抗幽门螺杆菌治疗在肿瘤化疗止吐中的作用研究  

Effects of Anti-Helicobacter pylori Treatment as Part of Antiemetic Cancer Chemotherapy

作　　者：朴瑛[1] 刘兆喆[1] 丁震宇[1] 徐龙[1] 郭放[1] 孙庆庆[1] 谢晓冬[1] 

机构地区：[1]沈阳军区总医院全军肿瘤诊治中心肿瘤科,沈阳市110840

出　　处：《中国肿瘤临床》2012年第22期1832-1834,共3页Chinese Journal of Clinical Oncology

基　　金：辽宁省自然科学基金项目(编号:201202239)资助

摘　　要：目的:评估抗幽门螺杆菌(Helicobacter pylori,HP)治疗及联合常规止吐药物对肿瘤患者化疗所致胃肠道不良反应的疗效。方法:2010年1月至2011年1月,共纳入176例患者,其中伴有幽门螺杆菌感染患者86例。将HP感染阳性者随机分为A组和B组。A组43例给予抗幽门螺杆菌联合止吐药物(奥美拉唑20 mg+克拉霉素500 mg+替硝唑500 mg,2次/d,口服7 d;联合托烷司琼5 mg,静脉滴注,1次/d;疗程共4周)治疗,B组43例仅给予止吐药物(托烷司琼5mg,疗程共4周)治疗,两组患者在性别、年龄、临床表现无差别。应用WHO胃肠道反应分度标准进行观测和评价,应用^(14)C-尿素呼气试验评估幽门螺杆菌根除率。结果:接受化疗并伴有幽门螺杆菌感染的患者呕吐程度比未感染者严重,其中Ⅲ～Ⅳ度呕吐(χ~2=21.92,P<0.001),Ⅰ～Ⅱ度呕吐(χ~2=9.73,P<0.01)差异均有统计学意义。联合抗菌治疗患者的恶心、呕吐等症状比常规止吐患者减轻,A组治疗恶心、呕吐的总有效率为81.39%(35/43),明显高于B组的58.14%(25/43),差异有统计学意义(χ~2=4.46,P<0.05)。结论:针对幽门螺杆菌阳性患者给予抗幽门螺杆菌联合常规止吐治疗,可以有效减轻和缓解化疗所致的胃肠道不良反应。Objecti ve：This work aims to assess the effects of anti-Helicobacter pylori （anti-H. pylori） therapy combined with antiemetic drugs on chemotherapy-induced gastrointestinal toxicity. Methods： Out of the176 patients who were enrolled in the research from January 2010 to January 2011 , 86 were infected by H. pylori. Infected patients were randomly divided into Groups A and B. Patients in Group A （n=43 ） received anti-H. pylori therapy combined with antiemetic drugs （ 20 mg omeprazole,500 mg clarithromycin, and500 mg tinidazole, twice a day, plus5 mg tropisetron, for four weeks）. Patients in Group B （n=43 ） only received antiemetic drugs （5 mg tropisetron for four weeks）. No statistical significance was observed between Groups A and B for gender, age, and clinical manifestations. Clinical symptoms were observed and evaluated based on the gastrointestinal reaction indexing standards of the World Health Organization. The H. pylori eradication rate was assessed by 4C-urea breath test. Results：The vomiting severity was higher in the patients who were infected by H. pylori and subsequently underwent chemotherapy compared with the non-infected patients. Significant differences were observed between grades Ⅲ and Ⅳvomiting （χ2=21 .92 , P〈0.001）, as well as between grades I and II vomiting （ χ2=9.73 , P〈0.01 ）. The degree of nausea and vomiting was reduced in the patients who underwent anti-H. pylori therapy combined with antiemetic drugs, compared with those who only received antiemetic drugs. The total efficiency of the treatment was significantly higher in group A than in group B （ χ2=4.46 , P〈0.05 ）. Conclusion： Anti-H. pylori treatment combined with antiemetic drugs may effectively reduce and relieve chemotherapy-induced gastrointestinal toxicity for patients infected with H. pylori.

关 键 词：幽门螺杆菌化疗 止吐药 

分 类 号：R730.5[医药卫生—肿瘤]