运动零食锻炼对肺癌化疗患者癌因性疲乏和锻炼依从性的影响 [中文引用][英文引用]

目的 探讨运动零食锻炼对肺癌患者癌因性疲乏（cancer-related fatigue，CRF）和锻炼依从性的影响。方法 采用历史前后对照研究，选取 2024 年 5 月至 11 月本院呼吸内科收治的 86 例肺癌患者作为研究对象，其中 2024 年 5 月至 7 月入院的 44 例设为对照组，2024 年 8 月至 11 月的 42 例设为干预组。其中干预组 4 例脱落，对照组 2 例脱落。对照组患者接受常规运动指导，干预组接受为期 8w 的运动零食锻炼的干预方案。比较两组患者基线（T0）、第 4 周（T1）及第 8 周（T2）3 个时间点的癌因性疲乏、生活质量、6min 步行距离以及肺功能指标。结果 干预组和对照组各 40 例患者完成研究。①两组的疲乏总分比较的时间主效应、组间主效应及交互效应具有统计学意义（均 P<0.01）；干预后 T1、T2 时点，干预组疲乏总分均低于对照组（均 P<0.001）。②两组 6MWD 比较的时间主效应、组间主效应与交互效应具有统计学意义（均 P<0.01）；T1、T2 时干预组 6MWD均高于对照组（均 P<0.001）。③两组 FEV1/FVC% 比较的时间主效应与组间主效应具有统计学意义（均 P<0.01），交互效应无统计学意义（P>0.05）；T1、T2 时干预组 FEV1/FVC% 优于对照组（P<0.01）。④两组 QLQ-C30 总分比较的时间主效应、组间主效应及交互效应具有统计学意义（均 P<0.01）；T1 及 T2 时干预组 QLQ-C30 总分高于对照组，两组比较，差异具有统计学意义（均P<0.001）。结论 运动零食锻炼能缓解肺癌患者的癌因性疲乏，并改善其功能状态，对提升生活质量和肺功能具有积极影响。

Objective To investigate the effects of a stepwise exercise prescription guided by the exercise snacking（ES） concept on cancerrelated fatigue（CRF）and exercise compliance in lung cancer patients after chemotherapy. Methods A historical controlled before and after study was conducted. A total of 86 lung cancer patients admitted to the Department of Respiratory Medicine of our hospital from May to November 2024 were selected as the research subjects. Among them, 4 patients admitted from May to July 2024 were set as the control group, and 42 patients from August to November 2024 were set as the intervention group. Among them, 4 cases dropped out in the intervention group and 2 cases dropped out in the control group. The intervention group received an 8 weeks ES-based stepwise exercise snacking intervention, while the control group received routine care. The primary outcome was the change in Piper fatigue scale（PFS）scores. Secondary outcomes included the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30（EORTC QLQ-C30）, 6 minute walk distance（6MWD）, and pulmonary function parameters（FEV1/ FVC%）. Data were collected at baseline（T0）, 4 weeks（T1）, and 8 weeks（T2）. Results Forty patients in both the experimental group and the control group completed the study. ① The time main effect, intergroup main effect and interaction effect of the total fatigue score between the two groups were statistically significant（all P<0.01）. At time points T1 and T2 after intervention, the total fatigue scores of the intervention group were lower than those of the control group（all P<0.001）. ② For the 6minute walking distances（6MWDs）of the two groups, the time main effect, intergroup main effect and interaction effect were statistically significant（all P<0.05）. At T1 and T2, the 6MWD in the intervention group were higher than those in the control group（all P<0.001）. ③ Regarding FEV1/FVC% of the two groups, the time main effect and intergroup main effect were statistically significant（all P<0.01）, while the interaction effect had no statistical significance（P>0.05）. ④ The time main effect, intergroup main effect and interaction effect of the total QLQ-C30 score between the two groups were statistically significant（all P<0.01）. At T1 and T2, the total QLQ-C30 score of the intervention group were higher than those of the control group, and the difference between the two groups was statistically significant（all P<0.001）. Conclusion The ES-guided stepwise exercise snacking significantly alleviates cancerrelated fatigue in lung cancer patients, improves functional status, and positively influence quality of life and pulmonary function.