甲氧氯普胺联合氟哌啶醇改善癌性恶心呕吐及乏力的临床研究  

Clinical study on treating cancer-related nausea, vomiting and fatigue using metoclopramide plus haloperidol

作　　者：李玲 马桂霞[2] 司壮丽 王鹏[3] 袁慧丽 高天慧[4] 马望[5] 王炜 LI Ling;MA Guixia;SI Zhuangli;WANG Peng;YUAN Huili;GAO Tianhui;MA Wang;WANG Wei(Department of Palliative Care and Hospice Care,the Ninth People＇s Hospital of Zhengzhou,Zhengzhou 450053,Henan Province,China;Department of Gynecology,the First People＇s Hospital of Zhengzhou,Zhengzhou 450000,Henan Province,China;Nursing College,Zhengzhou University,Zhengzhou 450052,Henan Province,China;Medical Oncology,Henan Province People＇s Hospital,Zhengzhou 450003,Henan Province,China;The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州市第九人民医院姑息缓和治疗暨安宁疗护中心,河南郑州450053 [2]郑州市第一人民医院妇科,河南郑州450000 [3]郑州大学护理学院基础教研室,河南郑州450052 [4]河南省人民医院肿瘤内科,河南郑州450003 [5]郑州大学第一附属医院肿瘤内科,河南郑州450052

出　　处：《中国癌症杂志》2018年第5期394-400,共7页China Oncology

基　　金：河南省科技厅重点科技攻关项目(142102310140);河南省医学科技攻关计划(201204139);郑州市卫生局2011博士创业基金项目;河南省卫生科技创新型人才工程中青年科技创新人才项目(4218)

摘　　要：背景与目的:癌性恶心呕吐及乏力可使晚期癌症患者机体功能严重受损并出现多种并发症,严重影响患者生活质量,甚至导致其死亡。该研究旨在探讨甲氧氯普胺联合氟哌啶醇对晚期癌症患者癌性恶心呕吐及乏力的影响。方法:选取晚期肿瘤伴恶心呕吐患者536例,随机分为甲氧氯普胺组(n=135)、氟哌啶醇组(n=132)、甲氟联合组(n=136)和昂丹司琼组(对照组,n=133)。采用WHO抗癌药不良反应恶心及呕吐分级标准、恶心、呕吐及干呕指数评价量表(Index of Nausea,Vomiting,and Retching,INVR)、药物不良反应及多维疲乏症状量表-简表(Multidimensional Fatigue Symptom Inventory-Short Form,MFSI-SF)分别对患者用药48 h、2和4周时的变化进行跟踪测评。结果:昂丹司琼组48 h后止吐有效率为66.2%,显著优于甲氟联合及两药单用组(P<0.05);而甲氟联合组应用第2、4周时止吐有效率分别为86.8%和94.9%,显著优于对照组和单药组(P<0.05),且INVR评分显著低于对照组和单药组(P<0.05)。甲氟联合组不良反应与两药单用相近,但显著低于对照组(P<0.05)。甲氟联合组应用2和4周时MFSI-SF评分均显著低于对照组和单用组(P<0.05)。结论:甲氧氯普胺联合氟哌啶醇对晚期癌性恶心呕吐具有明显的改善效果,并在一定程度上有改善癌性乏力的作用,值得临床推广。Background and purpose： Cancer-related nausea, vomiting and fatigue can cause severe damage to body functions and develop multiple complications in patients with advanced cancer, which can seriously affect the quality of life and even lead to death. This study aimed to evaluate the efficacy of metoclopramide combined with haloperidol in treating advanced cancer-related nausea and vomiting（CRNV） and determine whether it affected fatigue. Methods： A total of 536 advanced cancer patients with nausea and vomiting were included and randomly assigned to the ondansetron group（n=133）, the metoclopramide group（n=135）, the haloperidol group（n=132） and the metoclopramide plus haloperidol group（n=136）. Outcome parameters were measured at 48 h, 2 weeks and 4 weeks after receiving antiemetic using the Index of Nausea, Vomiting, and Retching（INVR）, and the Multidimensional Fatigue Symptom Inventory-Short Form（MFSI-SF）. Results： The efficacy rates of metoclopramide plus haloperidol groups were 53.7%, 86.8% and 94.9%, respectively. The INVR of using ondansetron 48 h was significantly lower than that of single and combined metoclopramide plus haloperidol regimens. However, 2 and 4 weeks after receiving metoclopramide plus haloperidol regimens, the INVR and MFSI-SF scores of metoclopramide plus haloperidol regimens significantly declined compared with the control and single antiemetic（P〈0.05）. Conclusion： Metoclopramide plus haloperidol can prevent and treat advanced cancer-related nausea and vomiting with significant clinical efficacy, and is helpful in alleviating fatigue. It is well worth spreading for clinical use.

关 键 词：甲氧氯普胺 氟哌啶醇 晚期癌症患者 癌性恶心呕吐 癌性乏力 

分 类 号：R730.6[医药卫生—肿瘤]