Acupoint Sticking at Shenque （CV 8） with Ginger-preparedBan Xia （Rhizoma Pinelliae） for Nausea and Vomiting Induced by Amifostine

Objective： To observe the treatment effect of acupoint sticking at Shenque （CV 8） with ginger-preparedBan Xia （Rhizoma Pinelliae） on nausea and vomiting induced by Amifostine for myelodysplastic syndromes （MDS）. Methods： Totally 124 eligible subjects intervened by Amifostine were randomized into 2 groups by the visiting order,an observation group and a control group,62 in each group. The control group was intervened by conventional treatment, while the observation group was by acupoint sticking at Shenque （CV 8） with ginger-preparedBan Xia （Rhizoma Pinelliae） in addition to the same conventional treatment. The occurrence rate of nausea and vomiting in the two groups were observed. Results： After intervention, the occurrence rate of nausea and vomiting in the observation group was significantly lower than that in the control group （P＆lt;0.01）. Conclusion： Acupoint sticking at Shenque （CV 8） with ginger-prepared Ban Xia （Rhizoma Pinelliae）can produce a content effect on nausea and vomiting induced by Amifostine for MDS.     

艾盐包热熨中脘穴治疗卵巢癌化疗后恶心呕吐疗效观察

目的观察艾盐包热熨中脘穴治疗卵巢癌化疗后恶心呕吐的临床疗效。方法将104例卵巢癌化疗患者随机分为治疗组53例和对照组51例。在化疗期间,对照组采用单纯止吐药物治疗,治疗组在对照组治疗基础上采用艾盐包热熨中脘穴治疗。结果治疗组总有效率为94.3%,对照组为70.6%,两组比较差异具有统计学意义(P0.05)。结论艾盐包热熨中脘穴是一种治疗卵巢癌化疗引起恶心呕吐的有效方法。     

盐酸帕洛诺司琼胶囊预防化疗性恶心呕吐的随机对照双盲多中心临床研究

目的 观察和评价国产新药盐酸帕洛诺司琼胶囊预防和控制化疗药物引起的恶心、呕吐的有效性和安全性。方法 采用随机、阳性药平行对照、双盲、双模拟的多中心临床试验方法,对使用中度致吐性化疗方案的恶性肿瘤患者,于第1天化疗前1h口服盐酸帕洛诺司琼胶囊1粒（0.5mg／粒）和盐酸格拉司琼分散片模拟剂1片（试验组）或口服盐酸格拉司琼分散片1片（1mg／片）和盐酸帕洛诺司琼胶囊的模拟剂1粒（对照组）,化疗12h后试验组和对照组分别再次给予盐酸格拉司琼分散片模拟剂1片和盐酸格拉司琼分散片1片（1mg／片）。观察用药当天至化疗后5天患者出现急性恶心呕吐、延迟性恶心呕吐、体力状况变化情况和对恶心呕吐控制的满意程度VAS评分,必要时给予格拉司琼+地塞米松的解救性止吐治疗。结果 7家研究中心共入组240例患者,试验组122例,对照组118例。经全数据分析集（FAS）分析,试验组与对照组急性呕吐的完全有效率差异无统计学意义（86.89％ vs.85.47％,P=0.8338）,经非劣效检验,试验组不亚于对照组（95％CI下界值=-7.33％,u=2.558,P=0.0105）。经符合方案数据集（PPS）分析,两组延迟性呕吐的完全控制率差异有统计学意义（74.38％ vs. 61.54％,P=0.0490）。整个观察期内试验组的呕吐发生率为21.31％,明显低于对照组的33.33％（P=0.0422）。化疗第2天试验组与对照组出现呕吐的患者呕吐次数（次／例）分别为0.15±0.52和0.31±0.68,差异有统计学意义（P=0.0090）;化疗第1～5天两组0级恶心发生率和PS评分的差异均无统计学意义（P＞0.05）;化疗第2～4天两组VAS评分的差异均有统计学意义（P＜0.05）。试验组发生便秘和总胆红素升高各2例,对照组发生便秘4例和药物性皮炎1例,两组不良反应的发生率分别为3.28％和4.24％（P＞0.05）。结论 国产盐酸帕洛诺司琼胶囊在预防中度致吐性化疗所致的急性恶心、呕吐与盐酸格拉司琼分散片疗效相当,而对延迟性呕吐的疗效优于盐酸格拉司琼分散片,且安全性好,给药方便,建议准予上市应用。     

