帕米膦酸二钠联合局部放疗治疗骨转移的临床研究

目的 观察帕米膦酸二钠联合局部放疗治疗骨转移肿瘤的疗效.方法 将52例骨转移肿瘤患者随机分为两组.A组静脉输注帕米膦酸二钠联合局部放疗,B组则单纯局部放疗.结果 A组与B组疼痛缓解率分别为92.3%和69.2%(P=0.035),A组生活质量改善明显优于B组.结论 帕米膦酸二钠联合局部放疗治疗骨转移肿瘤所致的疼痛疗效确切,明显改善患者生活质量.     

帕米膦酸二钠联合化疗治疗恶性肿瘤骨转移疗效观察

[目的]观察帕米膦酸二钠联合化疗治疗恶性肿瘤骨转移的疗效。[方法]52例恶性肿瘤患者随机分为两组,每组26例。治疗组接受帕米膦酸二钠联合化疗,对照组单用化疗,两组化疗方案相同。[结果]疼痛总有效率治疗组为80.8%,对照组为46.2%,治疗组疗效优于对照组(P<0.05)。两组均无明显的不良反应。[结论]帕米膦酸二钠联合化疗治疗恶性肿瘤骨转移有较好疗效。     

肺癌多发性骨转移疼痛治疗的临床观察

目的观察153Sm-乙二胺四甲基膦酸(153Sm-EDTMP)联合帕米膦酸二钠治疗肺癌多发性骨转移疼痛的疗效及毒副作用。方法将102例肺癌多发性骨转移疼痛患者,随机分为联合组(153Sm-EDTMP联合帕米膦酸二钠)1、53Sm-EDTMP内照射组,帕米膦酸二钠组,分别观察骨痛缓解效果及毒性反应。结果联合组缓解骨痛总有效率为91.4%,153Sm-EDTMP内照射组为68.6%,帕米膦酸二钠组为65.6%,联合组明显高于另外两组,差异均有显著性统计学意义(P<0.05)。3组均无严重的毒副作用。结论153Sm-EDTMP联合帕米膦酸二钠治疗肺癌多发性骨转移疼痛能提高疗效,不良反应小,值得临床推广使用。     

复方苦参注射液联合帕米膦酸二钠治疗恶性肿瘤骨转移所致疼痛效果观察

目的观察复方苦参注射液联合帕米膦酸二钠治疗恶性肿瘤骨转移所致疼痛的临床效果。方法搜集恶性肿瘤骨转移患者64例,随机分为观察组和对照组,每组32例,对照组采用帕米膦酸二钠治疗,观察组在对照组的基础上进行复方苦参注射液治疗,比较两组患者疼痛缓解效果。结果观察组患者的治疗总有效率(75.0%)高于对照组(46.9%),差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论复方苦参注射液联合帕米膦酸二钠治疗恶性肿瘤骨转移所致疼痛,能够明显缓解疼痛效果,且不会增加不良反应的发生率。     

帕米膦酸二钠和帕米膦酸二钠联合化疗治疗恶性肿瘤骨转移疼痛的疗效观察

目的 比较帕米膦酸二钠与帕米膦酸二钠联合化疗治疗恶性肿瘤骨转移性疼痛的疗效.方法 55例骨转移癌患者随机分为帕米膦酸二钠组(30例,将帕米膦酸二钠90mg加入5%葡萄糖注射液500ml中静脉滴注,隔2周后60mg重复)和帕米膦酸二钠加化疗组(25例,将帕米膦酸二钠90mg加入5%葡萄糖注射液500ml中静脉滴注,隔2周后60mg重复;应用帕米膦酸二钠后1d开始应用化疗,化疗方案:大肠癌患者采用FLP方案,乳腺癌患者采用TA方案,肺癌患者采用NP方案).结果 帕米膦酸二钠组与帕米膦酸二钠加化疗组止痛有效率分别为83.3%、92.0%(P＞0.05);单发骨转移癌痛病灶帕米膦酸二钠组与帕米膦酸二钠加化疗组止痛有效率分别为87.5%、81.8%(P＞0.05);多发骨转移癌痛病灶帕米膦酸二钠组与帕米膦酸二钠加化疗组止痛有效率分别为83.3%、94.7%(P＜0.05).结论 帕米膦酸二钠组与帕米膦酸二钠加化疗组治疗骨转移癌疼痛都具有良好的止痛效果,但对多发骨转移癌痛病灶,应首选帕米膦酸二钠加化疗的方案.     

