese Medicine between July 2021 and January 2022 were enrolled into the study.The patients were randomly divided into the control group and the trial group,with 40 patients in each group.Both groups of patients received chemotherapy of anthracyclines(Epirubicin+Cyclophosphamide)after surgery.During the period of chemotherapy,the control group was only given routine nursing including functional exercises of the affected upper limbs,balanced diet and psychological guidance.The patients of the trial group took standardized Baduanjin exercises based on the intervention for the control group,twice a day,and 30 minutes per time.Twenty-one days constituted one chemotherapy cycle,and the patients were observed for a total of 4 chemotherapy cycles.Before chemotherapy(T0)and at the end of the first(T1),third(T3)and fourth(T4)cycles of chemotherapy,we observed the echocardiographic parameters,serum levels of B-type brain natriuretic peptide(BNP)and cardiac troponin T(cTnT),and the scores of 12-item short-form health survey(SF-12)for quality of life in the two groups.Results(1)After chemotherapy,the echocardiographic parameter of left ventricular ejection fraction(LVEF)value decreased in both groups with the accumulation of chemotherapeutic drug doses.The LVEF value in the control group at T3 and T4 was lower than that at T0(P<0.01),and LVEF value in the trial group only at T4 was lower than that at T0(P<0.01),and the degree of decrease was less than that in the control group.The ratio of mitral ring early diastolic E-peak flow velocity to enddiastolic A-peak flow velocity(E/A ratio)in the control group at T4 was significantly lower than that at T0(P<

关 键 词:八段锦 乳腺癌 蒽环类药物 心功能 B型脑利钠肽(BNP) 肌钙蛋白(cTnT) 生活质量 术后康复 

分 类 号:R247.4[医药卫生—中医临床基础]

 

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