格拉司琼与胃复安及地塞米松联合预防化疗所致恶心呕吐的疗效观察

目的观察格拉司琼与胃复安及地塞米松联合预防化疗所致恶心呕吐及毒副反应,并与单用格拉司琼相比较。方法 采用随机交叉、自身对照法,将联合化疗患者分成两组:A组第一周期用格拉司琼与胃复安及地塞米松;B组第一周期单用格拉司琼,第二周期A、B组交叉使用。结果 格拉司琼与胃复安及地塞米松组对化疗恶心、呕吐的有效控制率均高于单用格拉司琼组,差异有显著性(P＜0.05)。结论 格拉司琼与胃复安及地塞米松联合作为预防和控制化疗致的恶心、呕吐的首选治疗。     

格拉司琼预防胃癌化疗引起恶心呕吐的临床研究

目的:观察格拉司琼注射剂预防顺铂引起的急性及延迟性恶心呕吐的作用和毒副反应,并与恩丹西酮比较.方法:采用随机自身对照方法,将48例接受联合化疗(含顺铂)的胃癌患者随机分为A、B两组,均接受2个周期相同方案的化疗.A组第1周期用格拉司琼,第2周期用恩丹西酮止吐;B组第1周期用恩丹西酮,第2周期用格拉司琼止吐.观察化疗后24小时(急性)及5日内(延迟性)恶心呕吐发生的情况.结果:在化疗后0h～6h,格拉司琼对恶心的控制率与恩丹西酮相似,但第1天、第2天、第3天格拉司琼对恶心的有效率(62.5%、47.9%、41.7%)优于恩丹西酮(41.7%、27.1%、22.9%,P＜0.05),提示格拉司琼作用时间较恩丹西酮长.格拉司琼控制呕吐的效果及所致毒副作用与恩丹西酮相似.结论:格拉司琼能有效控制胃癌化疗所致的恶心呕吐,作用时间较恩丹西酮长,它的不良反应轻,是良好的化疗止吐药.     

格拉司琼对恶性肿瘤预防化疗所致恶心、呕吐临床疗效观察

目的 观察格拉司琼与甲氧氯普胺对减轻化疗所致恶心、呕吐的临床效果.方法 观察95例恶性肿瘤患者自身先后四次化疗对格拉司琼、甲氧氯普胺的恶心、呕吐的程度及疗效.结果 格拉司琼对预防恶性肿瘤化疗所致恶心、呕吐总有效率0-Ⅰ度(62.6%)明显高于甲氧氯普胺(28.4%).结论 格拉司琼对恶性肿瘤化疗所致恶心、呕吐较甲氧氯普胺有更明显的预防作用.     

格雷司琼加甲氧氯普胺及地塞米松预防含顺铂化疗所致恶心呕吐的临床观察

目的观察格雷司琼加甲氧氯普胺(胃复安)及地塞米松联用预防含顺铂的联合化疗所致的恶心、呕吐及其他毒副反应,并与单用格雷司琼比较。方法采用随机交叉、自身对照法,将接受化疗的患者,随机分为两组。A组第1周期用格雷司琼联合甲氧氯普胺及地塞米松,第2周期单用格雷司琼;B组与A组相反。结果格雷司琼加甲氧氯普胺及地塞米松第1￣6天恶心、呕吐的有效控制率均高于单用格雷司琼组,其中第3、4天差异有显著性(P<0.05)。结论格雷司琼加甲氧氯普胺及地塞米松可作为预防和控制含顺铂联合化疗所致恶心、呕吐的一线治疗方法。     

