天晴日安治疗化疗后恶心呕吐的临床研究

目的观察选择性5-HT3受体拮抗剂———盐酸阿扎司琼氯化钠(天晴日安)预防化疗所致的消化道反应的临床疗效。方法随机选择52例化疗患者,治疗组26例,天晴日安10 mg,化疗前30 m in静注;对照组26例,盐酸恩丹西酮8 mg,静推,化疗前后15 m in应用。结果天晴日安对急性恶心的有效率为96.2%,恩丹西酮为92.3%;天晴日安对急性呕吐的有效率为100%,恩丹西酮为88.5%。天晴日安组便秘发生率42.3%,恩丹西酮组57.7%。结论天晴日安对化疗所致恶心呕吐具有良好的治疗作用,副作用小,且无锥体外系症状。     

格拉司琼预防胃癌化疗引起恶心呕吐的临床研究

目的:观察格拉司琼注射剂预防顺铂引起的急性及延迟性恶心呕吐的作用和毒副反应,并与恩丹西酮比较.方法:采用随机自身对照方法,将48例接受联合化疗(含顺铂)的胃癌患者随机分为A、B两组,均接受2个周期相同方案的化疗.A组第1周期用格拉司琼,第2周期用恩丹西酮止吐;B组第1周期用恩丹西酮,第2周期用格拉司琼止吐.观察化疗后24小时(急性)及5日内(延迟性)恶心呕吐发生的情况.结果:在化疗后0h～6h,格拉司琼对恶心的控制率与恩丹西酮相似,但第1天、第2天、第3天格拉司琼对恶心的有效率(62.5%、47.9%、41.7%)优于恩丹西酮(41.7%、27.1%、22.9%,P＜0.05),提示格拉司琼作用时间较恩丹西酮长.格拉司琼控制呕吐的效果及所致毒副作用与恩丹西酮相似.结论:格拉司琼能有效控制胃癌化疗所致的恶心呕吐,作用时间较恩丹西酮长,它的不良反应轻,是良好的化疗止吐药.     

格拉司琼与恩丹西酮防治食管癌术后化疗所致恶心呕吐的疗效对比

目的:比较格拉司琼与恩丹西酮防治食管癌术后患者化疗引起恶心、呕吐的作用及毒副反应。方法:回顾性研究439例食管癌术后化疗患者的临床资料,比较格拉司琼和恩丹西酮的治疗效果及毒副反应。结果:吻合口位于颈部患者比位于胸内患者易发生恶心、呕吐。格拉司琼对化疗后急性(1d)恶心、呕吐有效率为81.6%,延迟性恶心呕吐(2～5d)的有效率分别为75.0%、64.2%、60.8%、56.1%。恩丹西酮对化疗后急性恶心、呕吐有效率为71.4%,延迟性恶心、呕吐的有效率分别为68.7%、57.7%、52.0%、47.1%,两组差异显著(P<0.05),格拉司琼治疗效果优于恩丹西酮。两者不良反应基本相似。结论:格拉司琼对于防治食管癌术后患者化疗所致恶心、呕吐效果较好。     

格拉司琼预防胃癌化疗引起恶心呕吐的临床研究

目的 :观察格拉司琼注射剂预防顺铂引起的急性及延迟性恶心呕吐的作用和毒副反应 ,并与恩丹西酮比较。方法 :采用随机自身对照方法 ,将 48例接受联合化疗 (含顺铂 )的胃癌患者随机分为A、B两组 ,均接受 2个周期相同方案的化疗。A组第 1周期用格拉司琼 ,第 2周期用恩丹西酮止吐 ;B组第 1周期用恩丹西酮 ,第 2周期用格拉司琼止吐。观察化疗后 2 4小时 (急性 )及 5日内 (延迟性 )恶心呕吐发生的情况。结果 :在化疗后 0h～ 6h ,格拉司琼对恶心的控制率与恩丹西酮相似 ,但第 1天、第 2天、第 3天格拉司琼对恶心的有效率 ( 62 5 %、47 9%、41 7% )优于恩丹西酮 ( 41 7%、2 7 1%、2 2 9% ,P <0 0 5 ) ,提示格拉司琼作用时间较恩丹西酮长。格拉司琼控制呕吐的效果及所致毒副作用与恩丹西酮相似。结论 :格拉司琼能有效控制胃癌化疗所致的恶心呕吐 ,作用时间较恩丹西酮长 ,它的不良反应轻 ,是良好的化疗止吐药     

