中药复方联合托烷司琼防治化疗后消化道反应的临床比较

 目的 观察托烷司琼联合中药不同复方防治化疗所致恶心、呕吐的疗效及其不良反应。 方法 采用随机对照方法，将84例肿瘤患者随机分为对照组 (A=21)、治疗组 (B=63)，B组根据患者一般情况再分为胃寒组（B1=19）、胃热组（B2=16）、平证组（B3=28），在化疗前，两组均予盐酸托烷司琼，在此基础上B1、B2、B3分别予丁香柿蒂汤、橘皮竹茹汤、小半夏加茯苓汤各300ml，分3次口服。在化疗后7天内观察化疗所致胃肠道反应和止呕药的不良反应。 结果 A组急性恶心的完全控制率为42.9%，B组为66.7%(P<0.05)；A 组急性呕吐的完全控制率为61.9%，B组为85.7%(P<0.05)。A组延迟性恶心的完全控制率和有效控制率分别为19.0%和38.1%，B组为42.9%(P<0.05)和63.5%(P<0.05)；A组延迟性呕吐的完全控制率和有效控制率分别为33.3%和52.4%，B组为56.7%(P<0.05)和84.1%(P<0.01)。两组患者对不同止吐方案耐受性良好，不良反应发生率无差别(P>0.05)。 结论 托烷司琼联合中药不同复方可以较好的防治化疗药引起的消化道不良反应，方案安全、有效、易行。

Clinical Comparative of Tropisetron Hydrochloride with or without Traditional Chinese Medicine Compound in Prevention of Chemotherapy-induced Nausea and Emesis

Objective To evaluate the efficacy and side effects of tropisetron hydrochloride plus three Traditional Chinese Medicine Compounds for the prophylaxis of chemotherapy induced nausea and emesis. Methods A randomized trial was carried out. Eighty-four patients were randomly devided into group A and group B. According to the general appearances, Group B was further divided into B1(Stomach-Cold Group), B2(Stomach Heat Group) and B3(Neutral Group). All patients received tropisetron hydrochloride before CTX based or DDP based chemotherapy. Participants in group B1, B2 and B3 were additionally treated with Ding-xiang-shi-di Decoction, Ju-pi-zhu ru Decoction and Xiao ban xia Plus Fu ling Decoction respectively. Gastrointestinal reactions induced by chemotherapy and side effects of the anti emetics were recorded within 7d after chemotherapy. Results Acute nausea was prevented completely for 42.9% of the patients in group A and for 66.7% in group B (P<0.05). Complete control rate of acute emesis was achieved for 61.9% of patients in group A and 85.7% in group B (P<0.05). With regard to delayed nausea, complete control rate and effective control rate in Group A was 19.0% and 38.1%, while 42.9% (P<0.05) and 63.5% (P<0.05) in group B. Group B also had a better complete and effective control rate than Group A in delayed emesis with 56.7% vs. 33.3% (P<0.05) and 84.1% vs. 54.1%(P<0.01). Both anti emetic regiments were well tolerated and no difference in adverse events between the two groups was observed (P>0.05). Conclusion Tropisetron hydrochloride plus different Traditional Chinese Medicine Compound is more effective than Tropisetron hydrochloride alone in the prevention of chemotherapy-induced nausea and emesis. The therapeutic schedule is safe, effective and feasible.