乳腺癌患者化疗期间癌因性疲乏对生活质量影响的临床研究

目的:调查与了解癌因性疲乏状况对乳腺癌化疗患者生活质量的影响。方法:选择收治的乳腺癌患者120例,发放Piper疲乏修订量表(中文版)和SF-36健康状况量问卷表进行调查。结果:本组患者癌因性疲乏的3个维度得分均处于中等疲乏水平,患者生活质量的7个维度得分处于中等生活质量水平,同时癌因性疲乏与生活质量各个维度呈正相关(P<0.05)。结论:乳腺癌患者化疗期间多伴随有癌因性疲乏,对生活质量有负面影响,应加强干预,防止癌因性疲乏,相应提高了患者的生活质量。     

乳腺癌化疗患者化疗期间癌因性疲乏的变化及缓解方式探究

目的:探讨乳腺癌化疗患者化疗期间癌因性疲乏的变化及缓解方式。方法:选取接受化疗的乳腺癌患者98例作为研究对象,按照入院先后顺序分为对照组(n=42)与观察组(n=56),对照组采取常规干预,观察组在对照组的基础上采取心理干预,对比两组患者化疗前、化疗中(第2次化疗)、化疗后(第6次化疗结束)癌因性疲乏各指标变化;采取缓解方式前后SF-36简明健康量表、采取缓解方式后化疗第2、4、6次抑郁、焦虑评分情况。结果:观察组化疗中、化疗后总疲乏均高于对照组(P<0.05);观察组患者干预后的SF-36简明健康评分优于对照组,差异具有统计学意义(P<0.05);干预后观察组心理状况显著优于对照组(P<0.05);两组患者化疗中焦虑、抑郁评分比较,差异无统计学意义(P>0.05),观察组第4、6次化疗后焦虑、抑郁评分显著低于第2次,且低于对照组评分(P<0.05)。结论:在乳腺癌患者化疗期间应给予缓解方式的干扰治疗,可以缓解患者癌因性疲乏,提高患者生活质量,利于病情恢复。     

动机性访谈在癌因性疲乏患者中的应用研究

目的探讨动机性访谈（MI）在癌因性疲乏（CRF）患者中的应用效果。方法选择明确诊断为癌症,且评估存在CRF的患者40例作为研究对象,采用癌因性疲乏简明量表、抑郁自评表（SDS）和焦虑自评表（SAS）、生命质量量表测定。经MI技术2次干预后,再进行重测。结果 MI实施前后,患者疲乏程度、抑郁焦虑水平、生命质量具有明显改善（P〈0.05）。结论 MI在CRF患者中应用具有良好的作用,值得临床进一步的探索与应用。     

补中益气汤对癌因性疲乏的影响

目的研究补中益气汤对癌因性疲乏的影响。方法将我院收治的60例癌因性疲乏病例随机分为对照组(n=30,化疗)和实验组(n=30,化疗联合补中益气汤),比较两组治疗前后生活质量、疲乏改善情况及不良反应出现率。结果治疗后两组生活质量评分项目中的社会功能评分对比差异无统计学意义(P>0.05),实验组其他生活质量评分(躯体功能、心理功能、物质生活评分)、生活质量总评分和轻度疲乏率均显著高于对照组(P<0.05或P<0.01),重度疲乏率和消化道不良反应发生率明显低于对照组(P<0.05或P<0.01);骨髓抑制反应出现率两组比较差异无统计学意义(P>0.05)。结论补中益气汤可显著改善癌因性疲乏患者疲乏程度,减少消化系统不良反应,提高生活质量。     

肺癌化疗患者癌因性疲乏状况调查分析

目的探讨肺癌化疗患者癌因性疲乏状况及影响因素。方法便利抽样选取2008年1月在北京协和医院明确诊断为肺癌并接受治疗的患者101例,采用Piper疲劳自评量表进行癌因性疲乏程度及相关因素测量。结果肺癌患者癌因性疲乏属于中度程度,不同睡眠情况患者疲乏程度差异有统计学意义（P〈0．01）;不同情绪状态患者疲乏程度差异有统计学意义（P〈0．01）;性别、年龄、婚姻状况、教育程度和治疗方案对癌因性疲乏程度影响不明显。结论在患者接受化疗期间。化疗易发生中等程度的疲劳,睡眠、情绪状态是疲乏的主要影响因素,护理人员应针对患者的睡眠和情绪状况提供更有针对性的护理,以改善肺癌化疗患者的癌因性疲劳状况。     