多潘立酮直肠给药防治顺铂致迟发性恶心呕吐的临床观察

目的　探讨多潘立酮 (吗丁啉 )直肠给药在顺铂致胃肠道反应中的应用价值。方法　对 4 6例住院接受顺铂联合化疗方案化疗的恶性肿瘤病人进行止吐自身对照治疗观察。化疗第一周期只用昂丹司琼 (恩丹西酮 ) ,第 2周期用恩丹西酮加吗丁啉 2 0 mg直肠给药 1天 2次 ,连用 5天。结果　两种止吐方法对化疗后 2 4小时内急性恶心 ,呕吐有效率无差异 ,联用吗丁啉组化疗后 2～ 5天迟发性恶心、呕吐的控制率 ,明显高于单用恩丹西酮的对照组 (P<0 5 )。结论　吗丁啉直肠给药联合恩丹西酮防治顺铂致迟发性恶心、呕吐疗效较好     

以恩丹西酮为主的联合方案预防化疗所致呕吐的临床观察

[目的]观察恩丹西酮＋甲氧氯普胺＋苯海拉明＋地塞米松预防化疗引起的恶心呕吐的临床疗效和毒副反应。[方法]对60例患者采用随机自身对照试验法，分别用恩丹西酮单药及恩丹西酮＋甲氧氯普胺＋苯海拉明＋地塞米松联合方案预防呕吐。[结果]恩丹西酮＋甲氧氯普胺＋苯海拉明＋地塞米松3天内预防呕吐的有效率分别为93.3％、95．0％、96．7％，明显优于对照组的75．0％、78．3％和75．0％（P〈0．05）。毒副作用可以耐受。[结论]恩丹西酮＋甲氧氯普胺＋苯海拉明＋地塞米松联合方案预防化疗引起的呕吐效果明显优于思丹西酮单药。     

小剂量恩丹西酮联合方案预防化疗所致的胃肠道反应

目的研究小剂量恩丹西酮联合方案预防化疗引起的胃肠道反应。方法对３５例病人采用自身对照随机进行，用小剂量恩丹西酮、苯海拉明、氟美松、胃复安等药联合方案，与常规止吐方案（不用恩丹西酮）对比。结果小剂量恩丹西酮联合止吐方案控制急性恶心、呕吐的有效率为９５％，明显优于常规止吐方案（Ｐ＜０．０１）。对迟发性呕吐的有效率也高于常规止吐方案，但差异无显著性（Ｐ＞０．０５）。与应用单药恩丹西酮相比，第１～５天控制恶心、呕吐的有效率均有所提高。结论认为小剂量恩丹西酮联合止吐方案既获得了较好的止吐疗效又节省了医疗费用，便于基层医院推广。     

恩丹西酮与其它止吐剂在化疗中的疗效观察

目的　观察恩丹西酮和其他止吐药物的疗效及毒副作用。方法　采用随机双盲自身对照法对 3 18例接受顺铂、阿霉素联合化疗的恶性肿瘤病人采用恩丹西酮、胃复安、枢复宁进行止吐效果和毒副作用的比较分析。结果　用恩丹西酮、胃复安、枢复宁化疗后 3天内病人无恶心和轻度恶心分别为 88 7%、5 1 3 %、83 3 % ,对急性呕吐的止吐作用分别为 95 3 %、5 2 5 %、92 3 %。 3种止吐药的毒副作用以胃复安较大 ,多以头晕、困倦为主 ,尤其是有 7 5 %椎外系统症状。恩丹西酮以便秘较重。结论　国产盐酸恩丹西酮的疗效与进口枢复宁疗效相拟 ,明显优于胃复安 ,无锥外系统的副作用 ,且能口服 ,使用安全方便 ,价格便宜     

恩丹西酮与其它止吐剂在化疗中的疗效观察

目的 观察恩丹西酮和其他止吐药物的疗效及毒副作用。方法 采用随机双盲对照法对318例接受顺铂、阿霉素联合化疗的恶性肿瘤病人采用恩丹西酮、胃复安、枢复宁进行止吐效果和毒副作用的比较分析。结果 用恩丹西酮、胃复安、枢复宁化疗后3天内病人无恶心和轻度恶心分别为88.7%、51.3%、83.3%,对急性呕吐的止吐作用分别为95.3%、52.5%、92.3%。3种止吐药的毒副作用以胃复安较大,多以头晕、困倦为主,尤其是有7.5%椎外系统症状,恩丹西酮以便秘轻重。结论 国产盐酸恩丹西酮的疗效与进口枢复宁疗效相似,明显优于胃复安,无锥外系统的副作用,且能口服,使用安全方便,价格便宜。     

