胃复安联合5-HT3受体拮抗剂在化疗相关恶心呕吐患者中的疗效分析

Observation and analysis of Metoclopramide combined with 5-HT3 receptor antagonist in patients with chemotherapy-induced nausea and vomiting

目的观察胃复安联合5-HT3受体拮抗剂在晚期肿瘤化疗患者中对恶心及呕吐的治疗效果及不良反应。方法选取武汉大学人民医院肿瘤中心2016年10月~2018年5月单用多拉司琼、昂丹司琼、托烷司琼和帕洛诺司琼4种5-HT3受体拮抗剂无效的晚期化疗患者各30例,设为A、B、C、D四组,分别联合胃复安治疗。观察各组恶心、呕吐发生情况,并观察每组不良反应并探寻处理方法。结果四组预防急性、迟发性恶心、呕吐的有效率比较,差异均无统计学意义(P>0.05);四组最常见的不良反应均为头痛、便秘、腹胀、嗜睡、乏力、眩晕、口渴,但经过对症处理或停药后均可缓解。结论在单用5-HT3受体拮抗剂无效的晚期肿瘤化疗患者中,胃复安联合多拉司琼、昂丹司琼、托烷司琼和帕洛诺司琼在部分患者中有效,并且能减少不良反应,具有积极的临床意义。

Objective To observe the effect of Metoclopramide combined with 5-HT3 receptor antagonists on chemotherapy-induced nausea and vomiting in patients with advanced cancer chemotherapy and observe their side effects.Methods Advanced cancer patients ineffective with Dolastron,Ondansetron,Tropisetron,and Palonosetron in Center of Oncology of Renming Hospital of Wuhan University from October 2016 to May 2018 were selected respectively,with 30 cases in each variety,named group A,B,C,and D group.Then they were treated combined with Metoclopramide.The occurrence of nausea and vomiting and other side effcts in each group were observed.Results There were no statistically significant differences in the effectiveness of the four groups in preventing acute and delayed nausea and vomiting(P>0.05).The most common side effects of the four groups were headache,constipation,bloating,drowsiness,fatigue,dizziness,and thirst,but they could be alleviated after symptomatic treatment or withdrawal.Conclusion Among advanced cancer patients who were ineffective with 5-HT3 receptor antagonist alone,Metoclopramide combined with Dolastreline,Ondansetron,Tropisetron,and Palonosetron work in some patients and reduces the incidence of side reactions,which has positive clinical significance.