优质护理干预对乳腺癌化疗患者癌因性疲乏的影响

目的 探讨优质护理干预对乳腺癌化疗患者癌因性疲乏的影响。方法 于2020年9月—2021年9月随机选取莆田市第五医院收治的60例乳腺癌化疗患者为研究对象,将其随机分为对照组30例(常规护理)与研究组30例(对照组基础上优质护理),比较两组负面情绪、癌因性疲乏、生活质量及护理满意度。结果 护理前两组HAMA评分及HAMD评分值差异无统计学意义(P>0.05);护理后研究组HAMA评分(10.92±2.71)分及HAMD评分(9.42±2.93)分均显著低于对照组,差异有统计学意义(t=6.321、4.399,P<0.05)。研究组癌因性疲乏总发生率为10.00%,明显低于对照组的70.00%,差异有统计学意义(χ²=22.500,P<0.05)。护理前两组各项生活质量评分值比较差异无统计学意义(P>0.05);护理后研究组躯体功能(70.3±3.3)分、情绪功能(78.9±3.6)分、角色功能(78.4±3.2)分、社会功能(76.4±2.3)分均显著高于对照组,差异有统计学意义(t=9.947、3.925、8.635、8.442,P<...     

癌因性疲乏的护理干预

目的:探讨对癌因性疲乏患者进行护理干预后的意义。方法:护理人员在癌因性疲乏开始前,要积极为患者和家属讲解癌因性疲乏的一些知识,并提出建设性的指导意见,对癌因性疲乏患者采取积极有效的护理干预。结果:癌因性疲乏患者经有效的护理干预后,疲乏程度得到了明显减轻,患者的生活质量也得到了进一步的提升。结论:正确评估癌因性疲乏,采取相应的护理干预,对促进癌症患者的康复,改善癌症患者的生活质量有着非常重要的临床意义。     

系统性护理在缓解肺癌化疗患者癌因性疲乏中的作用

目的研究系统性护理在缓解晚期非小细胞肺癌(晕杂悦蕴悦)化疗患者癌因性疲乏中的作用。方法选择80例晚期晕杂悦蕴悦化疗患者随机分为干预组与对照组,各40例。对照组接受肿瘤内科常规护理,干预组在此基础上进行系统的针对癌因性疲乏的护理干预。结果干预后干预组患者的癌因性疲乏程度较对照组明显降低(字2越8.47,孕越0.04)。干预组患者情感状况、生理状况、功能状况、社会家庭状况、与医生的关系、附加的关注情况及量表总分均高于对照组,差异均有统计学意义(孕均<0.01)。结论在常规护理干预基础上给予系统性护理,可改善晚期晕杂悦蕴悦化疗患者疲乏程度,提高生活质量。     

大肠癌患者癌因性疲乏的护理

目的：探讨大肠癌患者癌因性疲乏正确有效的临床护理方法。方法：选取2013年1月～2013年12月皖南医学院第一附属医院收治的大肠癌患者25例,采用癌因性疲乏自评量表（PFS）评价患者接受个体化护理干预前后癌因性疲乏程度,采用癌症患者生命质量测定问卷（QOL）评价患者接受个体化护理干预前后生活质量。采用SPSSl3．0统计软件进行统计分析。结果：与护理前相比,护理后患者PFS评分下降和QOL评价升高均有统计学意义（P〈0．05）。结论：对大肠癌患者实施个体化护理,能够有效的缓解患者癌因性疲乏,提高患者的生活质量,值得临床推广。     

自拟扶正解毒方治疗胃癌患者化疗后癌因性疲乏的临床研究

目的 观察自拟扶正解毒方对胃癌患者化疗后癌因性疲乏(CRF)的影响.方法 将110例胃癌CRF患者采用随机数字表法分为治疗组和对照组各55例,治疗组予以扶正解毒方,对照组予以贞芪扶正胶囊,治疗前后2组患者分别进行癌因性疲乏量表(CFS)与简易疲乏量表(BFI)评分评估,检测T淋巴细胞亚群(CD3+、CD4+、CD8+、...     

