奥氮平预防中、高致吐化疗药物所致恶心、呕吐的临床观察

Clinical observation of olanzapine for prevention of high and moderate emetic risk chemotherapy- induced nausea and vomiting

目的:观察奥氮平治疗中、高致吐性化疗药物所致恶心、呕吐的疗效和不良反应。方法:对80例应用中、高致吐性化疗药物的患者,随机分为干预组(IG)和对照组(CG),每组40例。对照组给予常规药物止吐,干预组在常规止吐药物的基础上加用奥氮平5mg,每晚口服。以上给药方案的时间与化疗时间一致。比较两组控制急性和延迟性恶心、呕吐的疗效差别及不良反应。结果:干预组和对照组急性恶心、呕吐的发生率分别为17.5%(7/40)和22.5%(9/40,P>0.05);迟发性恶心、呕吐的发生率分别为25.0%(10/40)和65%(26/40,P<0.05)。治疗过程中的不良反应主要为嗜睡(32.5%和25.0%)、头晕(17.5%和16.7%)、水肿(12.5%和15.0%)、便秘(30.0%和35.0%),两组不良反应发生率没有统计学差异。结论:奥氮平对延迟性恶心、呕吐的缓解率更优,且患者的不良反应可以耐受,具有临床推广价值。

To observe the clinical effect and adverse reactions of olanzapine in the prevention of high and moderate emetic risk chemotherapy - induced nausea and vomiting. Methods：Eighty patients receiving highly or moderately emetogenic chemotherapy were randomly assigned to intervention group（IG）or control group（CG）. The patients in CG were given routine antiemetic drugs,while in IG were given olanzapine 5mg orally every night combined with routine antiemetic drugs. The time of drug administration was in keeping of cancer chemotherapy time. Results：Acute nausea and vomiting rates of the IG and CG were 17. 5%（7 / 40）and 22. 5%（9 / 40）respectively,there was no statistical significance（P ﹥ 0. 05）,delayed nausea and vomiting rate were 25. 0%（10 / 40）and 65%（26 / 40）respec-tively,there was statistical significance（P ﹤ 0. 05）. The adverse reactions during chemotherapy were drowsiness （32. 5% and 25. 0% ,respectively）,swirl（17. 5% and 16. 7% ,respectively）,edema（12. 5% and 15. 0% ,respec-tively）,constipation（30. 0% and 35. 0% ,respectively）. There were no statistical significances（P ﹥ 0. 05）. Conclu-sion：Olanzapine can improve the response of nausea and vomiting in patients receiving the highly or moderately eme-togenic chemotherapy comparing with the standard therapy of antiemesis,and have no significant side effects. Olanzap-ine is a safe and efficient drug for prevention of CINV.