雷莫司琼预防肺癌顺铂化疗所致恶心呕吐效果的随机对照临床研究

背景与目的顺铂对各种恶性肿瘤都有明显疗效,是肺癌联合化疗的常用药物。但它所引起的严重的恶心、呕吐成为临床应用顺铂的一个剂量限制因素。新一代止吐药物5-HT3受体拮抗剂雷莫司琼可以减轻顺铂化疗引起的恶心呕吐。为了观察雷莫司琼注射剂预防顺铂化疗所致恶心呕吐的临床疗效,我们进行了临床观察,并与恩丹西酮进行对照。方法采用随机平行对照方法,100例患者随机分为雷莫司琼组50例和恩丹西酮组50例。雷莫司琼0.3mg化疗前30min静脉冲入,恩丹西酮8mg化疗前15min和化疗结束时静脉冲入。结果雷莫司琼对顺铂所致恶心的控制率在第1~3天分别为82%、72%、84%,恩丹西酮分别为84%、70%、76%,两药疗效相似。雷莫司琼对呕吐控制的有效率在第1~3天分别为88%、86%、90%,恩丹西酮分别为80%、76%、86%,雷莫司琼对呕吐的有效率高于恩丹西酮,但无统计学上差异。两药不良反应的发生率相似。结论雷莫司琼能有效预防顺铂化疗引起的恶心呕吐,其疗效略优于恩丹西酮。     

A phase II study of ondansetron as antiemetic prophylaxis in patients receiving carboplatin for advanced ovarian cancer. The North Thames Ovary Group.

Thirty four patients who were receiving carboplatin 400 mg/m2 for advanced epithelial ovarian cancer were treated with ondansetron antiemetic prophylaxis. Ondansetron was given as 4 mg oral +4 mg iv 30 minutes prior to carboplatin followed by 8 mg oral tds for 5 days. Of the evaluable patients complete or major control of emesis on day one was achieved in 94% of previously untreated patients and 81% of patients refractory to conventional antiemetic therapy. For the 5 day period as a whole 88% of untreated patients and 69% of those with refractory emesis reported complete or major control of nausea and vomiting. Fifteen patients noted no side effects with mild headache (30%) and constipation (21%) the most frequent problems in the remainder. Ondansetron is effective antiemetic prophylaxis for carboplatin chemotherapy and should allow the majority of these patients to be managed on an out-patient basis.     

针刺联合穴位按摩治疗乳腺癌患者化疗胃肠道反应的临床疗效

目的:观察针刺联合穴位按摩对乳腺癌患者化疗后胃肠道反应的临床疗效,发掘针刺及穴位按摩在治疗化疗后胃肠道反应的优势,为改善乳腺癌化疗患者的生活质量提供一种新的途径.方法:60例乳腺癌患者随机分成两组,治疗组采用针刺联合穴位按摩治疗,对照组采用盐酸雷莫司琼治疗,评价患者化疗后恶心、呕吐等情况.结果:治疗组与对照组化疗后恶心、呕吐控制的有效率分别是86.7%和73.3%.结论:针刺联合穴位按摩防治乳腺癌化疗后导致的胃肠道反应疗效确切.     

The antiemetic efficacy of methylprednisolone compared with metoclopramide in outpatients receiving adjuvant CMF chemotherapy for breast cancer: a randomized trial

A randomized trial was performed comparing the antiemetic efficacy of methylprednisolone (MPN) and metoclopramide (MCP) in 60 breast cancer patients eligible for outpatient adjuvant chemotherapy with cyclophosphamide, methotrexate, and 5-FU (CMF). At the time of their first chemotherapy course patients were randomized to receive either MPN 375 mg or MCP 1 mg/kg both administered in 3 equal doses, IV just prior to chemotherapy and then IM 6 and 12 hours after treatment. Patients receiving MPN experienced significantly less nausea (p less than 0.0005) and vomiting (p less than 0.0005) and antiemetic protection was maintained in patients receiving multiple chemotherapy courses. Complete protection (0 emesis) was observed in 58% of patients receiving MPN as compared with 20% of patients treated with MCP (p less than 0.005). The most frequent side effects were facial flush in 38% of patients and somnolence in 15% of patients receiving MPN and MCP, respectively. Complete protection from CMF-induced gastrointestinal side effects was observed in two-thirds of our patients receiving antiemetic MPN treatment. In these patients administration of the maximum cumulative CMF dose was possible without impairing their quality of life. MPN, at the dose and schedule reported, is an affective antiemetic drug suitable for use in breast cancer outpatients receiving adjuvant CMF therapy.     

