渐进式肌肉放松训练缓解乳腺癌化疗期恶心呕吐的效果
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摘要
目的探讨渐进式肌肉放松训练对缓解乳腺癌化疗所致恶心呕吐的治疗效果。方法选取2017年1—6月收治于武汉大学人民医院乳腺甲状腺外科,行表阿霉素联合环磷酰胺(EC)方案化疗的乳腺癌术后患者68例,随机分为观察组和对照组各34例。对照组给予托烷司琼注射液、地塞米松止吐治疗;观察组在此基础上指导患者进行渐进式肌肉放松训练。采用MASCCA止吐评价工具比较两组患者化疗后24 h内及4 d后恶心、呕吐的发生情况。结果两组患者化疗后急性恶心、呕吐发生率及延迟性恶心发生率比较,差异均无统计学意义(P> 0. 05);观察组患者延迟性呕吐发生率及呕吐频次明显低于对照组,恶心缓解率明显高于对照组,差异有统计学意义(P <0. 05)。结论渐进式肌肉放松训练能显著降低乳腺癌EC方案化疗后延迟性呕吐的发生率及呕吐频次,提高恶心缓解率,对于提高患者化疗依从性有积极促进作用。
Objective To explore the effect of progressive muscle relaxation training on the prevention of chemotherapy-induced nausea and vomiting( CINV) in breast cancer patients. Methods A total of 68 breast cancer patients who accepted chemotherapy with epirubicin and cyclophamide( EC) in Renmin Hospital of Wuhan University were chosen from January to June 2017. They were randomly and equally divided into the observation group and control group. The control group was treated with tropisetron injection and dexamethasone,and the observation group was given progressive muscle relaxation training on this basis. The clinical efficacy of preventing CINV between the two groups was compared. Results There was no significant difference in the incidence of nausea and vomiting between the two groups in acute phase( P > 0. 05). There was no significant difference in the incidence of nausea between the two groups in delayed phase( P > 0. 05).But the observation group had significantly lower incidence of vomiting and frequency of vomiting and higher rate of nausea relief than the control group in delayed phase( P < 0. 05). Conclusion Progressive muscle relaxation training can significantly reduce vomiting frequency and incidence and improve the rate of nausea relief in delayed phase after chemotherapy with EC. It is simple and convenient to be used for the clinical prevention and treatment of CINV.
Objective To explore the effect of progressive muscle relaxation training on the prevention of chemotherapy-induced nausea and vomiting( CINV) in breast cancer patients. Methods A total of 68 breast cancer patients who accepted chemotherapy with epirubicin and cyclophamide( EC) in Renmin Hospital of Wuhan University were chosen from January to June 2017. They were randomly and equally divided into the observation group and control group. The control group was treated with tropisetron injection and dexamethasone,and the observation group was given progressive muscle relaxation training on this basis. The clinical efficacy of preventing CINV between the two groups was compared. Results There was no significant difference in the incidence of nausea and vomiting between the two groups in acute phase( P > 0. 05). There was no significant difference in the incidence of nausea between the two groups in delayed phase( P > 0. 05).But the observation group had significantly lower incidence of vomiting and frequency of vomiting and higher rate of nausea relief than the control group in delayed phase( P < 0. 05). Conclusion Progressive muscle relaxation training can significantly reduce vomiting frequency and incidence and improve the rate of nausea relief in delayed phase after chemotherapy with EC. It is simple and convenient to be used for the clinical prevention and treatment of CINV.
引文
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[12]YOO H J,AHN S H,KIM S B,et al. Efficacy of progressive muscle relaxation training and guided imagery in reducing chemotherapy side effects in patients with breast cancer and in improving their quality of life[J]. Support Care Cancer,2005,13(10):826-833.
[13]ADER R,COHEN N, FELTEN D. Psychoneuroimmunology:interactions between the nervous system and the immune system[J]. Lancet,1995,345(8942):99-103.
[14]张晓静,张频.肿瘤化疗所致恶心呕吐的发生机制和药物治疗的研究进展[J].癌症进展,2006,4(4):348-354.
[15]庄和珠,高虹.渐进性肌肉放松训练与药物在化疗所致恶心呕吐中应用的比较研究[J].国际护理学杂志,2010,29(2):306-308.
[2]GRADISHAR W J,ANDERSON B O,BALASSANIAN R,et al.Breast cancer version 2. 2015[J]. J Natl Compr Canc Netw,2015,13(4):448-475.
[3]GRUNBERG S M,DEUSON R R,MAVROS P,et al. Incidence of chemotherapy-induced nausea and emesis after modern antiemetics[J]. Cancer,2004,100(10):2261-2268.
[4]陆箴琦,胡雁.音乐放松训练对缓解乳腺癌患者化疗不良反应的效果研究[J].中华护理杂志,2010,45(5):405-408.
[5]袁敏,胡陵静,彭莉,等.止吐膏穴位贴敷辅助治疗化疗后恶心呕吐的临床观察[J].中国药房,2015,26(23):3241-3243.
[6]侯永梅,胡佩诚.渐进性肌肉放松在临床治疗应用中的研究与进展[J].中国组织工程与临床康复,2008,12(7):1331-1336.
[7]陈露露,王亚芹,欧阳冬生.化疗止吐药物的研究进展[J].肿瘤药学,2014,4(2):107-111.
[8]李香风,刘薇,秦瑛.中文版MASCC止吐评价的信效度评价[J].中国现代护理杂志,2016,22(19):2669-2673.
[9]SAITO M, AOGI K, SEKINE I, et al. Palonosetron plus dexamethasone versus granisetron plus dexamethasone for prevention of nausea and vomiting during chemotherapy:a doubleblind,double-dummy, randomised, comparative phase III trial[J]. Lancet Oncol,2009,10(2):115-124.
[10]SOMMARIVA S,PONGIGLIONE B,TARRICONE R. Impact of chemotherapy-induced nausea and vomiting on health-related quality of life and resource utilization:A systematic review[J].Crit Rev Oncol Hematol,2016,99:13-36.
[11] MOLASSIOTIS A, YUNG H P, YAM B M, et al. The effectiveness of progressive muscle relaxation training in managing chemotherapy-induced nausea and vomiting in Chinese breast cancer patients:a randomised controlled trial[J]. Support Care Cancer,2002,10(3):237-246.
[12]YOO H J,AHN S H,KIM S B,et al. Efficacy of progressive muscle relaxation training and guided imagery in reducing chemotherapy side effects in patients with breast cancer and in improving their quality of life[J]. Support Care Cancer,2005,13(10):826-833.
[13]ADER R,COHEN N, FELTEN D. Psychoneuroimmunology:interactions between the nervous system and the immune system[J]. Lancet,1995,345(8942):99-103.
[14]张晓静,张频.肿瘤化疗所致恶心呕吐的发生机制和药物治疗的研究进展[J].癌症进展,2006,4(4):348-354.
[15]庄和珠,高虹.渐进性肌肉放松训练与药物在化疗所致恶心呕吐中应用的比较研究[J].国际护理学杂志,2010,29(2):306-308.