奥氮平联合托烷司琼、地塞米松预防肺癌化疗所致恶心呕吐的随机对照临床研究

The effect of Olanzapine combined with Tropisetron and Hexadecadrol in preventing chemotherapy-induced nausea and vomiting: a randomized controlled clinical trial

目的比较在托烷司琼、地塞米松基础上联合使用奥氮平预防肺癌化疗所致恶心呕吐(CINV)的效果。方法采用随机交叉、自身对照法,将患者分成两组:A组第一周期用托烷司琼及地塞米松;B组第一周期用奥氮平与托烷司琼及地塞米松;第二周期A,B组交叉使用观察62例肺癌患者自身先后二次化疗对奥氮平、托烷司琼、地塞米松预防恶心、呕吐的疗效。结果研究组(联合奥氮平组)和对照组(未联合奥氮平组)急性呕吐的有效控制率分别为85.5%(53/62)和69.4%(43/62),差异有统计学意义,P<0.05;迟发性呕吐的有效控制率分别为79%(49/62)和62.9%(39/62),差异有统计学意义,P<0.05。结论在使用托烷司琼联合地塞米松的基础上加用奥氮平对于预防肺癌化疗所致恶心呕吐有更好的效果。

Objective To observe the clinical effect of Olanzapine combined with Tropisetron and Hexadecadrol in preventing the incidence of nausea and vomiting induced by chemotherapy .Methods A total of 62 lung carcinoma patients were randomly divided into two groups：group A and B.In the first cycle, patients in group A taken Tropisetron and Hexadecadrol and patients in group B received Olanzapine combined with Tropisetron and Hexadecadrol .In the second cycle , the drug of group A and B were exchanged .The clinical effect of Olanzapine combined with Tropisetron and Hexadecadrol in preventing chemotherapy -induced nausea and vomiting were observed.Results 85.5%patients of treatment group（with Olanzapine） got significant effect in acute vomiting controlling compared with 67.7% in the control group （Olanzapine not -used）,which had significant difference （χ^2 =4.93,P〈0.05）.And in delayed vomiting controlling , treatment group was 79%and control group was 59.7%, the difference was statistically significant （χ^2 =4.93,P〈0.05）.Conclusions Olanzapine combined with Tropisetron and Hexadecadrol in lung carcinoma chemotherapy induced nausea and vomiting have more obvious curative effect compared to Tropisetron and Hexadecadrol and without significant side effects.