经口营养支持治疗对结直肠癌化疗患者营养状态、癌因性疲乏及免疫功能的影响  

Effect of oral nutritional support therapy on the nutritional status,cancer-related fatigue,and immune function in patients with colorectal cancer undergoing chemotherapy

作　　者：晋俊 杨静蕊 薛延辉 赵广慧 JIN Jun;YANG Jingrui;XUE Yanhui;ZHAO Guanghui(Department of Oncology,General Hospital of Pingmei Shenma Medical Group,Pingdingshan 467000,He’nan,China)

机构地区：[1]平煤神马医疗集团总医院肿瘤科,河南平顶山4670000

出　　处：《癌症进展》2025年第3期368-372,共5页Oncology Progress

基　　金：河南省医学科技攻关计划联合共建项目和软科学项目(LHGJ20210209)。

摘　　要：目的 探讨经口营养支持治疗对结直肠癌化疗患者营养状态、癌因性疲乏及免疫功能的影响。方法 依据营养支持方式的不同将82例结直肠癌化疗患者分为常规组和观察组,每组43例,常规组患者化疗期间接受常规饮食指导,观察组患者化疗期间接受经口营养支持治疗。比较两组患者的营养状态指标[总蛋白(TP)、转铁蛋白(TRF)、前白蛋白(PAB)、白蛋白(ALB)水平及主观整体营养状况评量表(PG-SGA)评分]、癌因性疲乏程度[Piper疲乏修订量表(rPFS)]、免疫功能指标[免疫球蛋白(Ig)G、IgM、IgA、CD3^(+)、CD4^(+)/CD8^(+)]、炎性因子水平[C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]及不良反应发生情况。结果 治疗后,两组患者TRF、ALB、PAB、TP、IgG、IgM、IgA、CRP、PCT、IL-6、TNF-α水平均高于本组治疗前,CD3^(+)水平及CD4^(+)/CD8^(+)均低于本组治疗前,观察组患者TRF、ALB、PAB、TP、IgG、IgM、IgA、CD3^(+)水平及CD4^(+)/CD8^(+)均高于常规组,CRP、PCT、IL-6、TNF-α水平均低于常规组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者情感、认知与情绪、行为与严重程度、感觉及PG-SGA评分均低于本组治疗前,观察组患者情感、认知与情绪、行为与严重程度、感觉及PG-SGA评分均低于常规组,差异均有统计学意义(P﹤0.05)。观察组患者的不良反应总发生率为9.30%,低于常规组患者的25.58%,差异有统计学意义(P﹤0.05)。结论 经口营养支持治疗可更好地改善结直肠癌患者化疗期间的营养状态,减轻癌因性疲乏程度,增强免疫功能,减轻炎性反应,降低化疗不良反应发生率,有利于保障化疗的顺利完成。Objective To explore the effect of oral nutritional support therapy on the nutritional status,cancer-related fatigue,and immune function in patients with colorectal cancer undergoing chemotherapy.Method A total of 82 patients with colorectal cancer undergoing chemotherapy were divided into conventional group and observation group based on different nutritional support methods,with 43 patients in each group.Patients in the conventional group received routine dietary guidance during chemotherapy,while patients in the observation group received oral nutritional support treatment during chemotherapy.The nutritional status indicators[total protein(TP),transferrin(TRF),prealbumin(PAB),albumin(ALB)levels and patient-generated subjective global assessment(PG-SGA)score],cancer-related fatigue level[revised Piper fatigue scale(rPFS)],immune function indicators[immunoglobulin(Ig)G,IgM,IgA,CD3^(+),CD4^(+)/CD8^(+)],inflammatory factor levels[C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],and incidence of adverse reactions were compared between the two groups.Result After treatment,the levels of TRF,ALB,PAB,TP,IgG,IgM,IgA,CRP,PCT,IL-6,and TNF-αin both groups were higher than those before treatment,while the levels of CD3^(+)and CD4^(+)/CD8^(+)were lower than those before treatment,the levels of TRF,ALB,PAB,TP,IgG,IgM,IgA,CD3^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the conventional group,while the levels of CRP,PCT,IL-6,and TNF-αwere lower than those in the conventional group,and the differences were statistically significant(P<0.05).After treatment,the emotional,cognitive,affective dimension,behavior and severity,sensation and PG-SGA scores of both groups were lower than those before treatment,while the emotional,cognitive and emotional,behavior and severity,sensation,and PG-SGA scores of the observation group were lower than those of the conventional group,and the differences were statistically significant(P<0.05).The total incidence of adver

关 键 词：结直肠癌 化疗 经口营养支持治疗 癌因性疲乏 免疫功能 

分 类 号：R735.3[医药卫生—肿瘤]