格拉司琼联合方案控制化疗所致的恶心呕吐

目的：我们设计了格拉司琼联合止吐方案(单剂格拉司琼联合小别量胃复安 地塞米松来控制急性呕吐，口服胃复安控制迟发性呕吐)，并与常规止吐方案(中剂量胃复安 地塞米松控制急性呕吐，口服胃复安控制迟发性呕吐)对比。方法：全组共40例，顺铂组和阿霉素组各为20例。结果：随机接受止吐A方案和B方案结果显示，对急性呕吐的治疗，格拉司琼联合方案有效率为95％，明显优于常规组；对迟发性呕吐的治疗，格拉司琼联合方案有效率为85％～100％。结论：格拉司琼联合方案毒副作用轻微，大大减少了格拉司琼使用次数，节省了医疗费用，值得临床推广应用。     

格拉司琼用于抗肿瘤化疗所致恶心和呕吐的临床观察

目的:比较临床常规止吐治疗和加用格拉司琼在抗肿瘤化疗期间的止吐疗效.方法:选取100例恶性肿瘤患者随机分为对照组和观察组各50例 ,对照组在化疗期间给予泮托拉唑、甲氧氯普胺、维生素B6常规止吐治疗 ,观察组在此基础上加用格拉司琼3毫克 ,每日两次静脉注射 ,一天后停用甲氧氯普胺.而格拉司琼从化疗当日起使用一周.分别对两组患者化疗期间(化疗中和化疗后共计7天)进行呕吐频次、进餐频次、进餐量、体重、睡眠、药物副反应情况进行比较.结果:观察组各项指标好于对照组 ,对照组治疗有效率96% ,观察组治疗有效率72%.结论:格拉司琼用于治疗抗肿瘤化疗所致恶心呕吐的疗效比较理想 ,值得借鉴和推广.     

欧必亭预防化疗所致呕吐的临床研究

目的 :观察欧必亭对肿瘤化疗所致呕吐的疗效及不良反应。方法 :5 0例接受含顺铂化疗患者 ,采用随机自身对照方法 ,设AB组和BA组 ,均接受两个疗程相同化疗方案治疗 ,AB组第一疗程用欧必亭 ,第二疗程用格拉司琼 ,BA组第一疗程用格拉司琼 ,第二疗程用欧必亭。结果 :欧必亭止吐有效率为 90 % ,完全缓解率为 70 % ;格拉司琼止吐有效率为 86% ,完全缓解率为 60 % ,两者疗效无显著差异 ,且毒副反应均小。结论 :欧必亭与格拉司琼止吐效果相似。     

四类新药盐酸格拉司琼注射液预防抗肿瘤药物所致呕吐的Ⅱ期临床观察

目的在肿瘤的治疗中化疗药物所引起的恶心、呕吐是极为常见的,通过对盐酸格拉司琼注射液预防肿瘤化疗所致呕吐的Ⅱ期临床研究,探讨该药的止吐疗效及毒性反应.方法对31例病人的观察,采用自身对照新药盐酸格拉司琼与恩丹西酮预防抗肿瘤药物(DDP及蒽环类药物)所致呕吐进行比较.结果格拉司琼对强致吐剂顺铂所引起的呕吐其总的缓解率＞90%,恩丹西酮对顺铂引起的呕吐其缓解率＞85%.两止吐药毒性反应主要为便秘,恩丹西酮致便秘发生率高达41%,而格拉司琼所致便秘发生率为16%.结论两药预防呕吐的疗效相当,但格拉司琼的副反应明显低于恩丹西酮     

四类新药盐酸栈拉司琼注射液预防抗肿瘤药物所致呕吐的Ⅱ期临床观察

目的在肿瘤的治疗中化疗药物所引起的恶心、呕吐是极为常见的,通过对盐酸格拉司琼注射液预防肿瘤化疗所致呕吐的Ⅱ期临床研究,探讨该药的止吐疗效及毒性反应.方法对31例病人的观察,采用自身对照新药盐酸格拉司琼与恩丹西酮预防抗肿瘤药物(DDP及蒽环类药物)所致呕吐进行比较.结果格拉司琼对强致吐剂顺铂所引起的呕吐其总的缓解率＞90%,恩丹西酮对顺铂引起的呕吐其缓解率＞85%.两止吐药毒性反应主要为便秘,恩丹西酮致便秘发生率高达41%,而格拉司琼所致便秘发生率为16%.结论两药预防呕吐的疗效相当,但格拉司琼的副反应明显低于恩丹西酮     