格拉司琼预防胃癌化疗引起恶心呕吐的临床研究

目的 :观察格拉司琼注射剂预防顺铂引起的急性及延迟性恶心呕吐的作用和毒副反应 ,并与恩丹西酮比较。方法 :采用随机自身对照方法 ,将 48例接受联合化疗 (含顺铂 )的胃癌患者随机分为A、B两组 ,均接受 2个周期相同方案的化疗。A组第 1周期用格拉司琼 ,第 2周期用恩丹西酮止吐 ;B组第 1周期用恩丹西酮 ,第 2周期用格拉司琼止吐。观察化疗后 2 4小时 (急性 )及 5日内 (延迟性 )恶心呕吐发生的情况。结果 :在化疗后 0h～ 6h ,格拉司琼对恶心的控制率与恩丹西酮相似 ,但第 1天、第 2天、第 3天格拉司琼对恶心的有效率 ( 62 5 %、47 9%、41 7% )优于恩丹西酮 ( 41 7%、2 7 1%、2 2 9% ,P <0 0 5 ) ,提示格拉司琼作用时间较恩丹西酮长。格拉司琼控制呕吐的效果及所致毒副作用与恩丹西酮相似。结论 :格拉司琼能有效控制胃癌化疗所致的恶心呕吐 ,作用时间较恩丹西酮长 ,它的不良反应轻 ,是良好的化疗止吐药     

格拉司琼加甲泼尼龙预防含顺铂化疗所致恶心呕吐的临床研究

目的　观察格拉司琼 (凯特瑞、Kytril)与甲泼尼龙 (甲基强的松龙 )联用预防含顺铂的联合化疗所致的恶心、呕吐及其它不良反应 ,并与单用格拉司琼比较。方法　采用随机、交叉、自身对照法 ,将 4 0例接受含顺铂 30mg/( m2 · d)× 3的联合化疗的恶性肿瘤患者 ,随机分为 A、B两组。 A组第 1周期用格拉司琼 ,第 2周期用格拉司琼加甲基强的松龙 ;B组第 1周期用格拉司琼加甲基强的松龙 ,第 2周期用格拉司琼。止吐方案 :格拉司琼 3mg,静注 ,第 1～ 3天 ,甲基强的松龙 12 0 mg,静注 ,第 1～ 3天。结果　格拉司琼加甲基强的松龙 (联合组 )第 1～ 6天无恶心和轻度恶心 ,发生率均高于单用格拉司琼 (单用组 ) ,其中第 1～ 4和第 6天差异有显著性 ( P<0 .0 5 )。格拉司琼加甲基强的松龙 (联合组 )第 1～ 6天呕吐完全控制率 ( CR率 )和有效控制率 ( CR+ PR)均高于单用格拉司琼 (单用组 ) ,其中第 2、3天差异有显著性 ( P<0 .0 5 )。结论　甲基强的松龙能增强格拉司琼对含顺铂化疗所致的恶心、呕吐的控制 ,可作为预防和控制含顺铂联合化疗所致恶心、呕吐的一线治疗。     

格拉司琼与恩丹西酮防治食管癌术后化疗所致恶心呕吐的疗效对比

目的:比较格拉司琼与恩丹西酮防治食管癌术后患者化疗引起恶心、呕吐的作用及毒副反应。方法:回顾性研究439例食管癌术后化疗患者的临床资料,比较格拉司琼和恩丹西酮的治疗效果及毒副反应。结果:吻合口位于颈部患者比位于胸内患者易发生恶心、呕吐。格拉司琼对化疗后急性(1d)恶心、呕吐有效率为81.6%,延迟性恶心呕吐(2～5d)的有效率分别为75.0%、64.2%、60.8%、56.1%。恩丹西酮对化疗后急性恶心、呕吐有效率为71.4%,延迟性恶心、呕吐的有效率分别为68.7%、57.7%、52.0%、47.1%,两组差异显著(P<0.05),格拉司琼治疗效果优于恩丹西酮。两者不良反应基本相似。结论:格拉司琼对于防治食管癌术后患者化疗所致恶心、呕吐效果较好。     