腺样体肥大治疗的前瞻性随机对照研究

【目的】采用随机对照方法研究药物治疗及手术干预在腺样体肥大治疗中的效果和作用,以期为腺样体肥大规范治疗提供依据。【方法】将门诊符合研究入组原则和标准的儿童腺样体肥大患者83例(病史>12周)按照随机原则分为单纯药物治疗组或者手术干预治疗组,治疗3月后,通过对腺样体大小改变、免疫球蛋白水平的改变、分泌性中耳炎的疗效评价、儿童慢性鼻窦炎的疗效评价、儿童阻塞性睡眠呼吸暂停低通气综合征的疗效评价,采用单样本t检验及两组独立样本t检验、有序分类资料的秩和检验等统计学方法,比较两组患儿的治疗效果。【结果】治疗前两组患儿的腺样体大小无统计学差异,治疗后两组腺样体大小有统计学差异(P=0.038),两组患儿治疗后的腺样体大小分别同治疗前比较有统计学差异(P=0.000。两组治疗前及治疗后3月血清中IgA、IgG、IgM变化经t检验统计学比较均无差异(P>0.05)。两组分泌性中耳炎、儿童慢性鼻窦炎、儿童阻塞性睡眠呼吸暂停低通气综合征疗效对比无统计学差异(P值分别为0.822、0.773、0.559)。【结论】腺样体肥大通过规范的单纯药物治疗能够达到良好的治疗效果,治疗后3个月的疗效观察发现手术干预措施并不会增加此类患儿的治疗效果,因此,腺样体肥大患儿的治疗应首选规范的药物治疗,手术治疗的指征应更加严格。     

Use of the Percentage of Free Prostate-Specific Antigen to Enhance Differentiation of Prostate Cancer From Benign Prostatic Disease: A Prospective Multicenter Clinical Trial

Context.— The percentage of free prostate-specific antigen (PSA) in serum has been shown to enhance the specificity of PSA testing for prostate cancer detection, but earlier studies provided only preliminary cutoffs for clinical use. Objective.— To develop risk assessment guidelines and a cutoff value for defining abnormal percentage of free PSA in a population of men to whom the test would be applied. Design.— Prospective blinded study using the Tandem PSA and free PSA assays (Hybritech Inc, San Diego, Calif). Setting.— Seven nationwide university medical centers. Participants.— A total of 773 men (379 with prostate cancer, 394 with benign prostatic disease) 50 to 75 years of age with a palpably benign prostate gland, PSA level of 4.0 to 10.0 ng/mL, and histologically confirmed diagnosis. Main Outcome Measures.— A percentage of free PSA cutoff that maintained 95% sensitivity for prostate cancer detection, and probability of cancer for individual patients. Results.— The percentage of free PSA may be used in 2 ways: as a single cutoff (ie, perform a biopsy for all patients at or below a cutoff of 25% free PSA) or as an individual patient risk assessment (ie, base biopsy decisions on each patient's risk of cancer). The 25% free PSA cutoff detected 95% of cancers while avoiding 20% of unnecessary biopsies. The cancers associated with greater than 25% free PSA were more prevalent in older patients, and generally were less threatening in terms of tumor grade and volume. For individual patients, a lower percentage of free PSA was associated with a higher risk of cancer (range, 8%-56%). In the multivariate model used, the percentage of free PSA was an independent predictor of prostate cancer (odds ratio [OR], 3.2; 95% confidence interval [CI], 2.5-4.1; P<.001) and contributed significantly more than age (OR, 1.2; 95% CI, 0.92-1.55) or total PSA level (OR, 1.0; 95% CI, 0.92-1.11) in this cohort of subjects with total PSA values between 4.0 and 10.0 ng/mL. Conclusions.— Use of the percentage of free PSA can reduce unnecessary biopsies in patients undergoing evaluation for prostate cancer, with a minimal loss in sensitivity in detecting cancer. A cutoff of 25% or less free PSA is recommended for patients with PSA values between 4.0 and 10.0 ng/mL and a palpably benign gland, regardless of patient age or prostate size. To our knowledge, this study is the largest series to date evaluating the percentage of free PSA in a population representative of patients in whom the test would be used in clinical practice.      

国产辛伐他汀调脂疗效的多中心随机对照临床试验

目的　了解国产辛伐他汀 ( SS)的调脂疗效。方法　以默沙东生产的舒降之为对照 ,进行多中心随机对照临床观察。将 16 0例高脂血症患者随机分为试验组 (国产 SS,A组 )、对照组 (进口 SS,舒降之 ,B组 )和开放组 (国产 SS,C组 ) ,其中 A、B组为单盲。每例受试者均于每日晚餐后口服 SS10 mg,疗程 8周 ,且保持受试前的饮食和生活习惯不变。分别于受试后的 4周和 8周随访。结果　完成试验 15 5例 ,脱落 5例 (均因病员不合作 )。疗程4周时 ,A、B、C三组的血总胆固醇 ( TC)分别下降 16 .88%、19.2 3%和 14.10 % ,血甘油三酯 ( TG)分别下降19.2 7%、15 .6 6 %和 17.96 % ,HDL- C分别升高 7.6 9%、7.46 %和 6 .6 9% ,L DL- C分别下降 2 3.0 %、2 7.84%和2 4.43% ,三组间比较无显著性差异 ( P>0 .0 5 )。疗程 8周时 ,A、B、C三组的 TC分别下降 2 5 .0 3%、2 6 .5 3%和2 5 .2 2 % ,TG分别下降 2 3.85 %、2 4.74%和 2 4.75 % ;HDL- C分别升高 9.2 3%、8.95 %和 8.89% ,L DL- C分别下降33.72 %、35 .5 0 %和 30 .99% ,三组间比较也无显著性差异 ( P>0 .0 5 )。不良反应主要为消化道症状 ,其发生率 A、B、C三组分别为 2 0 .34 %、2 2 .81%和 17.95 % ,三组间无显著性差异 ( P>0 .0 5 )。 4周与 8周时比较 ,8周的疗效呈     

