药学干预对乳腺癌患者辅助化疗期间恶心呕吐和生活质量影响的研究

目的:探讨药学干预对乳腺癌患者辅助化疗期间恶心呕吐和生活质量的影响。方法:采用前瞻性队列研究,共入组87例乳腺癌术后患者。在接受辅助化疗前随机分为干预组(n=44)和对照组(n=43),干预组患者在接受化疗和常规支持治疗的同时,针对化疗引起的恶心呕吐由临床药师对患者进行咨询并指导用药,优化对症治疗方案,对照组仅接受化疗和常规支持治疗。比较两组患者对止吐药物的完全反应率、恶心严重程度、呕吐频次和生活质量。结果:化疗的前3个周期两组对止吐药物的完全缓解率分别为37.2%和63.6%,46.5%和75.0%,44.2%和72.7%,干预组完全缓解率明显高于对照组(P=0.014,P=0.006,P=0.007)。干预组的急性和迟发性恶心较对照组轻(P=0.023,P=0.045),急性和迟发性呕吐频率较对照组明显减少(P=0.006,P=0.034)。生活质量测评显示干预组患者的总健康状况较对照组升高(P=0.028),恶心、呕吐和食欲丧失的症状评分较对照组降低(P=0.025,P=0.045)。结论:临床药师对乳腺癌患者辅助化疗期间进行药学干预可明显减轻患者恶心、呕吐的副反应,并可改善生活质量。临床药师参与乳腺癌患者辅助化疗期间的对症治疗值得在临床广泛推广。

Effects of Pharmaceutical Intervention on Nausea and Vomiting as well as Quality of Life in Breast Cancer Patients Undergoing Adjuvant Chemotherapy

Objective:To investigate the effects of pharmaceutical intervention on nausea and vomiting as well as quality of life in breast cancer patients undergoing adjuvant chemotherapy.Methods:A total of 87 women surgically treated for breast cancer were randomly divided into two either intervention (n=44) or control group (n=43) before adjuvant chemotherapy. The intervention group received pharmaceutical intervention and routine health care during adjuvant chemotherapy, whereas the control group only received routine health care. Response rate to antiemetics, severity of nausea, frequency of vomiting and quality of life were compared between the two groups.Results:The complete response rates to antiemetic drugs in the two groups during the first three cycles of chemotherapy were 37.2% and 63.6%, 46.5% and 75.0%, 44.2% and 72.7%. Compared with the control group, patients in the intervention group acquired significantlyhigher complete response rate (P=0.014, P=0.006, P=0.007). The symptomof acute and delayed nausea in the intervention group were less severe than that in the control group (P=0.023, P=0.45).Moreover, the frequency of acute and delayed vomiting were significantly reduced compared with the control group (P=0.006, P=0.034). Quality of life evaluation showed the global health status of the patients in the intervention group was better than in the control group (P = 0.023), while the symptom scores in terms of nausea, vomiting and loss of appetite were reduced (P=0.034) as compared with the control group.Conclusion:Pharmaceutical intervention during adjuvant chemotherapy for breast cancer patients can not only reduce the side effects of nausea and vomiting but also improve the quality of life.