奥氮平治疗阿片类止痛药所致恶心呕吐的临床观察

Clinical Observation of Olanzapine in Treatment of Nausea and Vomiting Caused by Opioid Analgesics

目的观察奥氮平治疗阿片类止痛药所致恶心呕吐的疗效和不良反应。方法将85例阿片类止痛药所致恶心呕吐的患者随机分为两组,奥氮平组予奥氮平片,对照组予甲氧氯普胺注射液,比较两组的临床效果与药物不良反应。结果奥氮平组在抑制恶心、呕吐、减少阿片类药物中断率方面明显优于对照组,差异有统计学意义(均P<0.05);两组嗜睡、头晕、水肿等不良反应发生率相仿,差异无统计学意义(均P>0.05),对照组锥体外系反应(静坐不能)明显高于奥氮平组(P=0.024),奥氮平组发生1例跌倒。结论奥氮平治疗阿片类止痛药所致恶心呕吐疗效较好,值得临床推广应用。

Objective To observe the efficacy and side effects of olanzapine in the treatment of nausea and vomiting caused by opioid analgesics in cancer patients. Methods We randomly divided 85 cancer patients with nausea and vomiting caused by opioid analgesics into two groups. Treatment group was treated with olanzapine tablets and control group received metoclopramide injection solution. The clinical effect and medical side effects were compared between two groups. Results Compared with control group, the treatment group was significantly better in inhibiting nausea, vomiting and reducing opioid discontinuation rate（P〈0.05）. Two groups were similar in drowsiness, dizziness, edema and other adverse reactions rate（P〉0.05）. The control group showed significantly higher possibility in extrapyramidal reaction（akathisia） than the treatment group（P=0.024）, while only one case of tumble happened in treatment group. Conclusion Olanzapine is a good choice in the treatment of nausea and vomiting caused by opioid analgesics and worth extending its clinical application.