格拉司琼联合黄连上清片防治化疗药所致胃肠道副反应疗效观察

目的:观察格拉司琼联合黄连上清片对化疗药所致胃肠道反应的疗效,并与单用格拉司琼比较。方法:67例患者随机分为治疗组和对照组,治疗组在化疗前给予静脉注射格拉司琼3mgqd×5天加黄连上清片6#bid×5天;对照组在化疗前给予静脉注射格拉司琼3mgqd×5;观察每组病人一周内出现恶心呕吐和便秘的程度。结果:治疗组和对照组防治化疗所致的恶心呕吐有效率(CR PR%)分别为90.6%和85.7%,两者无显著性差异(P>0.05);便秘发生率(中 重度%)分别为9.4%和37.2%,两者有显著性差异(P<0.05)。结论:格拉司琼联合黄连上清片防治化疗药所致胃肠道恶心呕吐反应与单用格拉司琼效果相同显著,而发生便秘明显少于单用组。     

奥氮平联合格拉司琼控制乳腺癌化疗所致恶心呕吐的疗效观察

目的观察并比较奥氮平联合格拉司琼与单用格拉司琼控制乳腺癌化疗所致恶心呕吐的疗效。方法 120例乳腺癌患者被随机分为研究组（60例）及对照组（60例）,研究组和对照组均在化疗前30 min静脉滴注格拉司琼3 mg,研究组自化疗第1天早晨开始口服奥氮平10 mg,连用3天,第1个周期化疗结束后评价止吐效果。结果研究组的急性恶心呕吐的发生率（33.3%）和迟发性恶心呕吐的发生率（18.3%）均明显低于对照组（53.3%和40%）,差异有统计学意义（P〈0.05）。结论与单用格拉司琼相比,奥氮平联合格拉司琼对于控制乳腺癌化疗所致急性恶心呕吐和延迟性恶心呕吐的效果更好。     

盐酸帕洛诺司琼与格拉司琼预防儿童化疗呕吐比较的研究

目的:观察盐酸帕洛诺司琼与格拉司琼预防儿童恶性肿瘤化疗所致呕吐的临床疗效和不良反应。方法:将采用顺铂化疗(>50mg/m~2)的80例患儿随机分为2组,每组40例,分别运用盐酸帕洛诺司琼(试验组)及格拉司琼(对照组)止吐,观察患儿化疗后出现急性呕吐、延迟性呕吐和恶心的控制情况及相关不良反应的发生情况。结果:急性期防治呕吐的有效率实验组为77.5%、对照组为67.5%,延迟期有效率分别为57.5%及45%,差异均无统计学意义(P>0.05),全期呕吐的控制率分别为55.0%和35.0%,差异有统计学意义(P<0.05);治疗组23例患者出现恶心,发生率1级27.5%,2级22.5%,3级7.5%,平均分级0.8;对照组29例患者出现恶心,发生率1级32.5%.2级20.0%,3级10.0%,平均分级1.2;恶心控制率差异有统计学意义(P<0.05)。两组止吐药不良反应发生率低,为腹胀、便秘及头痛,症状较轻。结论:盐酸帕洛诺司琼与格拉司琼均为儿童化疗安全、高效的止吐药物,全期呕吐控制率盐酸帕洛诺司琼效果更佳。     

Comparative trial of oral granisetron and intravenous ondansetron in patients receiving chemotherapy for breast cancer. Study Group of Granisetron

This multicentric randomized trial compared two strategies in the prevention of acute and delayed nausea and vomiting induced by moderately emetogenic chemotherapy in patients with breast cancer. The antiemetic efficacy and side effects of oral granisetron, followed by metoclopramide, were compared to those of intravenous (IV) ondansetron followed by oral ondansetron. 198 chemonaive patients with breast cancer, treated with a moderately emetogenic chemotherapy, were randomly assigned to receive either oral granisetron 1 mg twice a day on day 1, followed by metoclopramide, 60 mg on day 2 and 3, or ondansetron, 8 mg IV on day 1, followed by ondansetron 8 mg tablet twice a day on day 2 and 3. Both treatments have shown similar control of acute emesis: complete response was achieved in 71% of granisetron group and 66% of ondansetron, and total response in respectively 49% and 53%. However, granisetron plus metoclopramide showed a trend towards better efficacy than oral ondansetron in the prevention of delayed emesis. Furthermore, during the overall study period (day 1 to 5), the percentage of complete responses in the group receiving oral granisetron followed by oral metoclopramide was significantly higher than in the group receiving ondansetron (53% versus 37%; p = 0.022). In conclusion, oral granisetron has shown similar efficacy as IV ondansetron in the prevention of acute emesis induced by moderately emetogenic chemotherapy. Oral granisetron followed by metoclopramide seems more efficient than IV plus oral ondansetron in the prevention of delayed emesis.     

