奥氮平联合托烷司琼、地塞米松预防顺铂所致恶心呕吐的临床观察

摘要

O bjective: To observe the efficacy and adverse reactions of olanzapine joint tropisetron and dexamethasone in prevention of nausea and vomiting induced by cisplatin. Methods: Lung cancer patients who used cisplatin-containing chemotherapy and met the inclusion criteria were randomly divided into olanza-pine group and control group. The efficacy and adverse reactions of the two groups were recorded. Results:Forty-two patients were included in the olanzapine group, and forty patients were included in the control group. Common clinical data of the two groups had no significant difference (P>0.05). Nausea and vomiting scores of the olanzapine group and the control group were 9.44±3.61 and 12.25±3.66 (P=0.012). There were significant difference in nausea and vomiting grading (P=0.046) and controlling (P=0.043), particularly in the full control rates of nausea and vomiting (54.76% vs 25.00%, P=0.006). Subgroup analysis found that olanzap-ine was more efficient in female patients, however, age, KPS and tumor stage had no effect on efficiency. Pa-tients in both groups occurred dizziness, fatigue, constipation and elevated blood sugar (P>0.05). Conclusion:Olanzapine can improve cisplatin-induced nausea and vomiting with well-tolerated adverse reactions.%目的：观察奥氮平联合托烷司琼、地塞米松预防顺铂所致恶心、呕吐的疗效及不良反应。方法：符合入选标准的肺癌患者，均采用含顺铂的化疗方案，随机分为奥氮平组和对照组，观察两种止吐方案防治顺铂所致恶心、呕吐的疗效及不良反应。结果：奥氮平组和对照组分别纳入42例和40例患者，两组间一般临床资料无统计学差异（P>0.05）。奥氮平组和对照组恶心、呕吐症状评分分别为9.44±3.61、12.25±3.66（P=0.012），用药后的恶心、呕吐分级（P=0.046）和止吐效果（P=0.043）有统计学差异，特别是呕吐完全控制率显著提高（54.76% vs 25.00%，P=0.006）。亚组分析发现，奥氮平组女性患者的有效率较高，年龄、KPS、肿瘤分期对有效率无影响。治疗期间两组患者均出现头晕、乏力、便秘和血糖升高，无统计学差异。结论：奥氮平联合止吐方案防治顺铂所致恶心、呕吐具有较好的临床效果，不良反应少，值得推广。