肿瘤患者化疗中托烷司琼与格拉司琼止吐作用的疗效观察

目的:采用托烷司琼和格拉司琼预防肿瘤化疗引起的恶心呕吐,并对其疗效进行观察.方法:将90例恶性肿瘤患者随机分为托烷司琼组和格拉司琼组,每组45例,两组患者均首次接受化疗,观察两组患者恶心、呕吐的程度及治疗效果.结果:托烷司琼组对预防恶性肿瘤化疗所致恶心、呕吐总有效率为75.5%,格拉司琼组总有效率为71.1%,两组疗效基本相似,P>0.05.结论:在肿瘤化疗中,托烷司琼与格拉司琼止吐作用的疗效基本相似,托烷司琼每日用药1次,更为方便.     

格拉司琼与甲氧氯普胺预防化疗引起呕吐反应的疗效观察

目的:观察格拉司琼注射液与甲氧氯普胺注射液对化疗引起呕吐反应的治疗作用。方法:将92例恶性肿瘤患者随机分成格拉司琼用药组(50例)和应用甲氧氯普胺作为对照组(42例),格拉司琼组患者在化疗前30min静脉注射格拉司琼注射液3mg,化疗结束时再静脉注射格拉司琼注射液3mg。甲氧氯普胺组在化疗前30min肌内注射甲氧氯普胺注射液10mg,化疗结束时再肌肉注射甲氧氯普胺注射液10mg。结果:格拉司琼组对急性恶心呕吐有效率为98.0%;,甲氧氯普胺对照组对急性恶心呕吐有效率为47.6%,两组间差异显著(P<0.05)。结论:格拉司琼注射液能有效控制静脉化疗方案治疗肿瘤引起的恶心、呕吐副反应。     

盐酸格拉司琼预防铂类化疗所致恶心呕吐60例

目的观察格拉司琼加糖皮质激素预防铂类化疗所致的恶心、呕吐等不良反应的疗效,并与甲氧氯普胺比较。方法将60例用铂类化疗的恶性肿瘤患者,采用随机、自身对照法,随机分为A,B2组,每组静滴铂类80mg/m2(1d);5-氟脲嘧啶0.5g+四氢叶酸0.2g化疗(5d)。止吐方法:A组用格拉司琼加地塞米松(试验组),B组用甲氧氯普胺加维生素B6加地塞米松(对照组)。结果格拉司琼加糖皮质激素(试验组)对急性呕吐和迟发呕吐的有效控制率分别是93.33%,91.67%～95.00%,均高于对照组,差异有显著性(P<0.05)。2组不良反应无差异。结论格拉司琼加地塞米松可以作为预防和控制铂类联合化疗所致的恶心、呕吐的一线治疗方案。     

雷莫司琼预防含顺铂化疗药物胃肠道反应80例

目的:观察雷莫司琼预防含顺铂化疗药物所致胃肠道反应的临床疗效和安全性。方法:采用随机自身对照方法,将入选80倒接受含顺铂联合化疗的恶性肿瘤患者,随机分成A、B两组,A、B两组病人于化疗第一周期分别使用甲氧氯普胺及格拉司琼作对照,第二周期均使用雷莫司琼止吐。结果:雷莫司琼预防化疗后呕吐明显优于甲氧氯普胺,其有效率分别为92.5%、42.5%。但雷莫司琼和格拉司琼预防化疗后呕吐无统计学差异,其有效率分别为90.0%、87.5%。结论:雷莫司琼能有效地预防含顺铂化疗药物所致胃肠道反应,与格拉司琼相似,但优于甲氧氯普胺。     

盐酸帕洛诺司琼预防乳腺癌术后化疗所致恶心呕吐的疗效观察及护理

目的观察盐酸帕洛诺司琼在乳腺癌化疗中预防恶心呕吐的疗效。方法 64例乳腺癌化疗患者随机分为盐酸帕洛诺司琼治疗组和盐酸托烷司琼治疗组,两组患者均为术后首次接受FEC方案化疗,观察24h、48h、96h内恶心呕吐发生的情况并作比较。结果在化疗后24h、48h、96h内盐酸帕洛诺司琼对预防化疗所致恶心呕吐的有效率分别为93.75%、87.5%、87.5%,盐酸托烷司琼对预防化疗所致恶心呕吐的有效率分别为75.0%、65.63%、59.38%,两组差异均有统计学意义(P<0.05),盐酸帕洛诺司琼在不同时段的疗效均优于盐酸托烷司琼。结论盐酸帕洛诺司琼能有效预防化疗所致恶心呕吐,可作为乳腺癌化疗中预防治疗恶心呕吐的首选药物之一,值得临床推广。     

