药学干预改善胃癌患者生活质量的初步研究

目的：：观察药学干预对在接受化疗期间的胃癌患者的生活质量的影响。方法：解放军第202医院2012年3月至2014年3月期间收治的178例胃癌术后患者，随机分为接受静脉化疗和药学干预的干预组（n ＝89）和仅接受静脉化疗的对照组（n ＝89）。针对术后化疗所引起的胃肠道症状，临床药师根据患者对药物的反应情况进行药学干预。药学干预内容为与临床医生沟通，将对症治疗方案优化并且对临床用药进行指导。观察两组患者在治疗期间的消化道反应及两组患者生活质量。结果：干预组患者在化疗前3个周期对止吐药物的完全缓解率分别为53.9％，61.8％和64.0％，对照组为32.6％，43.8％和46.1％，两组差异有统计学意义（P ＝0.004，P ＝0.016， P ＝0.016）。干预组的急性和迟发性恶心症状明显低于对照组（P ＝0.032，P ＝0.029）；干预组的急性和迟发性呕吐程度明显低于对照组（P ＝0.020；P ＝0.031）。生活质量评分：干预组总健康状况评分高于对照组（P ＝0.022），而食欲丧失、恶心和呕吐的症状评分低于对照组（P ＝0.021，P ＝0.018）。结论：以临床药师主导的药学干预可降低胃癌患者在辅助化疗期间恶心、呕吐发生率，可改善患者生活质量。

Effects of Pharmaceutical Intervention on Quality of Life in Gastric Cancer Patients

Objective:To observe the effects of pharmaceutical intervention on quality of life in gastric cancer pa-tients undergoing chemotherapy.Methods:One hundred and seventy-eight postoperative gastric cancer patients receiving chemotherapy in our institution between March 2012 and March 2014 were assigned into two groups randomly:intervention group(n =89;receiving chemotherapy plus pharmaceutical intervention)and control group(n =89;receiving chemotherapy only).The clinical pharmacists carried out pharmaceutical interventions according to the reaction of the medicines for the treatment of gastrointestinal symptoms during chemotherapy.The pharmacentical intervation included the communication with clinical doctors,optimizing the treatment plan and instruction for clinical medication.The gastrointestinal reactions during chemotherapy and the quality of life in two groups were observed.Results:The complete relief rates of the interven-tion group to the antemetics were 53.9%,61.8% and 64.0% in the first three cycle;those of the control group were 32.6%,43.8% and 46.1%,respectively.The difference was statistically significant between the two groups(P =0.004, P =0.016,P =0.016).The symptoms assessment of acute and delayed nausea in the intervention group were statistically lower than those in the control group(P =0.032,P =0.029).The symptoms assessment of acute and delayed vomiting in the intervention group were statistically lower than those in the control group(P =0.020,P =0.031).Quality of life evalu-ation showed that global health status score in the intervention group was higher than that in the control group(P =0.022), while the symptom scores in terms of loss of appetite and vomiting/nausea were lower than those in the control group (P =0.021,P =0.018).Conclusion:Pharmaceutical in-terventions can not only alleviate symptoms including nausea and vomiting but also improve the quality of life for gastric cancer patients who receive chemotherapy.