甲地孕酮联合PLF(双周疗法)方案治疗鼻咽癌的临床研究

目的　评价甲地孕酮联合PLF(双周疗法)对鼻咽癌新辅助化疗近期疗效的提高作用与不良反应。方法　52例住院的鼻咽癌患者随机分为甲地孕酮+PLF化疗组(n=25)和单纯PLF化疗组(n=27),所有病人均接受2疗程的治疗。结果　治疗组有效率(CR+PR) 88. 0%,对照组有效率92. 6%,两者间无显著性差异(P>0. 05),治疗组的不良反应低于对照组,白细胞下降、消化道反应差异均有显著性(P<0. 05 ),而其它不良反应比较差异无显著性(P>0. 05)。结论　甲地孕酮配合化疗可以改善鼻咽癌患者的生存质量,减轻化疗所致的不良反应,值得临床推广应用。     

醋酸甲地孕酮联合化疗治疗晚期胃癌疗效观察

目的 观察醋酸甲地孕酮对接受化疗的晚期胃癌患者生活质量的改善作用.方法 38例晚期胃癌患者分为治疗组和对照组.对照组18例采用常规化疗方法治疗;治疗组20例在化疗基础上加用醋酸甲地孕酮.观察2组患者生活质量改善状况及毒副反应.结果 治疗组较对照组生活质量有明显改善（P〈0.05）;胃肠道反应、骨髓抑制等毒副反应减轻（P〈0.05）.结论 醋酸甲地孕酮联合化疗能有效改善晚期胃癌患者生活质量,减轻化疗毒副反应.     

格拉司琼单药与联合用药预防含顺铂方案化疗所致呕吐的随机对照研究

目的:探讨格拉司琼单药与联合多药预防含顺铂方案化疗所致恶心呕吐的疗效和不良反应。方法:采用随机分组、交叉设计、自身对照的研究方法。联合用药组给予格拉司琼+地塞米松+胃复安+维生素B6,单药组仅给格拉司琼。对比第一、二周期化疗后两组急性和延迟性呕吐的完全缓解率、进食状况和不良反应。结果:共入组100例患者,其中1例自动退出,1例因顽固性呃逆退出,98例可评价疗效。联合组和单药组对急性呕吐的完全缓解率分别为73.5%(72/98)和61.2%(60/98)(P=0.009);对延迟性呕吐的完全缓解率分别为49.0％(48/98)和40.8％(40/98)(P=0.015);食欲下降的发生率分别为20.4％(20/98)和45.9％(45/98)(P=0.001)。两组头痛、便秘、胃部不适以及呃逆的发生率差别无统计学意义(均P>0.05),但联合用药组的兴奋失眠患者较单药组多(10例vs 1例)(P=0.005)。结论:格拉司琼联合地塞米松、胃复安、维生素B6对缓解顺铂等强致吐方案化疗的药物性呕吐效果更优,并能改善食欲,是一个安全、有效、经济的一线治疗方案。     