3种止吐剂的临床疗效及费用—效果分析

目的：观察不同止吐剂对化疗所致恶心呕吐的临床效果。方法：93例患者,根据肿瘤部位不同,随机分为3组,分别给予昂丹司琼,格拉司琼与托烷司琼防治化疗药物所致的恶心、呕吐、用药物经济学的方法给予评价。结果：托烷司琼组与格拉司琼组,防治化疗所致恶心、呕吐效果较好。结论：托烷司琼与格拉司琼防治化疗所致恶心、呕吐、均优于昂丹司琼,但结合药物经济学的费用－效果分析,托烷司琼优于格拉司琼。     

阿扎司琼预防化疗性恶心呕吐的临床观察

目的评价阿扎司琼预防恶性肿瘤患者化疗性恶心呕吐的疗效及安全性。方法 191例患者分为阿扎司琼组,甲氧氯普胺组,阿扎司琼组96例化疗前静推阿扎司琼10mg,一日一次,甲氧氯普胺组95例化疗前静滴甲氧氯普胺注射液20mg+地塞米松5～10mg一日一次。结果阿扎司琼组总有效率为88.54%,甲氧氯普胺组总有效率为58.94%,两组比较有显著性差异(P<0.05);阿扎司琼组不良反应轻。结论阿扎司琼预防恶性肿瘤化疗所致的恶心呕吐疗效好,使用安全。     

盐酸托烷司琼预防肺癌患者化疗所致恶心呕吐的临床研究

目的：采用托烷司琼和格拉司琼预防肺癌含顺铂的联合化疗引起的恶心呕吐,并对其疗效进行观察。方法：用随机、交叉、自身对照方法,37例肺癌患者接受含顺铂的联合化疗,将其随机分为A组19例和B组18例,A组第1个周期用托烷司琼,第2个周期用格拉司琼,B组第1个周期用格拉司琼,第2个周期用托烷司琼。止吐方法采用两种方案,试验方案为托烷司琼5mg加入0.9%氯化钠溶液100ml中于化疗前30min静滴,对照方案为格拉司琼3mg加入0.9%氯化钠溶液100ml中于化疗前后各静滴1次,均化疗当日应用。观察两种方案化疗1～4d后的恶心呕吐情况。结果：两种方案化疗1～4d后恶心、呕吐的有效控制率试验方案略高于对照方案,但差异均无统计学意义（P〉0.05）。结论：在肺癌应用含顺铂的化疗中,盐酸托烷司琼可有效防止化疗导致的恶心呕吐,每日1次,更为方便。     

托烷司琼针、甲氧氯普胺针独用及合用对肿瘤化疗恶心、呕吐的预防效果评价

目的探讨并评价托烷司琼针、甲氧氯普胺针独用及合用对肿瘤化疗恶心、呕吐的预防效果。方法将我院接收的120例肿瘤化疗患者分为3组:对照Ⅰ组、对照Ⅱ组和试验组,对照Ⅰ组、对照Ⅱ组在化疗的同时分别给予单独注射托烷司琼针和甲氧氯普胺针,试验组给予托烷司琼针和甲氧氯普胺针联合使用。3组患者都给予相同的精心护理。结果观察3组患者化疗过程中的恶心、呕吐情况,统计恶心、呕吐的预防效果。单独使用托烷司琼针和甲氧氯普胺针以及两者联合使用的预防呕吐的有效率分别为67.5%、60.0%、90.0%;单独使用托烷司琼针和甲氧氯普胺针以及两者联合使用的预防恶心的有效率分别为57.5%、52.5%、80.0%。两者联合使用预防恶心、呕吐有效率明显高于单独使用托烷司琼针和甲氧氯普胺针,差异有统计学意义(P0.05),而两者单独使用之间比较,差异无统计学意义(P0.05)。结论托烷司琼针联合甲氧氯普胺针能够有效的预防肿瘤化疗时出现的恶心、呕吐现象,效果明显优于两者单独使用,临床上具有重要的意义。     

昂丹司琼对肺癌化疗所致恶心呕吐的预防

目的：评价单剂昂丹司琼对肺癌化疗所致恶心、呕吐的预防作用。方法：选择35例肺癌化疗患者,采用自身交替对照的方法,观察单次静脉注射昂丹司琼8mg对化疗所致恶心、呕吐的预防作用。结果：单剂昂丹司琼对肺癌化疗所致恶心、呕吐的控制率分别为91．4％、94．3％;甲氧氯普胺的控制率分别为65．7％,74．3％,两者比较差异显著。结论：单剂昂丹司琼对肺癌化疗所致恶心、呕吐有明显的预防作用。     

Granisetron. A pharmacoeconomic evaluation of its use in the prophylaxis of chemotherapy-induced nausea and vomiting

