目的:探讨全病程管理模式在肺癌化疗患者中的应用效果.方法:收集2019年2月—2020年11月我院收治的104例肺癌化疗患者,随机分为常规组和观察组各52例.常规组给予常规护理,观察组给予全病程管理模式护理,比较两组患者的护理满意度、护理前后生活质量评分和睡眠质量评分.结果:观察组患者护理总满意度高于常规组(P＜0.05).护理前,比较两组患者生活质量评分、睡眠质量评分,差异均无统计学意义(P＞0.05).护理后,观察组患者生活质量评分、睡眠质量评分优于常规组,差异有统计学意义(P＜0.05).结论:为肺癌化疗患者给予全病程管理模式的护理干预,效果优,可改善患者的睡眠质量及生活质量,值得临床推广应用.

目的 观察排刺隔药饼灸联合痛点注射治疗臀上皮神经卡压综合征所致腰腿痛的疗效及对日常活动能力的影响.方法 将青海省第五人民医院2016年1月—2017年12月诊治的124例臀上皮神经卡压综合征所致腰腿痛患者随机分为对照组和观察组,每组62例.2组均行腰背肌锻炼,对照组给予1％利多卡因注射液痛点注射,观察组在对照组治疗基础上给予排刺隔药饼灸,2组疗程均为4周.比较2组治疗后疼痛视觉模拟评分(VAS)、下腰痛JOA量表评分、临床有效率、日常独立活动能力(Barthel指数)和SF-36量表评分.结果 治疗后2组VAS分级和Bar-thel指数评分分级均明显改善(P均<0.05),VAS评分明显降低而下腰痛JOA评分明显提高(P均<0.05),且观察组的改善情况明显优于对照组(P均<0.05);观察组和对照组的临床有效率分别为95.16％(59/62)和74.19％(46/62),观察组明显高于对照组(P<0.05);对照组治疗后躯体疼痛和精神健康评分均明显提高(P均<0.05),观察组治疗后生理职能、躯体疼痛、总体健康、活力、情感职能和精神健康评分均明显提高(P均<0.05),且各项评分均明显高于对照组(P均<0.05).结论 排刺隔药饼灸联合痛点注射可以有效治疗臀上皮神经卡压综合征所致的腰腿痛,改善患者日常活动能力,提高生活质量.

Objective:To evaluate the clinical effect of modified Shaoyao-Gancao Decoction combined with oral morphine sulfate sustained release tablets in the treatment of cancer pain with qi and blood deficiency. Methods:A total of 102 cancer pain patients with qi and blood deficiency from March 2017 to May 2018 were divided into two groups according to the random number table method, 51 in each group. The control group was treated with morphine sulfate sustained release tablets on the basis of conventional treatment, and the treatment group was treated with modified Shaoyao-Gancao Decoction on the basis of the control group. Both groups were treated for 4 weeks. Numerical rating scale (NRS) was used to assess the severity of cancer pain, and Karnofsky performance status (KPS) scale was used to assess the quality of life. The level of Endothelin-1 (ET-1) was measured by radioimmunoassay, The levels of 5-hydroxytryptamine (5-HT), Prostaglandin E2 (PGE2) and substance P (SP), TNF-α, IL-1β, IL-6, IL-2 were detected by ELISA, the clinical effects were evaluated, and the adverse reactions were recorded. Results:The total effective rate was 94.1% (48/51) in the treatment group and 78.4% (40/51) in the control group, the difference between two groups was statistically significant ( χ2=5.299, P=0.021). After the treatment, the NRS score (2.84 ± 1.32 vs. 4.22 ± 1.44, t=5.045) in the treatment group was significantly lower than that of the control group ( P<0.01), and the KPS score (73.13 ± 10.19 vs. 59.93 ± 8.81, t=6.998) was significantly higher than that of the control group ( P<0.01). After the treatment, serum 5-HT (0.34 ± 0.09 pg/ml vs. 0.53 ± 0.14 pg/ml, t=8.153), PGE2 (65.03 ± 15.79 pg/ml vs. 94.85 ± 20.88 pg/ml, t=8.135), ET-1 (99.96 ± 21.57 pg/ml vs. 176.78 ± 26.01 pg/ml, t=16.236), SP (60.27 ± 12.71 pg/ml vs. 65.63 ± 12.09 pg/ml, t=2.182) in the treatment group were significantly lower than those in the control group ( P<0.01 or P<0.05). Serum TNF-α, IL-1β, IL-6 level were significantly lower than that of the control group ( t value were 35.071, 12.472, 8.122, all Ps<0.01), and IL-2 level was significantly higher than that of the control group ( t=6.579, P<0.01). During the treatment, the incidence of adverse reactions was 13.7% (7/51) in the control group and 2.0% (1/51) in the treatment group. The difference between the two groups was statistically significant ( χ2=4.630, P=0.031). Conclusions:Modified Shaoyao-Gancao Decoction combined with morphine sulfate sustained release tablets can relieve the pain of cancer pain patients with qi and blood deficiency, reduce the level of inflammatory cytokines, and improve the clinical symptoms and quality of life of patients.