托烷司琼与格拉司琼联合甲氧氯普胺预防化疗所致恶心、呕吐的成本-效益分析

目的:评价托烷司琼与格拉司琼联合甲氧氯普胺预防化疗所致恶心、呕吐的治疗效果及成本-效益比。方法:收集2012年1月至2012年11月经病理学和细胞学证实的恶性肿瘤(食管癌、鼻咽癌)80例,随机分为A组40例、B组40例,分别应用托烷司琼及格拉司琼联合甲氧鲁普胺预防化疗所致恶心、呕吐,观察止吐效果并进行成本-效益分析。结果:A、B两组止吐有效率分别为92.5%和87.5%(P>0.05);成本/效益比分别为2.06和0.70。结论:托烷司琼与格拉司琼联合甲氧氯普胺预防化疗所致恶心、呕吐的疗效相似,但后者成本-效益比好。     

盐酸帕洛诺司琼治疗化疗所致恶心呕吐23例临床观察

目的:观察盐酸帕洛诺司琼治疗恶性肿瘤患者化疗所致恶心呕吐的临床效果以及不良反应。方法:44例接受含顺铂或蒽环类药物的患者随机分为观察组23例和对照组21例,观察组采用盐酸帕洛诺司琼,对照组采用格拉司琼,比较两组控制化疗后恶心呕吐的疗效及不良反应。结果:观察组总有效率为73.9%,对照组总有效率为71.4%,差异无统计学意义(P>0.05),不良反应主要为便秘和头痛。结论:盐酸帕洛诺司琼治疗化疗所致恶心呕吐的效果与格拉司琼相仿,疗效确切,使用方便,不良反应小。     

阿扎司琼与格拉司琼预防及治疗化疗呕吐疗效对比及护理

目的 观察阿扎司琼与格拉司琼预防及治疗化疗呕吐的效果对比.方法 94例非小细胞肺癌患者随机分为二组,治疗组为阿扎司琼,对照组为格拉司琼,两组均应用多西他赛+顺铂的化疗方案.结果 实验组和对照组止吐的有效率分别为87.2%和85.1%,差异无显著性.结论 国产阿扎司琼预防及治疗化疗所致恶心呕吐有效、安全,值得临床推广.     

格拉司琼与甲氧氯普胺联合应用预防化疗恶心呕吐临床疗效观察

目的:观察格拉司琼与甲氧氯普胺联合预防化疗引起的恶心呕吐疗效。方法:随机分为三组治疗:治疗组应用化疗前0.5h静脉点滴格拉司琼,化疗后静脉点滴甲氧氯普胺,对照Ⅰ组化疗前0.5h静脉点滴甲氧氯普胺。对照Ⅱ组化疗前0.5h静脉点滴格拉司琼。结果:联合用药预防化疗恶心有效率为69.8%,预防呕吐有效率为90.6%,明显高于对照组。结论:两种止吐药联合应用优于两药单用。     

乳腺癌患者化疗中托烷司琼与格拉司琼止吐作用的疗效观察与护理

目的：观察乳腺癌患者化疗中托烷司琼与格拉司琼止吐作用的疗效及有效护理措施。方法：将96名乳腺癌病人随机的分成2组,即格拉司琼组与托烷司琼组,每组包括48名病人,2组病人皆为首次接受化学药物治疗,比较2组病人的恶心、呕吐的程度,治疗效果及相关护理。结果：对于预防乳腺癌的化疗所引起的恶心、呕吐来说,托烷司琼组的有效率为75．0％,格拉司琼组的有效率为70．8％,2组药物的疗效基本相似,P＞0．05。结论：在乳腺癌化学药物治疗中,托烷司琼与格拉司琼所起的止吐作用的疗效无统计学差异,对于临床用药来说,托烷司琼每天1次用药,与格拉司琼相比,其更为方便。在化疗过程中严密观察药物副反应,做好患者心理护理,饮食护理,可使患者顺利完成化疗周期,提高生存质量。     

格拉司琼防治肿瘤化疗所致恶心、呕吐的临床观察

目的：观察格拉司琼对恶性肿瘤化疗所致恶心、呕吐的临床疗效。方法；38例接受联合化疗的恶性肿瘤病人，随机分格拉司琼组与胃复安组比较治疗效果。结果：格拉司琼组对恶心、呕吐的完全控制率和有效控制率明显优于胃复安组（P〈0．05）。结论：格拉司琼可作为预防化疗引起的恶心、呕吐的优选药物。     

康泉合用地塞米松控制化疗所致的胃肠道反应

目的：比较康泉及康泉合用地塞米松预防急性白血病化疗所致的胃肠道反应的效果。方法：在同一方案的不同疗程，分别单用康泉或康泉合用地塞米松，随机对照，共观察１１０疗程。结果：康泉及康泉合用地塞米松对预防化疗所致急性呕吐有效率分别为６９．５％和９５．１％，有明显差异（Ｐ＜０．０１）；对于迟发性呕吐两组的有效率分别为７４．５５５％和９１．８３％，亦有明显差异。结论：康泉和地塞米松合用对控制急性和迟发性恶性呕吐优于康泉单用     

