风扇疗法对缓解晚期癌症患者呼吸困难有效：一项平行臂、随机对照试验。

Fan Therapy Is Effective in Relieving Dyspnea in Patients With Terminally Ill Cancer: A Parallel-Arm, Randomized Controlled Trial.

机构信息

Section of Liaison Psychiatry and Palliative Medicine, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan; Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Department of Nursing, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.

Palliative and Supportive Care Division, Seirei Mikatahara Hospital, Hamamatsu, Shizuoka, Japan.

出版信息

J Pain Symptom Manage. 2018 Oct;56(4):493-500. doi: 10.1016/j.jpainsymman.2018.07.001. Epub 2018 Aug 6.

DOI:10.1016/j.jpainsymman.2018.07.001

PMID:30009968

Abstract

CONTEXT

Dyspnea is a common distressing symptom among patients with advanced cancer.

OBJECTIVE

The objective of this study was to determine the effect of fan therapy on dyspnea in patients with terminally ill cancer.

METHODS

This parallel-arm, randomized controlled trial included 40 patients with advanced cancer from a palliative care unit at the National Cancer Center Hospital in Japan. All patients experienced dyspnea at rest with a score of at least three points on a subjective 0- to 10-point Numerical Rating Scale (NRS), showed peripheral oxygen saturation levels of ≥90%, had an Eastern Cooperative Oncology Group grade of 3 or 4, and were aged 20 years or more. In one group, a fan was directed to blow air on the patient's face for five minutes. This group was compared to a control group wherein air was blown to the patient's legs. Patients were randomly assigned to each group. The main outcome measure was the difference in dyspnea NRS scores between fan-to-face and fan-to-legs groups.

RESULTS

No significant differences were seen in baseline dyspnea NRS between groups (mean score, 5.3 vs. 5.1, P = 0.665). Mean dyspnea changed by -1.35 points (95% CI, -1.86 to -0.84) in patients assigned to receive fan-to-face and by -0.1 points (-0.53 to 0.33) in patients assigned to receive fan-to-legs (P < 0.001). The proportion of patients with a one-point reduction in dyspnea NRS was significantly higher in the fan-to-face arm than in the fan-to-legs arm (80% [n = 16] vs. 25% [n = 5], P = 0.001).

CONCLUSION

Fan-to-face is effective in alleviating dyspnea in patients with terminally ill cancer.

摘要

背景

呼吸困难是晚期癌症患者常见的痛苦症状。

目的

本研究旨在确定风扇疗法对终末期癌症患者呼吸困难的影响。

方法

这是一项平行臂、随机对照试验，纳入了来自日本国家癌症中心医院姑息治疗病房的 40 名晚期癌症患者。所有患者在休息时均有呼吸困难，主观 0-10 分数字评分量表（NRS）评分至少为 3 分，外周血氧饱和度水平≥90%，东部肿瘤协作组（ECOG）分级为 3 或 4 级，年龄≥20 岁。一组将风扇对准患者面部吹风 5 分钟。将这组与向患者腿部吹风的对照组进行比较。患者被随机分配到每组。主要结局测量指标是面部吹风组和腿部吹风组之间的呼吸困难 NRS 评分差异。

结果

两组患者的基线呼吸困难 NRS 评分无显著差异（平均评分，5.3 比 5.1，P=0.665）。接受面部吹风的患者平均呼吸困难评分变化-1.35 分（95%CI，-1.86 至-0.84），接受腿部吹风的患者平均呼吸困难评分变化-0.1 分（-0.53 至 0.33）（P<0.001）。接受面部吹风的患者中，呼吸困难 NRS 评分降低 1 分的患者比例明显高于接受腿部吹风的患者（80%[n=16]比 25%[n=5]，P=0.001）。