奥氮平治疗恶性肿瘤非化疗所致恶心呕吐的临床疗效

Clinical observation of olanzapine in the treatment of non-chemotherapy-induced nausea and vomiting in malignant tumor patients

目的:观察奥氮平治疗恶性肿瘤患者非化疗所致恶心、呕吐的疗效。方法:120例中晚期伴不同程度恶心呕吐的恶性肿瘤患者随机分为试验组(60例)和对照组(60例),两组分别予静脉注射地塞米松10 mg,1次/日,胃复安10 mg肌肉注射,1次/日,试验组在上述基础上口服奥氮平5 mg/d,睡前口服,用药3～7天不等,观察两组患者恶心呕吐缓解情况及KPS改善情况。结果:两组患者临床一般资料无统计学差异(P>0.05)。用药后两组患者恶心、呕吐症状分级(P=0.043)和止吐效果(P=0.046)有统计学差异,试验组有效控制率和完全控制率分别为96.7%和45.0%,明显优于对照组88.3%和21.7%,差异有统计学意义(P<0.05)。两组患者不良反应均轻微,差异无统计学意义(P>0.05)。结论:奥氮平治疗恶性肿瘤患者非化疗所致恶心、呕吐疗效明显,不良反应小,安全有效,且能改善患者体能状态,值得临床应用。

Objective:To observe the efficacy of olanzapine in the treatment of non-chemotherapy-induced nausea and vomiting.Methods:120 cases of malignant tumors with different degrees of nausea and vomiting were randomly divided into the experimental group(60 cases)and the control group(60 cases),The two groups were intravenously injected with dexamethasone 10 mg,1 times per day,intramuscular injection of metoclopramide 10 mg,1 times per day,the experimental group was given olanzapine 5 mg/d on the basis above,oral administration before bedtime,for 3~7 days.To observe the remission of nausea and vomiting,and the improvement of KPS.Results:There was no statistical difference in clinical general data between the two groups(P>0.05).After treatment,the symptoms of nausea and vomiting grade(P=0.043)and antiemetic effect(P=0.046)had statistically significant difference,the effective control rate and total control rate of the test group were 96.7%and 45.0%,respectively,which were significantly better than those of the control group(88.3%and 21.7%),and the difference was statistically significant(P<0.05).The adverse reactions of the two groups were mild,and the difference was not statistically significant(P>0.05).Conclusion:Olanzapine is effective in the treatment of non-chemotherapy-induced nausea and vomiting in malignant tumor patients.It has obvious side effects,safe and effective,and can improve physical condition of patients.It is worthy of clinical application.