认知干预对经 DC-CIK 治疗的中晚期肝细胞癌患者生命质量、疼痛程度及临床疗效的影响

目的：研究认知干预对经 DC-CIK 治疗的中晚期肝细胞癌患者的生命质量、疼痛程度及临床疗效的影响。方法选择中国医科大学附属第一医院普通外科及肿瘤内科2011年1月—2014年1月收治的中晚期肝细胞癌156例，随机分为观察组（82例）与对照组（74例）。两组均予肿瘤常规方案、DC-CIK 方案治疗及常规心理干预，观察组同步予认知干预。治疗前后用肿瘤生命质量核心问卷（ QLQ-C30）评估两组生命质量，采用视觉模拟评分法（ VAS）评价两组疼痛程度，评估两组近、远期临床疗效，记录两组中位生存期，观察并记录治疗过程中的不良反应。结果治疗后两组 QLQ-C30整体功能、特异性症状模块各指标及整体生命质量评分均明显优于治疗前（ P ﹤0.05，P ﹤0.01），治疗后观察组上述指标均优于对照组（P ﹤0.05）；两组治疗后疼痛程度均明显低于治疗前（ P ﹤0.01），治疗后观察组疼痛程度明显低于对照组（P ﹤0.05）；治疗后两组近期临床疗效差异无统计学意义（ P ﹥0.05），观察组远期临床疗效优于对照组（P ﹤0.05），且中位生存期长于对照组（P ﹤0.05）；两组治疗中主要不良反应发生率差异无统计学意义（ P﹥0.05）。结论对于中晚期肝细胞癌患者在进行 DC-CIK 免疫治疗的基础上给予认知干预，能很好改善患者的生命质量、缓解疼痛、提高远期临床疗效，且安全性较高。

Effect of Cognitive Intervention on Quality of Life,Pain Degree and Clinical Efficacy of Patients with Middle-ad-vanced Hepatocellular Carcinoma by DC-CIK Therapy

Objective To investigate the effect of cognitive intervention on quality of life,pain degree and clini-cal efficacy of patients with middle-advanced hepatocellular carcinoma by dendritic cell- cytokine-induced killers cell (DC-CIK)therapy. Methods A total of 156 patients with middle-advanced hepatocellular carcinoma admitted during January 2011 and January 2014 were randomly divided into observation group(n = 82)and control group(n = 74). All patients were treated with routine chemotherapy,DC-CIK and routine mental intervention,and the observation group was added with cognitive intervention. In the two groups,quality of life was evaluated using Core quality of life questionnaire ( QLQ-C30)before and after the treatment;the pain degree was evaluated using visual analogue scales(VAS);short and long-term clinical efficacy was evaluated. The middle survival times were recorded,and adverse reactions during the ther-apy were also recorded in the two groups. Results After the treatment,the scores of QLQ-C30 allomeric function,spe-cific symptom modules and the whole score of life quality were better,compared with those before treatment in the two groups(P ﹤ 0. 05,P ﹤ 0. 01),and the above scores in the observation group were better than those in the control group (P ﹤ 0. 05);the pain degrees were milder,compared with those before the treatment in the two groups(P ﹤ 0. 01),and the pain degree in the observation group was milder than that in the control group(P ﹤ 0. 05). After the treatment,there was no significant difference in clinical efficacy in the two groups(P ﹥ 0. 05);long-term clinical efficacy was significant-ly better(P ﹤ 0. 05),and the mean times of survival was longer in observation group than those in the control group (P ﹤ 0. 05). There was no significant difference in the incidence rate of adverse reactions in the two groups during the treatment(P ﹥ 0. 05). Conclusion The cognitive intervention may well improve quality of life and long-term clinical ef-ficacy,and safely relieve pain for patients with middle-advanced hepatocellular carcinoma by DC-CIK immunotherapy.