格拉司琼联合甲氧氯普胺预防化疗呕吐的临床疗效观察分析

目的比较格拉司琼联合甲氧氯普胺与单药格拉司琼预防肿瘤化疗引起的恶心、呕吐的有效性。方法将接受顺铂化疗方案的46例患者随机分为两组,一组于化疗前30min及化疗后8h均给予格拉司琼3mg,至化疗结束后再用2d停药。另一组,于化疗前30min给予格拉司琼3mg,化疗后8h给予甲氧氯普胺10mg,至化疗结束后再用2d停药,观察急性期、延迟期及无呕吐发生率。结果 2组急性期、延迟期及总无呕吐发生率比较,差异无统计学意义(P>0.05)。结论格拉司琼联合甲氧氯普胺是一种较为理想的临床止吐方案。     

Ondansetron versus granisetron in the prevention of chemotherapy induced nausea and vomiting in children with acute lymphoblastic leukemia

Effect of ondansetron and granisetron were evaluated in sixty (60) children (age 4-11 years) irrespective of sex, diagnosed case of acute lymphoblastic leukemia (ALL) who received high dose methotrexate and did not receive any antiemetic 24 hours prior to HDMTX. This was a prospective, randomized, double-blind, single center study. Of 60 children, 30 received oral ondansetron (4mg) and rest 30 granisetron (1mg) half an hour before therapy. Drugs were randomly allocated with appropriate code. The patients were followed up from day 1 to day 5 of therapy. Episodes of nausea and vomiting were recorded and scorings was done every 24 hours following chemotherapy. No significant difference was found between two groups according to acute emesis (Day-1) (p=0.053). In day two and day three it was significant (p<0.05). In day four it was significant (p=0.002). Early chemotherapy induced nausea and vomiting (CINV) were controlled 90% in children who received granisetron and 70% in children who received ondansetron. Delayed (Day 2-4) CINV were controlled in 80% of children who received granisetron and 43.4% who received ondansetron (p<0.05). Granisetron group required additional doses only 3.3% cases and ondanseton group 30% cases on the second day (p<0.05). Result was significant between two groups. About 36.7% patients had episodes of nausea on day four of chemotherapy in ondansetron group and it was only 3.3% in granisetron group due to adverse effects of antiemetic drug itself (p=0.001). Maximum episodes of vomiting were found on the second day in ondansetron group 33.3% and in granisetron group 3.3% (p=0.003). Though adverse effects like headache, constipation, abdominal pain and loose motion were common in both group of children but their number was much less in children who received granisetron. On second day of therapy score of nausea and vomiting was maximum in ondansetron and minimum in granisetron treated on day 4 and the result was significant. So, to prevent acute and delayed CINV in children with ALL, oral graniseteron can be considered as more effective and well tolerated with minimum adverse effects compared with ondansetrons.     

Using a Multihospital Systems Framework to Evaluate and Establish Drug Use Policy

Purpose. In order to develop rational drug purchasing and use policy for a class of pharmaceuticals used in a consortium system of 14 university based hospitals, the antiemetic use patterns of inpatients receiving cancer chemotherapy were evaluated to assess the comparative effectiveness of granisetron, ondansetron, and conventional antiemetics. Patients and Methods. A prospective, observational study was conducted in 14 academic health centers linked under research and purchasing consortium arrangements from October to December 1994. The use of antiemetics was evaluated in hospitalized patients receiving cancer chemotherapy agents with a known propensity for causing, alone or in combination, varying degrees of nausea or vomiting. Clinical outcomes measured were the impact of chemotherapy administration on the functional status of patients, and the occurrence of post-treatment vomiting. Results. The most often prescribed cancer chemotherapy regimens consisted of cisplatin, paclitaxel, etoposide and cyclophosphamide, and the most often prescribed antiemetics were the 5-hydroxytryptamine subtype-3 antagonists (5-HT₃ antagonists, granisetron and ondansetron), dexamethasone and lorazepam. Of the 439 patients studied, 329 (75%) reported no episodes of emesis. Of the patients receiving highly emetogenic chemotherapy, those receiving 5-HT₃ antagonists experienced better overall outcomes (as measured by functional health status and the absence of vomiting) than patients receiving conventional (non-5-HT₃ antagonist) antiemetics. In contrast, patients receiving chemotherapy associated with moderate or low emetogenicity experienced similar outcomes, regardless of the antiemetic regimen selected. No statistical difference was seen between granisetron and ondansetron in achieving positive patient outcomes. Conclusion. The study results suggest that 5-HT₃ antagonists are associated with better clinical outcomes than other antiemetics in patients receiving highly emetogenic chemotherapy. Less costly conventional antiemetic therapy (or, in some cases, no antiemetic therapy) provide comparable outcomes in patients receiving chemotherapy associated with moderate or low emetogenic potential. Granisetron and ondansetron were found to be clinically comparable.     