The efficacy of granisetron in preventing acute nausea and vomiting during the 24 hours following chemotherapy in patients with cancer is equivalent to that of other serotonin 5-HT3 receptor antagonists (ondansetron and tropisetron) and similar to or greater than that of conventional antiemetic regimens such as metoclopramide plus dexamethasone. Like other 5-HT3 receptor antagonists, granisetron is generally well tolerated by most patients and its antiemetic efficacy is enhanced when used concomitantly with dexamethasone. To date, pharmacoeconomic evaluations of granisetron have involved intravenous administration of the drug to adult patients with cancer receiving single-dose or fractionated chemotherapy of moderate to high emetogenic potential. In economic analyses conducted in France, a single dose of granisetron 3mg was associated with a mean direct treatment cost per patient (or per well-controlled patient) approximately 50% lower than that for ondansetron 8mg intravenously followed by 8mg orally every 8 hours for 3 days, in patients receiving single-dose chemotherapy. Direct costs per patient were approximately 20 to 30% lower with granisetron (usually 3 mg/day) than ondansetron (usually 24 to 32 mg/day intravenously) in patients receiving chemotherapy fractionated over several days. Sensitivity analysis showed that the results, were robust to variations in the acquisition costs of the antiemetics. Granisetron also remained more cost effective than ondansetron with variations in the antiemetic dosage regimens, except when the granisetron dosage remained unchanged while the ondansetron dosage was reduced to a single 8mg intravenous dose on each day prior to chemotherapy (and no change in efficacy was assumed). Other economic evaluations suggest that granisetron may be more cost effective than a combined antiemetic regimen of high dose metoclopramide plus dexamethasone, and selected use of granisetron or ondansetron in patients receiving emetogenic chemotherapy can be implemented with relatively small incremental increases to the total cancer treatment budget, albeit with a marked increase in antiemetic acquisition costs. In conclusion, granisetron is an effective and well tolerated agent for the prophylaxis of acute chemotherapy-induced nausea and vomiting, and its selective use in this clinical setting can provide cost-effective antiemetic therapy.     

Tropisetron: an update of its use in the prevention of chemotherapy-induced nausea and vomiting

Tropisetron is a serotonin (5-hydroxytryptamine; 5-HT) antagonist that is primarily used in the prevention of chemotherapy-induced nausea and vomiting. Antagonism of 5-HT3 binding sites in the peripheral and central nervous system is the probable mechanism of prevention of acute nausea and vomiting. Effects on delayed nausea and vomiting are less well understood as these are probably not mediated solely by 5-HT3 receptors. Tropisetron monotherapy is effective for the control of acute, and to a lesser extent delayed, nausea and vomiting in patients receiving moderately to severely emetogenic chemotherapy. The combination of dexamethasone and tropisetron is more effective than monotherapy. Complete control of cisplatin-induced nausea and vomiting was obtained in 69 to 97% of patients receiving the combination compared with 46 to 80% receiving tropisetron monotherapy in randomised trials. There were generally no significant differences between the control of acute or delayed nausea and vomiting provided by tropisetron, ondansetron or granisetron in randomised, comparative trials. The antiemetic efficacy of tropisetron was maintained over multiple cycles of chemotherapy. Most comparative studies showed tropisetron monotherapy to be more effective than metoclopramide in controlling acute nausea and vomiting, with the exception of 1 study which showed similar efficacy. However, high dose metoclopramide plus dexamethasone provided similar control of delayed emesis to tropisetron plus dexamethasone. Tropisetron is also effective in children, including those who responded poorly to previous antiemetic treatment. Tropisetron and ondansetron generally have similar efficacies in this population. The drug enhanced patients' quality of life and was well tolerated by adults and children alike. The recommended oral and IV dosage of tropisetron is 5 mg once daily; there is no increase in efficacy with doses >5 mg. CONCLUSIONS: Tropisetron is similar to other 5-HT3 receptor antagonists for the prevention of chemotherapy-induced nausea and vomiting in both adults and children. It is suitable as first-line therapy (combined with a corticosteroid) for the prevention of acute nausea and vomiting in patients treated with moderately to severely emetogenic chemotherapeutic agents. This combination is also moderately effective in the prevention of delayed nausea and vomiting.     

