四药联合方案对肺癌化疗患者的止吐效果及消化道症状的影响

The effect of four drugs combination therapy on antiemetic efficacy and gastrointestinal symptoms in lung cancer chemotherapy patients

目的观察在肺癌化疗患者中应用阿瑞匹坦、地塞米松、昂丹司琼、奥氮平四药联合方案的止吐效果及其对消化道症状的影响。方法本研究纳入2020年1月—2022年10月黄山首康医院收治的144例肺癌化疗患者,所有患者均接受含顺铂方案化疗。将144例肺癌化疗患者以随机数字表格法分组,对照组72例予以地塞米松、昂丹司琼、奥氮平三联方案止吐,观察组72例患者在对照组基础上加用阿瑞匹坦行四联止吐治疗,对比两组患者的止吐治疗有效率,干预后不同阶段诱发性恶心、呕吐发生率,消化道症状控制情况。结果观察组治疗有效率为91.67%,显著高于对照组的75.00%(P<0.05)。观察组患者急性期、迟发期、持续期等不同阶段诱发性恶心、呕吐发生率均低于对照组(P<0.05)。消化道症状控制方面,观察组患者呕吐天数、补救性止吐人数均低于对照组(P<0.05),且止吐效果满意人数、KPS评分均高于对照组(P<0.05)。观察组与对照组治疗期间发生的非化疗药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论阿瑞匹坦、地塞米松、昂丹司琼、奥氮平四药联合方案对肺癌化疗患者诱导性恶心、呕吐等消化道症状有较好的预防和治疗效果,可提高患者对止吐效果的满意度,且安全性良好,不增加非化疗不良反应风险。

Objective To observe the effect of combination therapy of aprepitant,dexamethasone,ondansetron and olanzapine on antiemetic efficacy and gastrointestinal symptoms in patients with lung cancer undergoing chemotherapy.Methods A total of 144 patients with lung cancer undergoing chemotherapy in Huangshan Shoukang Hospital between Jan-uary 2020 and October 2022 were included in this study.All patients received cisplatin-based chemotherapy.Patients were randomly divided into control group(72 cases)and observation group(72 cases).The control group was given dexa-methasone,ondansetron and olanzapine triple antiemetic therapy,and the observation group was added with aprepitant on the basis of the control group.The antiemetic efficiency,the incidence of induced nausea and vomiting at different stages af-ter intervention,and the control of gastrointestinal symptoms were compared between the two groups.Results The effective rate of the observation group was 91.67%,which was significantly higher than 75.00%of the control group(P<0.05).The in-cidence of induced nausea and vomiting in the observation group was lower than that in the control group in the acute stage,delayed stage,and persistent stage(P<0.05).In terms of the control of gastrointestinal symptoms,the vomiting days and the remedial antiemetic patients were less in the observation group than in the control group(P<0.05).Moreover,patients with satisfaction to antiemetic effect and the KPS scores of the observation group were more than those of the control group(P<0.05).There was no significant difference in non-chemotherapy-induced adverse reactions between the observation group and the control group(P>0.05).Conclusion The combination therapy of aprepitant,dexamethasone,ondansetron and olan-zapine was effective in the prevention of gastrointestinal symptoms such as induced nausea and vomiting in lung cancer pa-tients undergoing chemotherapy,and can improve their satisfaction to the antiemetic effect.The quadruple regimen had a good safety,for it did not increase the risk of non-chemotherapy-induce adverse reactions.