NK-1抑制剂预防头颈部恶性肿瘤PF方案化疗相关恶心、呕吐的疗效观察

目的 观察在头颈部恶性肿瘤PF方案（顺铂+5-氟尿嘧啶）化疗过程中应用NK-1抑制剂阿瑞匹坦（aprepitant）的止吐疗效及不良反应。方法 56例需行PF方案静脉化疗的头颈部恶性肿瘤患者,随机分为实验组及对照组,各28例。实验组患者接受NK-1抑制剂阿瑞匹坦+5-HT3受体拮抗剂格拉司琼+地塞米松的三药联合方案预防止吐,对照组接受5-HT3受体拮抗剂格拉司琼+地塞米松的两药联合方案预防止吐。1个化疗周期结束后评估两组患者的恶心、呕吐缓解情况及相关不良反应。结果 56例患者均按期完成化疗,在急性恶心、呕吐控制情况上,实验组均高于对照组,完全缓解率（CR）分别为57.1% vs 50.0%、50.0% vs 42.9%,有效率（RR）分别为82.1% vs 71.4%和78.6% vs 67.9%,差异无统计学意义（P>0.05）。在延迟性恶心、呕吐控制情况上,实验组与对照组完全缓解率CR分别为50.0% vs 21.4%、53.6% vs 25.0%,有效率（RR）分别为78.6% vs 46.4%、82.1% vs 53.6%,实验组明显高于对照组,差异有统计学意义（P<0.05）。两组患者主要不良反应均为轻度,差异无统计学意义（P>0.05）。结论 本研究表明含NK-1抑制剂阿瑞匹坦的三药联合方案预防头颈部恶性肿瘤PF方案化疗引起的急性期及延迟期恶心、呕吐安全有效,可在临床进一步研究推广。     

雷莫司琼与格拉司琼预防化疗药物引起的胃肠道反应的临床观察

目的　观察雷莫司琼预防顺铂或阿霉素所引起的胃肠道反应的疗效及安全性 ,并与格拉司琼进行对比。方法　采用随机自身交叉对照。入选患者随机分为AB组或BA组 ,AB组第 1周期应用雷莫司琼 0 3mg,第 2周期应用格拉司琼 3mg ;BA组则相反。结果　可评价患者 4 7例 ,顺铂组 2 7例 ,阿霉素组 2 0例。化疗后 0～ 2 4h雷莫司琼对食欲不振 ,恶心的控制率优于格拉司琼 (P <0 0 5 ) ;0～ 2 4h雷莫司琼对呕吐的控制率与格拉司琼相似。两组不良反应发生率相似 ,主要为头痛。结论　雷莫司琼是安全、高效的止吐药物 ;与格拉司琼比 ,雷莫司琼更具药效经济学优势。     

阿瑞匹坦治疗顺铂方案化疗引起的呕吐临床分析

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(80 mg/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24 h、24~72 h、>72~144 h的完全有效率(CR).结果 阿瑞匹坦组与格拉司琼组的24 h内CR率分别为66.67% 和51.61%,差异无统计学意义(P=0.232);24~72 h CR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).>72~144 h CR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.     

CLINICAL COMPARISON OF THE SELECTIVE SEROTONIN3 ANTAGONISTS RAMOSETRON AND GRANISETRON IN TREATING ACUTE CHEMOTHERAPY—INDUCED EMESIS,NAUSEA AND ANOREXIA

INTRODUCTIONThecontrolofchemotherapy－inducedemesisandnausearemainsanimportantissueincancertherapy．Thediscoveryof５－hydroxytryptamine３（５－HT３）receptorsinafferentvagalnervefibersandinneuronswithinthegastrointestinaltractsuggeststhatchemotherapeutica     

恩丹西酮、格拉司琼、托烷司琼预防化疗呕吐的比较

目的:观察不同国产止吐药预防头颈部癌含顺铂(cisplatin,DDP)方案化疗引起的恶心、呕吐的临床疗效和不良反应.方法:63例患者采用含DDP方案化疗90周期,随机分为3组,各化疗30周期,分别给予国产恩丹西酮(欧贝)、格拉司琼(琼沙奥或君凯)、托烷司琼(赛格恩)预防恶心、呕吐反应.结果:防治恶心、呕吐的有效率格拉司琼组为93.3%,托烷司琼组为86.7%,恩丹西酮组为83.3%,3组之间疗效比较差异无显著性;3种止吐药毒副反应相似,以便秘、倦怠及头痛多见,但程度较轻.结论:国产恩丹西酮、格拉司琼、托烷司琼均为头颈部癌含DDP方案化疗的有效止吐药,其疗效相似,不良反应轻,病人可耐受.