肌肉放鬆於化學治療期間噁心及嘔吐之成效

The Effects of Muscle Relaxation on Nausea and Vomiting Induced by Chemotherapy

噁心及嘔吐是接受化學治療病患最常出現的副作用，本研究目的在探討接受化學治療之癌症病患，於施行肌肉放鬆後，對噁心及嘔吐、焦慮及放鬆程度的影響。採類實驗法研究設計，針對第一次接受高劑量Cisplatin化學治療方案之癌症病患，隨機分派至實驗組（接受肌肉放鬆）及對照組。兩組人數各為20人，共40人。實驗組於化學治療前及化學治療期間，接受每日兩次每次30分鐘肌肉放鬆訓練，對照組則接受30分鐘常規護理衛教及關懷。兩組於化學治療前及治療四天期間以羅氏噁心及嘔吐量表、史氏情境－特質焦慮量表、生理指標測量及病患放鬆視覺類比評量表，瞭解化學治療期間噁心及嘔吐的變化、焦慮改變及放鬆程度。資料分析包括：百分比、平均值、標準差、卡方檢定、獨立t檢定、配對t檢定及重複測量變異數分析。結果發現：(1)對照組噁心嘔吐程度在化學治療的的第三及第四天，均較接受肌肉放鬆處置的實驗組明顯增加。(2)兩組在接受肌肉放鬆處置前後焦慮程度未呈顯著改變。(3)實驗組在接受肌肉放鬆處置後生理指標明顯下降，放鬆程度也明顯增加，研究結果支持肌肉放鬆可降低癌症病患於化學治療期間噁心及嘔吐程度。

Nausea and vomiting are the most common side effects experienced by patients receiving chemotherapy. In this study, we examined the effects of muscle relaxation in reducing nausea, vomiting, and anxiety induced by chemotherapy in cancer patients. This study utilized an experimental design. Forty patients who received the high dose cisplatin chemotherapy the first time were randomly assigned into experimental or control group. The experimental group received a 30-minute program on muscle relaxation twice a day during pre-chemotherapy and chemotherapy periods. The control group received ward routine and caring care. The times, frequency, and uncomfortable level of nausea and vomiting were measured by Rhodes Index of Nausea and Vomiting (RINV). Spielberger's State-Trait Anxiety Inventory (STAI) was used to measure patients' state anxiety and trait anxiety. In addition, patients' physical index and patient's relaxation visual analogue scale were also measured to examine their relaxation level. Statistical analysis included descriptive statistics, Chi-square test, independent t-test, paired t-test, and two-factor (time and group) repeated measure's ANOVA. We found that: (1) Nausea and vomiting level in control group was more severe especially in the third and fourth chemotherapy days. (2) There was no significant difference in the anxiety level. (3) The use of muscle relaxation training in experimental group significantly lessened the physical index and relaxation level than control group. Our findings suggested that muscle relaxation could reduce chemotherapy-induced nausea and vomiting.