Diclectin Therapy for Nausea and Vomiting of Pregnancy: Effects of Optimal Dosing

Objectives: (1) To quantify rates of suboptimal use of pyridoxine hydrochloride-doxylamine (Diclectin); and (2) to study responses to optimal doses of Diclectin in women previously taking a suboptimal dose.Methods: Women who called the Motherisk NVP helpline, and were taking only Diclectin (vitamin B₆ 10 mg and doxylamine 10 mg), were enrolled in the study and assessed for the severity of nausea and vomiting of pregnancy (NVP) with the Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system. Their Diclectin doses were subsequently increased according to body weight and individual symptoms. A follow-up phone call occurred within I to 3 weeks after the intervention, at which time the overall PUQE score was repeated, along with individual scoring of symptoms of nausea, vomiting, and retching.Results: Sixty-eight women were enrolled and completed the study. Despite moderate to severe NVP, defined by the validated PUQE scoring system, most women (50/68) were receiving 2 tablets a day of Diclectin instead of the recommended dose of 4 tablets a day. Following a mean doubling of the dose to 4 tablets a day, there was a significant decrease in length of nausea (from 4 to 3 hours, P < 0.001), frequency of vomiting (from mean 1.6 to 1.3 a day, P = 0.02), and overall PUQE score (from mean 7.5 to 6.1, P < 0.001).Conclusion: Women suffering from NVP are often given subtherapeutic doses of Diclectin. Women should receive a dosage according to their body weight and severity of their symptoms.     

昂丹司琼不同时间和不同剂量给药预防妇科腹腔镜手术术后恶心呕吐的疗效分析

目的探讨给于妇科腹腔镜手术患者不同时间和不同剂量的昂丹司琼对术后恶心呕吐的预防作用。方法152例妇科腹腔镜手术患者随机分为A、B、C三个给药组和空白对照组,给药组各组给于昂丹司琼时间及剂量分别为麻醉诱导前给予8mg、结束时8mg、麻醉诱导前4mg。结果与对照组比较,A组、B组、C组的术后恶心发生率明显较低,差异具有统计学意义（P〈0．05）,A组与B组、A组与C组比较术后恶心呕吐发生率差异无著性（P〉0．05）。结论对于妇科腹腔镜手术患者不同时间和不同剂量给予昂丹司琼均能有效预防恶心呕吐的发生,麻醉诱导前与结束时给药、药量8mg与4mg给药差异较小。     

结肠癌术后化疗所致恶心呕吐的防治

目的:观察盐酸格拉司琼联合地塞米松预防结肠癌术后化疗所致恶心呕吐的效果。方法:66例结肠癌术后化疗患者,随机分为治疗组21例,对照组一23例,对照组二22例。所有患者均采用FOLFOX化疗方案,均系第1次化疗,治疗组每天应用盐酸格拉司琼6m g联合地塞米松12m g静滴,对照组一单用盐酸格拉斯琼6m g静滴,对照组二单用地塞米松12m g每天静滴。观察患者发生恶心呕吐的情况。结果:治疗组预防结肠癌术后化疗所致恶心呕吐的有效率明显高于对照组,差异有统计学意义(P<0.05)。结论:盐酸格拉司琼联合地塞米松能够有效的预防结肠癌术后化疗所致恶心呕吐。     

