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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。
OBJECTIVE: To observe the effect of pharmaceutical intervention on the quality of life of gastric cancer patients undergoing chemotherapy. METHODS: A total of 178 patients with gastric cancer admitted to the 202nd Hospital of PLA from March 2012 to March 2014 were randomly divided into intervention group (n = 89) treated with intravenous chemotherapy and pharmacological intervention and control group receiving intravenous chemotherapy alone (n = 89). According to the symptoms of gastrointestinal tract caused by postoperative chemotherapy, clinical pharmacists perform the pharmacological intervention according to the patients’ response to the drugs. The content of the pharmacy intervention is to communicate with the clinician, to optimize the symptomatic treatment plan and to guide the clinical medication. The two groups of patients were observed during the treatment of gastrointestinal reactions and quality of life of patients in both groups. Results: The complete remission rate of antiemetic drugs in intervention group was 53.9%, 61.8% and 64.0% respectively in the three cycles before chemotherapy and 32.6%, 43.8% and 46.1% in control group, with significant difference between the two groups P = 0.004, P = 0.016, P = 0.016). The acute and delayed nausea symptoms in the intervention group were significantly lower than those in the control group (P = 0.032, P = 0.029). The acute and delayed vomiting in the intervention group was significantly lower than that in the control group (P = 0.020; P = 0.031). The quality of life score was significantly higher in the intervention group than in the control group (P = 0.022), while the symptoms of loss of appetite, nausea and vomiting were lower than those in the control group (P = 0.021, P = 0.018). Conclusion: Pharmacological intervention led by clinical pharmacists can reduce the incidence of nausea and vomiting in patients with gastric cancer during adjuvant chemotherapy and improve the quality of life of patients.