| Research background:With the advancement of medical technology,the survival period of patients with malignant tumors has been further prolonged,but the quality of life of patients with tumors has become more prominent,and higher requirements have been put forward for the rehabilitation of malignant tumors.At present,modern medical rehabilitation research related to non-small cell lung cancer(Non-small Cell Lung Cancer,NSCLC)surgery mainly focuses on the perioperative period.Rehabilitation interventions for patients after discharge from the hospital are mainly functional training and sports training,which are relatively lacking in pertinence.Of personalized medicine.Traditional Chinese medicine takes"holistic concept" and "syndrome differentiation and treatment" as the theoretical core.It has the same goal as the "holistic functional recovery" pursued by rehabilitation medicine,and has individualized diagnosis and treatment characteristics,which meets the rehabilitation needs of patients with non-small cell lung cancer after surgery.The tutor,Professor Lin Hongsheng,has long been concerned about the rehabilitation needs of patients with malignant tumors and created the "five nourishment" malignant tumor rehabilitation concept,which has significant clinical effects.Therefore,this study analyzes the symptoms of patients with non-small cell lung cancer after surgery and the characteristics of TCM syndromes through symptom investigations,and clarifies the rehabilitation needs of patients at this stage.Based on the experience of Professor Lin Hongsheng,a comprehensive TCM approach with dialectical decoctions as the core is carried out for patients at this stage.Rehabilitation treatment uses two methods,Patient-Report Outcome(PRO)and functional evaluation,to observe the effect of comprehensive rehabilitation of traditional Chinese medicine after non-small cell lung cancer surgery,and provide references for further research on comprehensive rehabilitation of malignant tumors.Research purpose:Investigate the main discomfort symptoms and effects of patients with non-small cell lung cancer after surgery,explore and analyze the characteristics of discomfort symptoms and the characteristics of Chinese medical syndromes of patients at this stage,and observe the effect of comprehensive rehabilitation treatment of traditional Chinese medicine with dialectical decoction as the core on patients at this stage.Research method:This study is a self-controlled before-and-after clinical study.Patients with non-small cell lung cancer who met the inclusion criteria of this study who were in the outpatient department of the supervisor group from August 2020 to February 2021 were enrolled for a 4-week comprehensive rehabilitation treatment of traditional Chinese medicine:(1)Traditional Chinese medicine decoction treatment,one dose a day,decocted in water,and divided into the morning and evening.The specific decoction prescriptions are based on the experience of Professor Lin Hongsheng,with Astragalus,Radix Astragali,and Lily as the core medicines,according to the situation to add or subtract medicines:patients with evidence of qi deficiency can add codonopsis,Taizishen,Atractylodes,Rhodiola and other Qi-enriching drugs;Patients with evidence of yin deficiency can be added with yin-nourishing drugs such as Asparagus,Ophiopogon japonicus,and white peony;for patients with evidence of phlegm-dampness,damp-removing and phlegm-reducing drugs such as Pinellia,Magnolia officinalis,tangerine peel,and Poria can be added;For patients with evidence of blood stasis,drugs for promoting blood circulation and removing blood stasis such as notoginseng,zedoary turmeric,and spatholobi can be added;for patients with chest tightness and abdominal distension,drugs for promoting qi and regulating qi,such as scallion white,bergamot,big abdomen skin,and Citrus aurantium can be added;To relieve patients,use Bupleurum,Turmeric,Albizia Flower and other drugs for soothing the liver and relieving depression;for patients with poor appetite,add hawthorn,Shenqu,malt,grain sprout,Gallus gallus domesticus and other digestive and appetizing drugs;disturbed sleep In patients with,you can add soothing drugs such as jujube seed,baiziren,lotus seed meat,etc.;and use Smilax glabra,golden buckwheat,Baiying and other anticancer drugs such as heat-clearing and detoxifying as appropriate.(2)Breathing function training,2 times a day,based on abdominal breathing training,and according to individual conditions,with the selection of hip-lifting breathing training,lip-reducing breathing training and/or candle blowing breathing training.(3)Routine health education,and give psychological counseling,dietary guidance and exercise guidance based on individual conditions,using online consultation and answering questions at any time,without setting specific frequency requirements.Evaluation methods and nodes of this study:(1)Symptom investigation,using the Chinese version of Anderson Symptom Inventory-Chinese(MDASI-C)and the revised lung cancer specific module,before treatment,2 weeks and 4 weeks of treatment At the end of the week treatment.(2)Functional evaluation,using breath-hold test,stair climbing test,and simple lung function rating,before treatment and after 4 weeks of treatment.