| Objective:There were two groups of breast cancer patients,who were respectively accepting routine breast cancer care and treatment and routine care plus individualized nutrition support,Meridian massage and psychological interventions.The objectives of this study were to compare the activity of peripheral blood T lymphocytes and NK cell among two groups of patients before surgery,post surgery and post chemotherapy,and to comprehensively analyze the effect of nutritional support and meridian massage on the breast cancer patient's immune function.Methods:This study chose experimental study design.All study participants were from a category A with the third level's hospital. During October 2007 to October 2008,in Breast Surgery Division,there were a total of 69 cases diagnosed and confirmed by biopsy as breast cancer at the stage ofⅢ-Ⅳ.These patients were no immune system diseases,did not affect the immune function by drugs,and had a need for comprehensive treatment.Among these 69 patients,they were randomly assigned into intervention group and control group.The experimental group included 35 cases.The means of their age was 43±3.1 years old.The diagnosing characteristics were 29 cases of infiltrating ductal carcinoma,4 cases of invasive lobular carcinoma,and 2 cases were classified as others;16 cases were at the stageⅢand 9 cases were at the stageⅣ.Among 34 cases in the control group,the means of their age was 45±3.2 years old.28 cases were invasive ductal carcinoma,4 cases were invasive lobular carcinoma,and 2 case was classified as others;16 cases were at the stageⅢand 8 cases were at the stageⅣ.Two groups of patients were female with the metastasis of axillary lymph node.In addition,both groups had no statistic significance in their age,educational level,occupation,economic conditions,and marital status(P＞0.05).The experimental group was accepted the routine basis of treatment and care,at the same time the rehabilitation nurse conducted interventions including nutritional assessment,nutrition management,and personalized dietary guidance, periodic limb function at the same time exercise,rehabilitation exercises with aerobic exercise,music,meditation,group psychotherapy intervention,emotional support,acupuncture,massage,massage with a variety of methods such as scrape,to help patients with the overall physical and psychological rehabilitation for the experimental group of patients;the control group was only accepted routine hospital treatment and care.The peripheral blood of patients with T-lymphocyte subsets and NK cell's activity were detected before surgery,post surgery and post chemotherapy.All participants signed the informed consent form. Data collection and analysis:Instruments for data collection included the self-designed Demographic Profile Sheet,the scale of HAMD-24, the Quality of Life Scale for Breast Cancer(FACT-G,Version 4).All breast cancer patients under the same instructions self-reported the Demographic Profile Sheet(including age,occupation,education level, family economic condition,martial status,medical insurance status etc.), the time to complete the instruments ranges from 15 to 30 minutes.The management and analysis of data were performed in SPSS 10.0.Statistic analysis techniques included descriptive analysis,two independent t-test, paired t-test,and chi-square test.Results:(1) Before surgery making comparison between breast cancer patients and healthy adult controls,the level of CD3+(%),CD4+(%), and NK were reduced(P＜0.01);the level of CD4+/CD8+was also reduced(P＜0.05),CD8~+(%) was increased(P＞0.05),there was statistic significance.Before surgery,the experimental group's HAMD-24 scores were 25.67±6.3,HAMA score was 18.97±5.6.Both scores among the controlled group were respectively 24.78±5.9,19.69±7.1. (2) After surgery,the level of CD3+(%),CD4+(%),CD4+/CD8+ among both groups were significantly increased(P＜0.05).The level of CD8+(%) was decreased but without statistic significance,the activity of NK was increased.There was no statistic significance(P＞0.05).After surgery,the experimental group's HAMD-24 scores were 16.7±6.3, HAMA score was 13.8±5.1(P＜0.05).Both scores among the controlled group were respectively 22.5±7.1,17.7±6.6(P＜0.01). (3) After chemotherapy,the level of CD3+(%),CD4+(%),CD8+(%), CD4+/CD8+and the activity of NK were changed,there was no statistic significance between experimental and controlled groups(P＞0.05).Yet,the experimental group has an increasing trend compared with post surgery(P＜0.05),there was statistic difference between experimental group and the controlled group.After chemotherapy,the experimental group's HAMD-24 scores were 12.57±5.4,HAMA score was 9.56±4.37.Both scores among the controlled group were respectively 15.6±4.3(P＜0.01),13.4±6.71(P＜0.05).Conclusion:(1) Breast cancer patients have the decreasing level of cell immunity.(2) Surgery can improve the level of cell immunity.(3) The nutritional management and meridian massage can affect the breast cancer patient's immune levels,improve the patient's immune function,enhance the efficacy of treatment,and promote the quality of life of patients.(4) Breast cancer patients have severe psychological problems, psychological interventions can enhance the immune function of breast cancer patients. |
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