盐酸帕洛诺司琼预防含顺铂化疗所致恶心、呕吐的临床观察

目的通过与格拉司琼比较,观察和评价帕洛诺司琼预防含高度催吐危险化疗药物顺铂所致恶心、呕吐的疗效和安全性。方法采用随机、交叉、自身对照法,将84例含顺铂化疗方案治疗的恶性肿瘤患者分成两组：A组第1周期用帕洛诺司琼及地塞米松;B组第1周期用格拉司琼及地塞米松;第2周期A、B组交叉使用。止吐方案：帕洛诺司琼0．25mg,静脉推注d1,d3;格拉司琼3mg,静脉滴注dl-3;地塞米松10nag,静脉推注d1—3。观察化疗后7天内恶心、呕吐的情况以及与止吐药相关不良反应。结果帕洛诺司琼与格拉司琼对化疗后急性呕吐完全控制率分别为77．4％和71．4％,总有效率分别为90．5％和86．9％,差异均无统计学意义（均P〉0．05）;帕洛诺司琼与格拉司琼对化疗后延迟性呕吐完全控制率分别为66．7％和47．6％,总有效率82．1％和59．5％,差异均具有统计学意义（均P〈0．05）;与止吐药相关不良反应主要为便秘和头痛,两药发生率分别为22．6％和25．0％,差异无统计学意义（P〉0．05）。结论帕洛诺司琼对预防含顺铂化疗所致的急性呕吐的疗效与格拉司琼相当,但对预防延迟性呕吐的疗效优于格拉司琼,且不良反应发生率低、程度较轻、安全性好。     

康泉改进方案预防原发性肝癌化疗栓塞术后恶心呕吐的临床观察

目的探讨康泉改进方案预防原发性肝癌化疗栓塞术后恶心、呕吐的临床应用价值。方法将６０例肝癌患者随机分为两组。治疗组３０例，采用康泉改进方案，即康泉３ｍｇ加地塞米松１０ｍｇ和安定１０ｍｇ，化疗栓塞当天控制急性恶心呕吐；甲氧氯普胺３０ｍｇ加地塞米松１０ｍｇ，术后第３、５天控制迟发性反应。对照组３０例，采用康泉３ｍｇ、化疗栓塞当天注射。结果治疗组急性呕吐和恶性控制率分别为１００％和９３．３％，明显优于对照组的７３．３％和６６．７％（Ｐ＜０．０１），而且控制迟发性呕吐的疗效也优于对照组。结论康泉改进方案可提高预防原发性肝癌化疗栓塞术后恶心呕吐的疗效。     

Oral granisetron alone and in combination with dexamethasone: A double-blind randomized comparison against high-dose metoclopramide plus dexamethasone in prevention of cisplatin-induced emesis

PATIENTS AND METHODS:: Three anti-emetic treatment regimens were compared in 357 patientsreceiving cisplatin therapy (mean dose 81 mg/m²) in this double-blindrandomized study. Regimens studied were i) granisetron 1 mgbd orally for 7 days (granisetron alone); ii) gran 1 mg bd orallyfor 7 days plus prophylactic dexamethasone (12 mg i.v.) on thefirst day only (gran/dex); iii) metoclopramide (3 mg/kg i.v.loading dose; 4 mg/kg i.v. infusion) plus dex (12 mg i.v.) onthe first day followed by met 10 mg orally tds for a further6 days (met/dex). RESULTS:: At 24 hours, gran/dex was significantly superior to met/dexin terms of total anti-emetic control, defined as no nausea,no vomiting, no rescue anti-emetic therapy, not withdrawn (54.7%gran/dex vs. 37.2/ met/dex; (P < 0.01). There was also asignificant delay in time to onset of nausea (P < 0.01) andvomiting (P < 0.01) following gran/dex compared with met/dex.Oral granisetron alone was as effective as met/dex in controlof acute emesis in all parameters examined. There were no significantdifferences between the three groups in the control of delayednausea and vomiting. The most common adverse experiences in both granisetron groupswere headache and constipation, both characteristic of 5-HT₃antagonists. Agitation, somnolence, diarrhoea and decreasedappetite were reported more frequently by the met/dex group. CONCLUSIONS:: Oral granisetron as a single agent is as effective as high dosesof i.v. met/dex in preventing cisplatin-induced emesis. Oralgranisetron in combination with a corticosteroid provides superioranti-emetic control to the met/dex regimen in patients undergoinghighly emetogenic chemotherapy. granisetron, oral, metoclopramide, dexamethasone, anti-emetic, cisplatin     

