泮托拉唑防治化疗药物所致胃肠道反应的疗效观察

Therapeutic effect observations of pantoprazole for preventing and treating gastrointestinal reactions caused by chemotherapy drugs

目的探讨泮托拉唑预防及抑制恶性肿瘤化疗药物所引起胃肠道反应的有效性及安全性。方法 90例晚期恶性肿瘤患者,按随机对照的方法分为2组,所有患者均应用阿霉素、铂类、伊力替康或5-Fu为基础的联合化疗,试验组患者化疗同时应用泮托拉唑、地塞米松和5-HT3受体拮抗剂预防胃肠道反应、保护胃粘膜,对照组常规给予地塞米松和5-HT3受体拮抗剂,观察并比较两组患者1周内消化道不良反应的发生率,患者耐受性及安全性。结果化疗后1周内无任何胃肠道症状或体征者,试验组症状控制率为75%(33/44),对照组为率52%(24/46),化疗1周内有部分胃肠道症状或体征者,即症状不完全控制者,试验组发生率25%(11/44),对照组发生率48%(22/46),两组间有统计学差异(P<0.05)。结论泮托拉唑作为胃粘膜保护剂,与止吐药物协同作用可对晚期恶性肿瘤化疗过程的胃肠道反应有明显预防及抑制作用,有效率高、无明显不良反应、患者耐受性良好,安全性高,增强了患者化疗的依从性。

Objective To explore the effect and safety of pantoprazole in preventing and inhibiting the gastrointestinal reactions caused by chemotherapy drugs.Methods A total of 90 advanced malignant tumor patients were selected and randomly divided into two groups.All patients received combined chemotherapy with adriamycin,platinum-based drugs,irinotecan and 5-fluorouracil.Meanwhile,the treatment group was administered with pantoprazole,dexamethasone and 5-HT3 inhibitor to prevent gastrointestinal reactions and protect gastric mucosa.The control group received dexamethasone and 5-HT3 inhibitor.The incidence rates of adverse gastrointestinal reactions within seven days,tolerance and safety of the patients after chemotherapy were observed and compared in the two groups.Results A total of 33 out of 44 patients in the treatment group had no gastrointestinal reactions within one week after chemotherapy with a control rate of 75%,while it was 52%（24/46） in the control group.11 out of 44 patients in the treatment group had partial gastrointestinal reactions one week after chemotherapy with a rate of 25%,which was 48%（22/46） in the control group.The differences between two groups had statistical significance（P0.05）.Conclusion As a protective agent for gastric mucosa,pantoprazole combined with antiemetic drugs can obviously prevent and inhibit gastrointestinal reactions caused by chemotherapy drugs with a higher efficacy and safety and increased tolerance with no obvious side effects,which contribute to the patients′ compliance in the course of chemotherapy.