(3)TCM syndrome investigation is based on the criteria of lung cancer syndrome elements in the "Guidelines for the Diagnosis and Treatment of Malignant Tumors" and is only conducted once before treatment.This study uses WPS OFFICE 2019 EXCLE input data,IBM SPSS 26:0 analysis data.Research result:(1)Symptoms and effects:Symptoms with an incidence of not less than 80%before treatment are:fatigue and shortness of breath(both 100%),insomnia(both 93.3%),dry mouth,distress and forgetfulness(both 90.0%),Poor appetite and pain(both 86.7%),cough and chest tightness(both 83.3%).In the two weeks of treatment,they were:fatigue(100%),shortness of breath(96.7%),insomnia(93.3%),dry mouth(90.0%),forgetfulness,chest tightness and pain(all 86.7%),cough and poor appetite(both 83.3%).After four weeks of treatment,they were fatigue(96.7%),forgetfulness(90.0%),shortness of breath and dry mouth(86.7%both),poor appetite(83.3%),insomnia,pain and chest tightness(both 80.7%).The impact of these uncomfortable symptoms on the life of patients is comprehensive,covering general activities,emotions,work(including housework),relationships with others,walking,and joy of life.(2)Symptom severity:The high-scoring symptoms before treatment are:shortness of breath(5.10±2.074),fatigue(4.40±1.499),cough(3.77±2.487),distress(3.67±2.324),forgetfulness(3.67 ± 2.249),Insomnia(3.63±1.542),chest tightness(3.27±2.303),dry mouth(3.03±1.866).After two weeks of treatment,the high-scoring symptoms were:shortness of breath(3.60±2.111),forgetfulness(3.53±2.240),fatigue(3.47±1.432),cough(3.10±2.440),insomnia(2.90±1.322),distress(2.73±2.227)),dry mouth(2.70±1.512),chest tightness(2.70±2.152).The high-scoring symptoms at the end of four weeks of treatment were:forgetfulness(3.13±2.030),shortness of breath(2.60±1.812),fatigue(2.37±1.129),cough(2.17±1.895),insomnia(2.10±1.583),dry mouth(2.10±1.423)),poor appetite(2.07±1.617).(3)Distribution of syndrome elements:Qi deficiency syndrome(93.3%),Yin deficiency syndrome(66.7%),Phlegm-dampness syndrome(43.3%),Blood stasis syndrome(36.7%).There was no heat toxin syndrome in this study.Qi-deficiency syndrome and Yin-deficiency syndrome are the most common(56.7%).The specific TCM syndrome type of patients is mainly composed of 2 or 3 syndrome elements(83.3%in total).(4)Changes in the scores of symptoms and symptoms before and after treatment:repeated measures analysis of variance and non-parametric tests were selected for statistical analysis.Most of the symptoms have been significantly improved:shortness of breath,cough,sputum,chest tightness,fatigue,insomnia and distress all have P<0.001,sadness,dry mouth,pain,poor appetite,nausea,constipation,forgetfulness and lethargy all have P<0.001 0.05,activities,emotions,work(including housework),relationship with others,walking,and joy of life all have P<0.01.(5)Changes in functional assessment before and after treatment:while choosing chi-square test and non-parametric test,perform statistical analysis on the before and after results of breath-hold test,stair climbing test,and simple lung function rating.Both statistical analysis methods suggest three functional assessments.The results before and after have significant differences(both P<0.05).(6)Symptom clusters:perform three cluster analysis before,during and after treatment,and combine the incidence and severity of symptoms to retain the clusters of symptoms that persist and have a significant impact-on the patient,and conclude that they exist at this stage The symptom groups are:symptom group 1(cough,sputum,chest tightness and shortness of breath),symptom group 2(sadness and distress),symptom group 3(dry mouth and poor appetite),symptom group 4(fatigue and forgetfulness).Research conclusions and significance:1.The main symptoms of non-small cell lung cancer after surgery are fatigue,shortness of breath,dry mouth,cough,chest tightness,distress,insomnia,forgetfulness,pain and poor appetite.These discomfort symptoms have a comprehensive impact on the patient's life,covering general activities and emotions,Work(including housework),relationship with others,walking,and fun in life.Some symptoms coexist steadily and have a greater impact on patients,which can be summarized as a symptom group.This study found that there are 4 symptom groups after non-small cell lung cancer surgery:symptom group 1(cough,sputum,chest tightness And shortness of breath),symptom group 2(sadness and distress),symptom group 3(dry mouth and poor appetite),symptom group 4(fatigue and forgetfulness).Or,targeted interventions can be made to improve the clinical efficacy according to the characteristics of the symptoms and symptom clusters of patients at this stage.2.The hot spots of TCM syndromes in patients with non-small cell lung cancer after surgery are:Qi deficiency syndrome is widespread,followed by Yin deficiency syndrome,and the two often appear together.Some patients have phlegm-dampness syndrome or(and)blood stasis syndrome.The specific TCM syndrome type is mainly composed of 2 or 3 single syndrome elements.It may have certain reference value for clinical syndrome differentiation and treatment.3.The comprehensive rehabilitation treatment of traditional Chinese medicine with dialectical decoction as the core can effectively improve the uncomfortable symptoms of patients with non-small cell lung cancer after surgery,and promote the recovery of patients'cardiopulmonary function. |
PDF Full Text Request