Anti-emetic effect and safety of ondansetron tablet in double-blind comparison with placebo]

Ondansetron, a selective 5-HT3 receptor antagonist, has already been reported to have a marked effect to alleviate or prevent nausea and vomiting associated with cancer chemotherapy, after its intravenous administration. The present study was planned to examine the usefulness of its tablet form, which was prepared for the convenient use in outpatients receiving chemotherapy. In order to make an objective evaluation of anti-emetic effect and safety of ondansetron 4 mg tablet, this study was conducted in double-blind comparison versus placebo in patients receiving cisplatin at a single dose of 50mg/m2 or higher. Either 4 mg of ondansetron or placebo (lactose tablet) was administered orally once at 2 hrs prior to administration of cisplatin. If any satisfactory anti-emetic effects were not obtained, 4 mg of ondansetron injection was given once intravenously as a rescue medication. The inhibitory effect on nausea and vomiting was assessed in 4 grades as "excellent", "good", "fair" and "poor" based on severity of nausea and number of vomiting that occurred during the first 24hrs after administration of cisplatin. When rescue medication was conducted, the case was assessed as "poor". Ondansetron was significantly superior to placebo in inhibition of nausea and vomiting, in which efficacy rates (excellent+good) of ondansetron and placebo groups were 58.1% (25/43 cases) and 16.7% (7/42 cases), respectively. Number of cases requiring rescue medication with ondansetron injection was obviously greater in placebo group (31 cases) than that in ondansetron group (12 cases). In those patients given ondansetron injection as the rescue medication, satisfactory effects were obtained in 5 cases in ondansetron group and in 18 cases in placebo group. Although side effects including chest itching (ondansetron group), headache and dull headache (placebo group) were observed after the rescue medication with ondansetron injection, these symptoms were not severe and disappeared after 1-2 days. As mentioned above, ondansetron tablet was shown to possess excellent anti-emetic effect on nausea and emesis induced by high dose of cisplatin and to have no problem in safety. Hence ondansetron was proven to be clinically very useful anti-emetic.     

恩丹西酮与灭吐灵加地塞米松控制化疗所致恶心呕吐的临床观察

目的对照观察恩丹西酮预防化疗所致急性及延迟性恶心呕吐的作用，比较其对含顺铂方案和5-氟尿嘧啶 醛氢叶酸方案的止吐作用。方法采用自身交叉随机对照方法，观察化疗后24小时(急性)及5日内(延迟性)恶心呕吐发生的情况。结果大剂量顺铂化疗中恩丹西酮控制急性及延迟性恶心呕吐疗效明显好于对照组，而5-氟尿嘧啶 醛氢叶酸方案化疗中两组结果无显著差异。结论恩丹西酮能有效控制化疗所引起的恶心呕吐反应，在用顺铂时疗效尤为突出，5-氟尿嘧啶 醛氢叶酸化疗则可考虑用较经济的灭吐灵加地塞米松处理。     

Ondansetron (GR 38032F), a competitive 5-HT3 receptor antagonist as an antiemetic in cytostatic drug-induced nausea and vomiting. An open, substance-oriented phase II/III study

In an open, drug-oriented phase-II/III-study 24 patients were treated with the 5-HT3-antagonist Ondansetron as an antiemetic drug for chemotherapy-induced nausea and emesis. Patients with treatment regimen containing cisplatin were excluded. All patients had suffered from severe nausea and vomiting under conventional antiemetic drugs during a previous identical chemotherapy cycle and were treated with 8 mg Ondansetron t.d. on the day of the chemotherapy and on the four following days. The drug was given with 90 cytostatic cycles ranging from 1 to 14 cycles per patient. Only 2 patients (8%) did not experience an improvement of their symptoms in any of the treatment cycles as measured by a self-conducted grading of nausea and by the frequency of vomiting in comparison to a previous treatment cycle under conventional antiemetic therapy. Eleven out of 18 patients, who were treated with Ondansetron more than once (61%) noted a diminished frequency of vomiting in each treatment cycle with Ondansetron. Sixty of the 90 therapy cycles with Ondansetron resulted in complete (no vomiting) or major (one to two vomits within 24 h following chemotherapy) protection from emesis (37 and 29 per cent, respectively). The most frequent side effect noted was obstipation (7 patients), followed by slight diffuse abdominal pain (4 patients, probably also due to chemotherapy) and slight to severe headache (3 patients, 1 patient was therefore withdrawn from the study). No other side effects were seen. In conclusion, our study indicates that Ondansetron is an effective and safe drug for the treatment of cytostatic drug-induced nausea and vomiting.     