A Prospective Randomized Multicenter Controlled Trial on Salvianolate for Treatment of Unstable Angina Pectoris in A Chinese Elderly Population

Objective: To evaluate the efficacy and safety of salvianolate in elderly patients with unstable angina pectoris (UAP). Methods: A prospective double-blind randomized placebo-controlled multicenter trial in elderly patients with UAP from 13 third-grade class-A hospitals in China was performed. A total of 318 patients were randomly allocated in a 1:1 ratio to an experimental group (160 patients) and a control group (158 patients). The experimental group was treated with salvianolate for 14 days on the basis of conventional medicine, and the control group was given a placebo for 14 days with the same criteria. Follow-up was lasted 28 days in both groups. The primary endpoint was biweekly frequency of angina pectoris attacks. The secondary endpoints included biweekly dosage of nitroglycerin, the Seattle Angina Questionnaire, angina pectoris severity and duration, myocardial injury markers, high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), as well as major adverse cardiovascular events (MACEs). Safety was assessed according to adverse events and serious adverse events. Results: Baseline characteristics were similar between treatment groups. Compared with those in the control group, the frequency of biweekly angina attacks (2.92 vs. 4.08, P=0.025), the biweekly dosage of nitroglycerin, as well as the severity and duration of angina attacks (P<0.01) were reduced by salvianolate. The Seattle Angina Questionnaire score was also significantly improved in the experimental group than in the control group (P<0.05). No significant differences were observed between the two groups with respect to the incidence of MACEs. Salvianolate was well tolerated. Conclusions: Salvianolate appear to have efficacy and well tolerated for elderly patients with UAP. [ClinicalTrials.gov identifier: NCT03037047]     

Efficacy and Safety of "URSA Complex" in Subjects with Physical Fatigue: A Multicenter,Randomized, Double-blind,Placebo-controlled Trial

Background:

Fatigue is a common symptom both in diseases status and in healthy subjects. Various supplements and nutraceuticals for relieving of fatigue have been used. However, there are a few studies to evaluate the efficacy and the safety of the drug for fatigue alleviation, we conducted using URSA Complex to evaluate the efficacy on physical fatigue via score changes in the checklist individual strength (CIS).

Methods:

The study was designed as a multicenter, randomized, double-blind, placebo-controlled trial, with subjects randomized to one of the two arms, receiving either placebo or URSA Complex administered as identical capsules. The primary efficacy endpoints of this clinical trials are the ratio of improving CIS scores < 76 points in patients at the end (4 weeks). Secondary efficacy variables are as follows one is an improvement of fatigue and the other is an improvement of the liver enzyme.

Results:

The fatigue recovery rate in who had improved CIS scores of < 76 points were 70.0%, 50.9% in the therapy group and placebo group, respectively (P = 0.019). The fatigue recovery rate in CIS score was higher in URSA Complex therapy group than placebo group. The difference between therapy group and placebo group was statistically significant at 4 weeks later, but not 2 weeks.

Conclusions:

Our results provided that the URSA Complex was effective in alleviating physical fatigue. The adverse event frequency in the therapy groups was similar to that in the placebo group.     

