Molassiotis Alexander, Yung Hilary P, Yam Bernard M C, Chan Flora Y S, Mok T S K
University of Nottingham, School of Nursing, A Floor, Medical School, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
Support Care Cancer. 2002 Apr;10(3):237-46. doi: 10.1007/s00520-001-0329-9. Epub 2001 Dec 18.
This study was a randomised controlled trial designed to assess the effectiveness of progressive muscle relaxation training (PMRT) in the clinical management of chemotherapy-related nausea and vomiting as an adjuvant intervention to accompany pharmacological antiemetic treatment (metoclopramide and dexamethasone i.v.). Seventy-one chemotherapy-naive breast cancer patients of an outpatient oncology unit of a university hospital in Hong Kong participated, with 38 subjects randomised to the experimental group and 33 to the control group. The intervention included the use of PMRT 1 h before chemotherapy was administered and daily thereafter for another 5 days (for a total of six PMRT sessions). Each session lasted for 25 min and was followed by 5 min of imagery techniques. The instruments used for data collection included the Chinese versions of the Profile of Mood States and the State-Trait Anxiety Inventory (measured before chemotherapy and then at day 7 and day 14 after chemotherapy), and the Morrow Assessment of Nausea and Vomiting Scale, which was used daily for the first 7 post-chemotherapy days. The use of PMRT considerably decreased the duration of nausea and vomiting in the experimental group compared with the control group ( P<0.05), whereas there were trends toward a lower frequency of nausea and vomiting ( P=0.07 and P=0.08 respectively). Neither nausea nor vomiting differed in intensity between the two groups. The significant effects were mainly evident on the first 4 post-chemotherapy days, when differences were statistically significant. Although there was a significantly less severe overall mood disturbance in the experimental group over time ( P<0.05), this did not apply in the case of anxiety. Such findings suggest that PMRT is a useful adjuvant technique to complement antiemetics for chemotherapy-induced nausea and vomiting and that incorporation of such interventions in the care plan can enhance the standards of care of cancer patients who experience side effects of chemotherapy.
本研究为一项随机对照试验,旨在评估渐进性肌肉放松训练(PMRT)作为辅助干预措施,伴随药物性止吐治疗(静脉注射甲氧氯普胺和地塞米松)在化疗相关恶心和呕吐临床管理中的有效性。香港一所大学医院门诊肿瘤科的71名未接受过化疗的乳腺癌患者参与了研究,其中38名受试者被随机分配到实验组,33名被分配到对照组。干预措施包括在化疗前1小时使用PMRT,此后每天使用,持续5天(共进行6次PMRT疗程)。每次疗程持续25分钟,之后进行5分钟的意象技术训练。用于数据收集的工具包括中文版的情绪状态剖面图和状态-特质焦虑量表(在化疗前以及化疗后第7天和第14天进行测量),以及化疗后前7天每天使用的恶心和呕吐Morrow评估量表。与对照组相比,PMRT的使用显著缩短了实验组恶心和呕吐的持续时间(P<0.05),而恶心和呕吐的频率有降低趋势(分别为P=0.07和P=0.08)。两组之间恶心和呕吐的强度没有差异。显著效果主要在化疗后的前4天明显,此时差异具有统计学意义。尽管随着时间推移,实验组的总体情绪障碍明显较轻(P<0.05),但焦虑情况并非如此。这些发现表明,PMRT是一种有用的辅助技术,可补充用于化疗引起的恶心和呕吐的止吐药,并且将此类干预措施纳入护理计划可以提高经历化疗副作用的癌症患者的护理标准。