格拉司琼和恩丹西酮预防顺铂所致消化道反应的随机对照研究

目的 观察并比较格拉司琼与恩丹西酮在预防顺铂所致的消化道反应的疗效和毒性反应。方法 采用随机自身前后对照试验设计，将37例接受顺铂联合化疗的肺癌患者，分为AB和BA两组，AB组第1周期用A方案（盐酸格位司琼3mg静注）每日1次，连用5d，第2周期用B方案（盐酸恩丹西酮8mg静注）每12h 1次，连用5d;BA组第1周期用B方案，第2周期用A方案，前后两周期化疗方案完全相同。结果 A，B方案均有良好的止吐疗效，在呕吐控制率，平均呕吐次数，恶心控制率及食欲影响方面两方案无统计学差异（P＞0．05）。两方案毒副反应均较小，可以耐受。结论 格拉司琼与恩丹西酮预防顺铂所致的消化道反应均有较好的疗效，毒副反应低。格拉司琼价格较低廉，更适合临床应用。     

格拉司琼与恩丹西酮预防化疗后恶心、呕吐的成本-效果分析

目的 :比较格拉司琼与恩丹西酮预防化疗后恶心呕吐的疗效、不良反应及成本 -效果。方法 :以相关疗效指标及药物经济学成本 -效果分析法进行评价 ,观察药物不良反应。结果 :格拉司琼预防化疗后恶心、呕吐的有效率分别为83 6 %和86 8 %,每化疗周期人均费用为210 48元 ,成本 -效果比分别为251 77和242 37 ;恩丹西酮的有效率分别为72 9 %和83 7 %,每化疗周期人均费用为381 35元 ,成本 -效果比分别为523 11和456 62。两组患者均未发现不良反应。结论 :格拉司琼能有效地预防化疗后的恶心、呕吐 ,成本 -效果比优于恩丹西酮。     

格拉司琼与恩丹西酮预防化疗后恶心、呕吐的成本-效果分析

目的比较格拉司琼与恩丹西酮预防化疗后恶心呕吐的疗效、不良反应及成本-效果.方法以相关疗效指标及药物经济学成本-效果分析法进行评价,观察药物不良反应.结果格拉司琼预防化疗后恶心、呕吐的有效率分别为83.6%和86.8%,每化疗周期人均费用为210.48元,成本-效果比分别为251.77和242.37;恩丹西酮的有效率分别为72.9%和83.7%,每化疗周期人均费用为381.35元,成本-效果比分别为523.11和456.62.两组患者均未发现不良反应.结论格拉司琼能有效地预防化疗后的恶心、呕吐,成本-效果比优于恩丹西酮.     

含服生姜片联合托烷司琼预防顺铂所致恶心呕吐的研究

目的：探讨含服生姜片联合托烷司琼预防顺铂所致的恶心呕吐的效果。方法将100例含顺铂标准化疗的患者随机分为观察组和对照组各50例,对照组使用托烷司琼静脉滴注预防恶心呕吐,观察组在对照组治疗的基础上联合采用生姜片含服,观察比较两组病人恶心呕吐情况。结果观察组化疗后恶心呕吐发生率显著低于对照组（P＜0．05）。结论含服生姜片联合托烷司琼能缓解顺铂化疗后引起的恶心呕吐,止吐效果显著。     

帕诺洛司琼与托烷司琼分别联合地塞米松预防含顺铂化疗所致恶心呕吐的临床对照研究

目的:观察和评价国产帕洛诺司琼联合地塞米松预防含高致吐性顺铂化疗引起的恶心、呕吐的有效性和安全性。方法:采用随机对照的试验方法,对使用含高致吐性顺铂（≥50mg/m2）化疗方案的患者,于化疗前半小时缓慢静脉推注帕洛诺司琼0.25mg (观察组)或静滴托烷司琼2mg (对照组),两组均于第1、2、3天化疗前分别静脉滴入地塞米松16mg、8mg、8mg,观察患者化疗引起的急性期（0-24h）、延迟期（24-120h及全期（0-120h）的呕吐的完全缓解率及无呕吐发作百分比,必要时给予解救性止吐治疗(托烷司琼或甲氧氯普胺)。结果:共入组72例患者,观察组35例,对照组37例,观察组对化疗引起的急性期、延迟期完全缓解率(CRR)与对照组相比无显著性差异(82.9%vs75.7%、65.7% vs43.2%,P＞0.05),但前者对化疗引起的全期CRR明显高于对照组(65.7% vs40.5%,P＜0.05）);观察组化疗后急性期无呕吐发作率与对照组相比无显著性差异（91.4%vs 83.8%, P＞0.05）,但在延迟期及全期则具有显著性差异（77.1% vs48.6%、74.3%vs43.2%, P＜0.05）。两组不良反应主要为头痛、便秘、眩晕、腹部不适等,均症状轻微,患者耐受性好。 结论:国产帕洛诺司琼联合地塞米松能有效地预防高致吐性化疗所致急性期、延迟期呕吐反应,对于延迟期呕吐反应其疗效优于托烷司琼,且安全性好。