阿瑞匹坦治疗顺铂方案化疗引起的呕吐临床分析  

Clinical analysis of aprepitant for treating vomiting caused by cis-platin regimen

作　　者：姚二华 郑银燕 林连兴[1] 黄河澄[1] 梁平[3] 吴发胜[3] 刘嘉毅 YAO Erhua;ZHENG Yinyan;LIN Lianxing;HUANG Hecheng;LIANG Ping;WU Fasheng;LIU Jiayi(Department of Tumor Radiotherapy,Affiliated Shantou Hospital of Sun Yat-Sen University, Shantou,Guangdong 515031,China;Department of Prevention and Health Care,Affiliated Shantou Hospital of Sun Yat-Sen University,Shantou,Guangdong 515031,China;Department of Tumor Radiotherapy,Affiliated Ruikang Hospital,Guangxi University of Traditional Chinese Medicine,Nanning,Guangxi 530011,China)

机构地区：[1]中山大学附属汕头医院/汕头市中心医院肿瘤放疗科,广东汕头515031 [2]中山大学附属汕头医院预防保健科,广东汕头515031 [3]广西中医药大学附属瑞康医院肿瘤放疗科,广西南宁530011

出　　处：《重庆医学》2018年第9期1194-1196,1199,共4页Chongqing medicine

基　　金：广西壮族自治区卫生和计划生育委员会科研课题(Z2015437)

摘　　要：目的探讨阿瑞匹坦用于以顺铂为基础的化疗所致恶心呕吐的临床疗效。方法选取中山大学附属汕头医院2014年12月1日至2016年12月1日采用含顺铂(80mg/m2)化疗方案的肿瘤患者,使用格拉司琼和地塞米松常规止吐后仍有呕吐的患者61例,进一步止吐采用阿瑞匹坦和地塞米松的患者为阿瑞匹坦组,采用格拉司琼和地塞米松的患者为格拉司琼组,观察两组患者小于24h、24~72h、>72~144h的完全有效率(CR)。结果阿瑞匹坦组与格拉司琼组的24h内CR率分别为66.67%和51.61%,差异无统计学意义(P=0.232);24~72hCR率分别为80.00%和54.84%,阿瑞匹坦组显著优于格拉司琼组(P=0.036)。>72~144hCR率分别为86.67%和64.52%,阿瑞匹坦组优于格拉司琼组(P=0.045)。两种止吐药物的不良反应发现便秘、腹泻、荨麻疹、疲乏、焦虑差异无统计学意义(P>0.05),阿瑞匹坦组总的不良反应发生率在23.33%,而格拉司琼组为25.81%,差异无统计学意义(P>0.05)。结论阿瑞匹坦联合地塞米松用于高致吐性化疗药物顺铂化疗所致恶心呕吐的疗效较好,耐受性良好。Objective To investigate the clinical efficacy of aprepitant in the treatment of cisplatin based chemotherapy induced nausea and vomiting.Methods The tumor patients treated with cisplatin(80 mg/m 2)chemotherapeutic regimen in Affiliated Shantou Hospital of Sun Yat-Sen University from December 1,2014 to December 1,2016 were selected,61 cases still had vomiting after using granisetron and dexamethasone for routinely stopping vomiting,the patients with aprepitant and dexamethasone for further stopping vomiting served as the aprepitant group,while the patients with granisetron and dexamethasone as the granisetron group.Then the complete response(CR)rates within 24,24-72,>72-144 h were observed in the two groups.Results The CR rates within 24 h in the aprepitant group and granisetron group were 66.67%and 51.61%respectively,the difference was not statistically significant(P=0.232),which at 24-72 h were 80.00%and 54.84%respectively,the aprepitant group was significantly better than the granisetron group(P=0.036),which at>72-144 h were 86.67%and 64.52%respectively,the aprepitant group was better than the granisetron group(P=0.045).The comparison of adverse reactions between the two antiemetic drugs found that constipation,diarrhea,urticaria,fatigue and anxiety had no significant difference(P>0.05),the occurrence rate of total adverse reactions in the aprepitant group was 23.33%,which in the granisetron group was 25.81%,the difference between the two groups was not statistically significant(P>0.05).Conclusion Aprepitant combined with dexamethasone has better effect for treating hyperemetic chemotherapy drug cisplatin chemotherapy caused nausea and vomiting with good tolerance.

关 键 词：阿瑞匹坦 顺铂 药物疗法 手术后恶心呕吐 5-HT3受体拮抗剂 治疗结果 

分 类 号：R730.5[医药卫生—肿瘤]