甲状腺癌根治术后恶心呕吐的预防

[目的]研究枢丹和格拉司琼在甲状腺癌根治术患者术后的抗呕吐作用 ,并比较两者对术后恶心呕吐(PONV)的预防效果。[方法]选择甲状腺癌根治术患者90例 ,随机分为枢丹组(4mg,n=30)、格拉司琼组(3mg,n=30)和安慰剂组(生理盐水 ,n=30) ,诱导前静推枢丹或格拉司琼或安慰剂 ,双盲法观察术后24小时恶心、呕吐的发生率。[结果]枢丹组恶心、呕吐的发生率(23 % ,17 %)与格拉司琼组(20 % ,13 %)无显著性差异(P>0 05) ,用药组恶心、呕吐的发生率明显低于安慰剂组(67 % ,57 %;P<0 01)。[结论]枢丹和格拉司琼均能有效地预防甲状腺癌根治术后的恶心、呕吐 ,两者对PONV的预防效果无明显差别。     

奈西雅崩解片预防抗肿瘤药物所致急性胃肠反应的临床研究

目的：观察奈西雅口内崩解片（OD片）预防顺铂或阿霉素所致胃肠反应的疗效和安全性,并与凯特瑞片进行对照。方法：采用开放、我中心随机自身交叉对照方法,入选患者按照随机表随机分为AB或BA组,AB组第1周期含服奈西雅OD片0．1mg,第2周期口服凯特瑞片2mg;BA组则相反。结果：入选患者73例,其中顺铂组44组,阿霉素组29例,可评价疗效病例62例,可评价安全性病例70例,在化疗后0－24h,奈西雅OD片控制食欲不振,恶心,呕吐的有效率分别为74．2％、77．4％和83．9％,凯特瑞片为74．2％和88．7％,两者相似,在控制顺铂所致呕吐反应中,奈西雅OD片和凯特瑞片均显示了较高的疗效,其对呕吐的完全控制率分别为83．3％和86．1％,有效率分别为91．7％和97．2％,奈西雅OD片不良反应轻,主要为头重,口干,嗜睡,为一过性,其发生率与凯特瑞片相似,结论：奈西雅OD片能有效预防抗肿瘤药物所致的胃肠反应,适用于因各种原因不能吞服药片的癌症患者。     

国产和进口盐酸托烷司琼防治化疗所致恶心、呕吐的随机对照临床研究

背景与目的：进口盐酸托烷司琼（商品名为欧必亭）可有效预防化疗所致的恶心和呕吐．但价格昂贵,限制临床广泛使用。本研究旨在比较国产盐酸托烷司琼和欧必亭的止吐效果和不良反应。方法：采用多中心、随机对照试验,将132例人组肿瘤患者随机分为两组,存用含顺铂或阿霉素方案化疗前,A组给予5mg国产盐酸托烷司琼．B组给予5mg欧必亭。在化疗后7天内观察两组止吐药预防化疗所致胃肠道反应的效果及不良反应。结果：A组急性恶心的完全控制率为48．5％．B组为43．8％;A组急性呕吐的完全控制率为69．7％,B组为67．2％,A组和B组急性恶心和呕吐的完全控制率均无显著性差异（P〉0．05）。A组延迟性恶心的完全控制率为25．8％,B组为28．1％;A组延迟性呕吐的完全控制率为47．0％,B组为51．6％,A组和B组延迟性恶心和呕吐的完全控制率均无显著性差异（P〉0．05）。两组止吐方案患者耐受性良好,不良反应的种类及发生率两组间无显著性差异（P〉0．05）。结论：国产盐酸托烷司琼预防化疗所致恶心呕吐的效果及不良反应与欧必亭相近。