氯丙嗪对比奥氮平预防顺铂相关性恶心呕吐的临床分析  

The Clinical analysis of compared with chlorpromazine and olanzapine in preventing nausea and vomiting induced by chemotherapy associated with cisplatin

作　　者：邹梦莎 周光华[1] Zou Meng-sha;Zhou Guang-hua(The Second Affiliated Hospital of Hunan Normal University/PLA 921Hospital,Changsha 410003,China)

机构地区：[1]湖南师范大学附属第二医院/解放军联勤部队第921医院,长沙410003

出　　处：《湖南师范大学学报（医学版）》2021年第3期99-103,共5页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:比较氯丙嗪(CLO)与奥氮平(OLN)预防含顺铂方案化疗所致的恶心呕吐(CINV)的临床疗效、安全性,并评估对患者生活质量的影响。方法:收集2020年1月~2020年10月在本院肿瘤科计划使用含顺铂化疗方案的恶性肿瘤患者95例,随机分2组,实验组45例和对照组50例。实验组的止吐方案为氯丙嗪(25mg,im,d1-d3),昂丹司琼(8mg,iv,d1-d3),地塞米松(10mg,iv,d1-d3);对照组止吐方案为奥氮平(5mg,po,d1-d4),昂丹司琼(8mg,iv,d1-d3),地塞米松(10mg,iv,d1-d3)。比较两组患者化疗后各时期CINV(急性期、延迟期、总观察期)的完全缓解率和有效率,并评估治疗的安全性和生活质量。结果:实验组和对照组急性期、延迟期、总观察期恶心呕吐的完全缓解率、暴发性呕吐的发生率无明显差异;实验组头晕的副作用高于对照组,两组乏力、嗜睡、便秘、失眠、直立性低血压均无统计学差异,均未出现Ⅲ-Ⅳ度副反应;生命质量测定量表(QLQ-C30):实验组在健康状况领域评分明显低于对照组,但功能领域、症状领域、特异性单项领域评分均无统计学差异。结论:氯丙嗪与奥氮平预防高致吐性化疗所致CINV疗效相近,大多数患者能耐受不良反应,生活质量大致相当,但氯丙嗪价格低廉,是更经济的选择,值得临床推广。Objective To compare the clinical effects,side-effects and impacts on the quality of patients’life of chlorpromazine and olanzapine when they are used in prevention of nausea and vomiting induced by the chemotherapy with cisplatin-containing.Methods Select 95 patients with malignant tumors who planned to receive the chemotherapy with cisplatin from January 2020 to December 2020 in our hospital,The patients were randomly divided into treatment group(n=45)and control group(n=50),The antiemetic scheme of treatment group was as follow:chlorpromazine(25mg im d1-d3),ondansetron(8mg iv d1-d3),and dexamethasone(10mg iv d1-d3).The antiemetic scheme of control group was as follow:olanzapine(5mg po d1-d4),ondansetron(8mg iv d1-d3),and dexamethasone(10mg iv d1-d3).The complete remission rate and effective rate during acute phase,delay phase,and overall phase were compared by the two groups.To assess the occurrence of untoward drug effect and the quality of patients’life.Results The complete remission rate(CRR)and effective rate(EER)during acute phase,delay phase,and overall phase of the treatment group and control group were 71.11%vs74.00%、48.89%vs 62.00%、40.00%vs 50.00%、100%vs 96.00%、86.67%vs 96.00%、86.67%vs 92.00%.The complete remission rate and effective rate of the two groups was of no significant difference.The incidence of explosive of the treatment group and control group were15.56%and10.00%,There was no significant difference between the two groups;The side effects of dizziness in the treatment group were higher than the control group,and there was no significant difference in fatigue,lethargy,constipation,insomnia,and orthostatic hypotension between the two groups.The total health status of the treatment group(46.85±27.71)was lower than control group,but there were no statistical differences in functional areas,symptom areas,and specific individual areas.Conclusion The antiemetic effects of chlorpromazine group and olanzapine group are similar.Most patients can tolerate the adverse reactions and their

关 键 词：氯丙嗪 奥氮平 化疗所致的恶心呕吐 顺铂 

分 类 号：R749.3[医药卫生—神经病学与精神病学]