Metoclopramide versus metoclopramide and lorazepam. Superiority of combined therapy in the control of cisplatin-induced emesis

Sixty-four patients treated with cisplatin-containing regimens were entered into a randomized, double-blinded study examining the antiemetic efficacy of metoclopramide with and without lorazepam for control of cisplatin-induced emesis. Metoclopramide was administered to all patients at 2 mg/kg, intravenously, 30 minutes before chemotherapy and 1.5, 3.5, and 5.5 hours posttreatment. Patients randomized to receive combined antiemetic therapy were administered lorazepam at 2 mg/m2 (maximum, 4 mg dose) intravenously, 30 minutes before chemotherapy. Those patients not receiving lorazepam were given normal saline placebo. Degree of nausea and number of vomiting episodes were recorded on a data flow sheet with a visual analogue scale. Drug toxicities were evaluated before each administered dose. Patients receiving both metoclopramide and lorazepam experienced significantly less vomiting episodes (P less than 0.05) and nausea (P less than 0.01) when compared to patients given metoclopramide alone. Forty-four percent of those receiving the combined therapy reported no nausea or vomiting episodes compared to only 22% receiving metoclopramide alone. Sedation was significantly more common in patients receiving lorazepam (88%) as opposed to patients receiving only metoclopramide (43%), P less than 0.01. Amnesia was seen in 25% receiving lorazepam. No significant difference in diarrhea, dystonia, or disinhibition was observed between the two arms. The authors conclude that the combination of lorazepam and metoclopramide was superior to metoclopramide alone in the prevention of cisplatin-induced nausea and vomiting, with sedation and amnesia more commonly observed in the combined regimen.     

枢复宁防止由非顺铂化疗所致呕吐的疗效观察

本文报道用枢复宁十地塞米松与灭吐灵十地塞米松随机对照,控制非顺铂化疗诱发的呕吐。58例病人经随机分组后,28例用枢复宁加地塞米松,30例按本院常用剂量灭吐灵加地塞米松治疗。枢复宁十地塞米松对急性恶心和呕吐的完全控制率均显著高于灭吐灵十地塞米松(分别为87％比72％,P<0.05,94％比67％,P<0.001)。对延缓性呕吐的完全控制。枢复宁十地塞米松也高于灭吐灵十地塞米松,分别为85％—94％比58％—82％(P<0.05)。枢复宁十地塞米松副作用轻,主要有头痛(13％)和便秘(9％),不引起锥体外系反应。因此,枢复宁十地塞米松是一个较为有效的联合止吐方案。     

Sustained-Release Metoclopramide Plus Methylprednisolone Versus Placebo Plus Methylprednisolone as Antiemetic Prophylaxis During Non-Cisplatin Chemotherapy: A randomized double-blind cross-over trial

In a randomized double-blind cross-over trial, sustained-release metoclopramide (S) plus methylpred-nisolone (M) was compared with placebo (P) plus methylprednisolone as antiemetic prophylaxis during two cycles of non-cisplatin chemotherapy. S was administered as 60 mg every 12 h commmencing on the evening before chemotherapy up to total of 300 mg metoclopramide in 2.5 days. Evaluation of nausea and vomiting was done by self-assessment schemes and visual analog scales. Fifty patients were included and 36 fulfilled both cycles. Mild nausea and vomiting were experienced by 81% and 83% in the S + M and P + M groups, respectively, while 42% and 39% showed complete control of nausea and vomiting during the first day of treatment. Moderate-dose S did not add to the antiemetic efficacy of M in non-cisplatin chemotherapeutic regimens.