34例新辅助化疗后行加速超分割放疗治疗鼻咽癌的临床应用研究

目的 :研究新辅助化疗加后程加速超分割放疗治疗鼻咽癌的临床疗效。方法 :6 8例经病理确诊的鼻咽癌患者随机分为研究组 (n =34)和对照组 (n =34)。研究组先按FP方案 (5 -Fu +DDP)行 1周期新辅助化疗 ,然后行加速超分割放疗 ,每次 1.4～ 1.6Gy、每日 2次 ,间隔时间≥ 6小时 ,鼻咽部总剂量照射至 6 8.0～ 70 .0Gy ;对照组仅行常规分割放疗 ,鼻咽部总剂量照射至 6 8.0～70 .0Gy。放疗结束后 1月 ,两组再行 3～ 4周期辅助化疗。结果 :研究组口腔粘膜急性放射反应较对照组重 (P <0 .0 5 ) ,而皮肤和血液学急性放射反应两组无显著性差异 (P >0 .0 5 )。放疗结束时CT检查显示两组鼻咽部和颈部肿瘤的完全消退率分别为 72 .3%和 6 5 .2 % ,经统计学处理无显著性差异 (P >0 .0 5 )。但在放疗结束后 3个月和 6个月 ,两组肿瘤的完全消退率分别为 95 .3%和72 .2 %和 96 .3%和 76 .2 % ,研究组肿瘤的完全消退率均高于对照组 ,两组间都有显著性差异 (P <0 .0 5 )。放疗结束后 6个月 ,两组中、晚期 (Ⅲ和Ⅳa期 )病例肿瘤的完全消退率分别为 92 .3%和4 1.7% ,有显著性差异 (P <0 .0 5 )。结论 :新辅助化疗加后程加速超分割放疗能提高鼻咽癌的局部控制率 ,尤其适合局部晚期鼻咽癌的治疗。     

线管分期引流法治疗复杂性肛瘘的多中心随机对照临床研究

目的:客观评价线管分期引流法治疗复杂性肛瘘的有效性和安全性,以形成技术规范和推广应用方案。方法:将来自4个研究中心的180例复杂性肛瘘(高位和低位)患者随机分为治疗组和对照组,每组90例。采用全分析集(full analysis set,FAS)进行病例分布和基线资料的比较,采用符合方案集(per pro-tocol set,PPS)进行疗效和安全性评价。治疗组中,高位复杂性肛瘘采用高位旷置加线管分期引流术,低位复杂性肛瘘采用线管分期引流术;对照组中,高位复杂性肛瘘采用切开挂线术,低位复杂性肛瘘采用切开术。观察并比较两组患者的住院时间、治愈时间、住院费用,同时评价两组患者的生存质量及安全性。结果:纳入的180例患者,最终有效179例,剔除1例。治疗组的住院时间、治愈时间较对照组均明显缩短(P<0.05),住院费用较对照组亦明显减少(P<0.05);治疗后治疗组和对照组患者的生存质量较治疗前均明显提高(P<0.05),两组间生存质量差异不具有统计学意义(P>0.05)。结论:线管分期引流法治疗复杂性肛瘘安全、有效,具有极大的临床推广和应用价值。     

新辅助化疗加后程加速超分割放疗治疗鼻咽癌的临床研究

目的　评价新辅助化疗加后程加速超分割放疗治疗鼻咽癌的近期疗效及急性放射反应。方法　将同期收治的 4 3例经病理确诊且无远处转移的鼻咽癌患者随机分为研究组 (n=2 3)和对照组 (n=2 0 )。研究组先按 FP方案 (5 - Fu+DDP)行 1周期新辅助化疗 ,然后行放疗。放疗又分两个阶段 ,首先设面颈联合野加下颈切线野 ,行常规分割放疗 ,照射 36 .0～ 4 0 .0 Gy后缩野 ,而后改用面颈分野 ,研究组行加速超分割放疗 ,每次 1.4～ 1.6 Gy、每日 2次 ,间隔时间≥ 6小时 ,鼻咽部总剂量照射至 6 8.0～ 70 .0 Gy;对照组仅行常规分割放疗 ,鼻咽部总剂量照射至6 8.0～ 70 .0 Gy。放疗结束后 1月 ,两组再行 3～ 4周期辅助化疗 ,方案同前。结果　研究组口腔粘膜急性放射反应较对照组重 (P<0 .0 5 ) ,而皮肤和血液学急性放射反应两组无显著性差异 (P>0 .0 5 )。放疗结束时 CT检查显示两组鼻咽部和颈部肿瘤的完全消退率分别为 78.2 6 %和 6 5 .0 0 % ,无显著性差异 (P>0 .0 5 )。但在放疗结束后 3个月和 6个月 ,两组鼻咽癌和颈部肿瘤的完全消退率分别为 95 .6 5 %比 70 .0 0 %及 95 .6 5 %比 75 % ,均有显著性差异 (P<0 .0 5 )。放疗结束后 6个月 ,两组中、晚期 ( 期 + A+ B期 )病例肿瘤的完全消退率分别为 92 .31%和 5 0 .0 0 %