Granisetron transdermal system and dexamethasone for the prevention of nausea and vomiting in multiple myeloma patients receiving chemo-mobilization: An observational real-world study of effectiveness and safety

PURPOSECyclophosphamide (CY) in a dose of 2–4 g/m² is widely used for hemopoietic progenitor stem cells mobilization. CY administration is associated with several adverse effects, including chemotherapy-induced nausea and vomiting (CINV). This study aimed to evaluate the efficacy and tolerability of granisetron transdermal system (GTDS) plus dexamethasone in the management of CINV in MM patients undergoing chemo-mobilization with CY.METHODSIn this single-center, prospective, observational, real world study, GTDS plus dexamethasone was administered to MM patients receiving chemo-mobilization based on CY 2 g/m2 plus G-CSF in an outpatient setting. The rate of complete response was evaluated as the main outcome. Other outcomes were rate of complete control of CINV, incidence of nausea/vomiting of any grade and safety.RESULTSA total of 88 patients were enrolled. A complete response was achieved in 45.5 % of patients; among them, 39.77 % attained complete control of CINV. Nausea and vomiting never occurred in 34.1 % and 45.5 % of patients, respectively. No episodes of grade 3–4 nausea and/or vomiting were documented. GTDS was safe and well tolerated.CONCLUSIONIn real world, GTDS provided an innovative, effective, and well-tolerated control of CINV in MM patients after chemo-mobilization with CY. The study found out effectiveness of a non-invasive delivery system of antiemetic.     

针刺治疗癌症化疗后恶心呕吐疗效的Meta分析＊

目的 系统评价针刺治疗癌症化疗后恶心呕吐的有效性和安全性。方法 采用计算机检索PubMed、荷兰医学文献数据库（Embase）、Cochrane图书馆（Cochrane Library）、中国期刊全文数据库（CNKI）、中国生物医学文献数据库（CBM）、维普中文科技期刊全文数据库（VIP）、万方学术期刊全文数据库（Wan fang）建库至2021年02月28日针刺治疗化疗后恶心呕吐的随机对照试验。采用RevMan5.4软件进行Meta分析。结果 本研究共纳入18篇文献，涉及1538名患者。Meta分析结果显示，针刺治疗化疗后的恶心呕吐在有效率（P<0.01，RR=1.17，95%CI=［1.09，1.26］）、症状完全缓解率（恶心：P<0.01，RR=1.42，95%CI=［1.14，1.76］；呕吐：P=0.01，RR=1.18，95%CI=［1.04，1.34］）及Karnofsky功能状态评分（KPS）（P<0.01，MD=3.97，95%CI=［1.55，6.39］］）等方面均优于对照组。亚组分析显示，消化道肿瘤试验组与对照组治疗有效率相当（P=0.45，RR=1.07，95%CI=［0.89，1.29］）；非消化道肿瘤试验组有效率优于对照组（P<0.01，RR=1.29，95%CI=［1.10，1.52］）。同时，试验组药物不良事件发生数远低于对照组，且针刺不良事件发生数较少。结论 针刺治疗癌症化疗后恶心呕吐是安全的，并可以提高有效率、症状完全缓解率，改善化疗后KPS评分，提高患者生活质量。     

Monitoring,prevention and treatment of side effects of long-acting neuraxial opioids for post-cesarean analgesia

Long-acting neuraxial opioids such as morphine and diamorphine, administered via spinal or epidural routes, are staple components of a multimodal approach to postoperative analgesia following cesarean delivery. The widespread use of neuraxial opioids is due largely to their significant analgesic efficacy and favorable safety profile. The most common side effects of neuraxial opioids are pruritus, nausea and vomiting. These symptoms appear to be dose-related. The most serious complication of neuraxial opioids is respiratory depression, which occurs in 0–0.9% of cases. Hypothermia has also been reported in association with neuraxial morphine use at cesarean delivery. This article will review recent advances in prophylaxis, treatment and monitoring of the side effects of long-acting neuraxial opioids.