阿瑞吡坦三联疗法预防和改善顺铂恶心呕吐临床疗效  

Aprepitant Triple Therapy to Prevent and Improve the Clinical Curative Effect of Cisplatin on Nausea and Vomiting

作　　者：何永明[1] 俞晨[1] 李伟兵[1] 

机构地区：[1]江苏省肿瘤医院中西医结合科,江苏南京210009

出　　处：《安徽科技学院学报》2016年第5期30-35,共6页Journal of Anhui Science and Technology University

基　　金：国家自然科学基金(81503526);江苏省干部保健科研课题(BJ15028)

摘　　要：目的：研究阿瑞吡坦三联疗法在预防和改善顺铂化疗导致恶心呕吐方面的疗效。方法：选择患有肺癌、食管癌、生殖系统肿瘤患者共40位，随机分为单独组和合并组，其中单独组使用大剂量顺铂化疗方案（60mg／m^2）加帕洛诺司琼联合地塞米松止吐治疗，合并观察组在使用大剂量顺铂化疗（60mg／m^2）方案化疗同时开始口服阿瑞吡坦，连用3d，同时给予帕洛诺司琼以及地塞米松方案，比较两组使用后恶心呕吐的发生率以及生活质量、消化道反应情况。评估患者在整个治疗过程中达到CR（患者完全没有恶心呕吐）和CC（完全控制率）的百分比，其中没有呕吐或者干呕、没有恶心或者有轻微恶心感觉的患者我们都认为疗效评价为CC，在急性期（化疗第1d）和延迟期（化疗第2～5d）分别做了评估，同时对影响恶心和呕吐症状的危险因素进行了调查。结果：40例患者，在化疗急性期，合并组能达到CR的患者有30个，达到75％，而单独组患者为20个，达到50％，有明显统计学差异（P〈0．05）；而在延迟期，合并组能达到CR的患者有28个，单独组只有14个，合并组绝大多数病人在化疗后以及化疗过程中能正常进食，评估各组危险因子单因素方差分析后发现性别和怀孕期间妊娠反应大以及情绪容易波动接近于有统计学意义，而多因素方差分析均无统计学意义。结论：在恶性肿瘤患者化疗过程中，大剂量使用顺铂化疗后，阿瑞吡坦联合帕洛诺司琼以及地塞米松的三联疗法是优于单用帕洛诺司琼和地塞米松的，三联疗法对于以顺铂为基础药物的化疗方案是具有优势和发展前景的。Objective： To investigate the aprepitant triple therapy in the prevention and improvement of curative effect of cisplatin chemotherapy which leads to nausea and vomiting. Methods： Patients with lung cancer, esophageal cancer, and with genital tumors in 40 patients were randomly divided into single group and combined group, using high dose cisplatin （60 mg/m^2） Fagafaga Palo Nor granisetron combined with dexamethasone and antiemetic therapy, while the observation group were treated with high dose cisplatin （60 mg/m^2） and chemotherapy oral aprepitant, for 3 d, while giving palonosetron and dexamethasone, and the incidence of gastrointestinal reactions and quality of life of nausea and vomiting between the two groups after use. Evaluation of patients reached CR in the whole course of treatment （with no nausea and vomiting） and CC （complete control rate） percentage, in which no vomiting or retching, no nausea or slight nausea patients we all think efficacy evaluation for CC in acute period （first days of therapy） and delayed phase （the chemotherapy 2 -5 day） respectively have been eval- uated, the factors that influence the risk of nausea and vomiting were investigated. Results： 40 patients in acute stage, chemotherapy, combined group can reach CR in 30, reached 75%, and a separate group of patients was 20, reached 50%, there was significant difference （P 〈 0.05） ; and in the delay period, the combined group can reach CR in 28 patients, single group only 14, the combined group of most patients can eat normally after the chemotherapy and chemotherapy process, assessed risk factors for single factor variance analysis showed that gender and pregnancy pregnancy reaction and emotional volatility close to have statistical significance, but there were no significant variance analysis. Conclusion： in the course of chemotherapy in patients with malignant tumor, a large dose of cisplatin chemotherapy, aprepitant combined palonosetron and dexamethasone triple therapy is better than the sin

关 键 词：顺铂恶心呕吐 高致吐化疗 阿瑞吡坦 完全反应率 

分 类 号：R969.4[医药卫生—药理学]