泮托拉唑联合格拉司琼预防含顺铂方案化疗所致恶心呕吐的疗效

Efficacy of Pantoprazole Combined with Granisetron in Prevention of Nausea and Vomiting induced by Cisplatin-based Chemotherapy

目的探讨泮托拉唑联合格拉司琼、地塞米松预防含顺铂方案化疗所致恶心呕吐的临床疗效和不良反应。方法将108例行化疗的恶性肿瘤患者按随机数字表法随机分为2组:A组和B组,每组54例。2组化疗方案均采用顺铂60～75mg.m-2+生理盐水500mL静脉滴注,第1天。21d为1个疗程,完成2个疗程的化疗。2组预防恶心呕吐:A组化疗时,第1个疗程采用泮托拉唑注射液40mg+生理盐水100mL化疗前30min静脉滴注,1次.d-1,第1-3天;格拉司琼注射液3mg+生理盐水10mL化疗前30min静脉注射,1次.d-1,第1-3天;地塞米松注射液5mg+生理盐水100mL化疗前30min静脉滴注,1次.d-1,第1-3天。化疗第2个疗程采用西米替丁800mg+生理盐水100mL化疗前30min静脉滴注,1次.d-1,第1-3天。B组化疗时,第1个疗程采用西米替丁800mg+生理盐水100mL化疗前30min静脉滴注,1次.d-1,第1-3天;格拉司琼注射液3mg+生理盐水10mL化疗前30min静脉注射,1次.d-1,第1-3天;地塞米松注射液5mg+生理盐水100mL化疗前30min静脉滴注,1次.d-1,第1-3天。化疗第2个疗程采用泮托拉唑注射液40mg+生理盐水100mL化疗前30min静脉滴注,1次.d-1,第1-3天。观察2组患者的临床疗效及不良反应(头痛、头晕、乏力、腹痛、腹泻、口干、失眠)。结果 A组总有效率明显高于B组(P<0.05)。A组头痛、头晕及乏力、腹痛、腹泻、口干、失眠发生率与B组比较差异均无统计学意义(均P>0.05)。结论泮托拉唑联合格拉司琼、地塞米松预防含顺铂方案化疗所致恶心呕吐有较好的疗效。

Objective To explore the clinical curative effect and adverse reactions of pantoprazole combined with granisetron and dexamethasone in the prevention of nausea and vomiting induced by cisplatin-based chemotherapy.Methods A total of 108 cancer patients undergoing chemotherapy were randomly divided into group A and group B,with 54 patients in each group.All patients received two courses of cisplatin-based chemotherapy(21 days per course).Cisplatin 60-75 mg·m-2 diluted in 500 mL of physiological saline was administered by intravenous infusion on day 1.For the prevention of nausea and vomiting,patients in group A were intravenously infused with pantoprazole 40 mg in 100 mL of physiological saline,granisetron 3 mg in 10 mL of physiological saline and dexamethasone 5 mg in 100 mL of physiological saline 30 minutes before chemotherapy once per day within the first 3 days during the first treatment course,followed by cimetidine 800 mg in 100 mL of physiological saline 30 minutes before chemotherapy once per day within the first 3 days during the second treatment course.Patients in group B were intravenously infused with cimetidine 800 mg in 100 mL of physiological saline,granisetron 3 mg in 10 mL of physiological saline and dexamethasone 5 mg in 100 mL of physiological saline 30 minutes before chemotherapy once per day within the first 3 days during the first treatment course,followed by pantoprazole 40 mg in 100 mL of physiological saline 30 minutes before chemotherapy once per day within the first 3 days during the second treatment course.Clinical curative effects and adverse reactions(headache,dizziness,fatigue,stomachache,diarrhoea,dry mouth and insomnia) were observed in both groups.Results The total effective rate in group A was significantly higher than that in group B(P<0.05).No obvious differences in adverse reactions were found between the two groups(P>0.05).Conclusion Pantoprazole combined with granisetron and dexamethasone is effective for the prevention of nausea and vomiting induced by cisplatin-based chemotherapy.