放疗联合帕米膦酸二钠治疗多发骨转移癌的疗效观察

目的：观察放疗联合帕米膦酸二钠治疗骨转移癌疼痛的疗效。方法：48例骨转移癌性疼痛的病人,分为两组。放疗联合帕米膦酸二钠组（联合组）24例;单纯放疗组（单放组）24例。放射治疗剂量为DT3000cGy／10f,两组相同;帕米膦酸二钠为90mg静滴,时间大于6h,每三周重复,至少两次。结果：放疗结束后两组疼痛缓解率分别为85％,80％,无统计学差异;随访8周后疼痛缓解率分别为79．17％,62．5％,P〉0．05,无统计学差异;2月后KPS评分改善两组有效率分别为70．8％,50％。未发现严重放疗反应及药物毒性反应。结论：放疗或放疗联合帕米膦酸二钠治疗骨多发转移癌均能取得满意疗效,但放疗联合帕米膦酸二钠治疗疗效可能更优,且未见严重不良反应。     

高剂量帕米膦酸二钠治疗恶性肿瘤骨转移所致疼痛的效果分析

目的分析高剂量的帕米膦酸二钠治疗恶性肿瘤骨转移所致疼痛的疗效。方法选取永城市人民医院2013年2月至2014年3月收治的72例恶性肿瘤骨转移患者,随机分为治疗组和对照组,均口服盐酸羟考酮控释片,同时加用帕米膦酸二钠。对照组采用常规剂量帕米膦酸二钠(每周期90 mg),观察组采用高剂量(每周期150 mg)。结果治疗组镇痛总有效率为86.11%,对照组为66.67%;两组比较,差异具有统计学意义(P<0.05)。治疗组总有效率达63.89%,高于对照组41.67%(P<0.05)。所有患者均未出现呼吸抑制、精神异常和肝肾功能异常等严重不良反应。结论高剂量帕米膦酸二钠治疗转移性骨转移所致疼痛的疗效优于常规剂量,安全性高,值得临床推广。     

复方苦参注射液联合帕米膦酸二钠治疗恶性肿瘤骨转移疼痛

目的观察复方苦参注射液联合帕米膦酸二钠治疗恶性肿瘤骨转移疼痛的临床疗效。方法将64例恶性肿瘤骨转移疼痛的患者随机分为2组,对照组32例,单纯应用帕米膦酸二钠治疗;治疗组32例,在对照组基础上联合复方苦参注射液治疗。结果治疗组与对照组的总有效率分别为62．5％（20／32）和34．4％（11／32）,2组比较有统计学意义（P〈0．05）。结论复方苦参注射液联合帕米膦酸二钠治疗恶性肿瘤骨转移疼痛,有明显的协同作用,能提高近期疗效,明显改善患者疼痛症状。     

帕米膦酸二钠治疗36例恶性肿瘤骨转移疼痛疗效观察及护理

目的采用帕米膦酸二钠治疗36例恶性肿瘤骨转移疼痛进行临床观察及护理.方法36例恶性肿瘤骨转移患者疼痛Ⅰ～Ⅲ级.静脉滴注帕米膦酸二钠90 mg,每月1次,共用2～4次.结果止痛有效率86%(31/36).活动能力改善有效率75%(27/36).结论帕米膦酸二钠治疗恶性肿瘤骨转移性疼痛应用方便,疗效肯定,不良反应小.     

帕米膦酸二钠和唑来膦酸治疗45例乳腺癌骨转移患者临床分析

目的:分析帕米膦酸二钠和唑来膦酸治疗乳腺癌骨转移患者的临床疗效。方法:选择45例乳腺癌骨转移患者,随机分为治疗组(25例)与对照组(20例),对照组给予帕米膦酸二钠治疗,治疗组给予唑来膦酸治疗。记录两组患者疼痛缓解情况和骨转移灶清退情况。结果:治疗后,治疗组的疼痛缓解情况明显优于对照组,差异有统计学意义(P<0.05);治疗组的骨转移灶清退情况显著优于对照组,差异有统计学意义(P<0.05)。结论:唑来膦酸治疗乳腺癌骨转移的疗效较帕米膦酸二钠治疗乳腺癌的疗效明显。     

NP方案与XD方案治疗应用蒽环类药物治疗失败的乳腺癌的疗效观察

目的 观察诺维本联合顺铂(NP方案)与多西紫杉醇联合希罗达(XD方案)治疗应用蒽环类药物治疗失败的乳腺癌的疗效及不良反应.方法 将64例应用蒽环类药物治疗失败的乳腺癌患者随机分为两组,NP组34例,治疗方法:NVB25 mg/m2,静脉输注,第1、8天;DDP25 mg/m2,静脉输注,第2、3、4天.每21 d为1个治疗周期.XD组30例,治疗方法:DOC 75 mg/m2,静脉输注,第1天;XELODA 1275 mg/m2,口服,每日2次,第1～14天.两组均以21 d为1个治疗周期,每例至少完成2个周期.结果 NP方案总有效率(41.2%)与XD方案总有效率(50.0%)差异无统计学意义(P>0.05);两组不良反应均以粒细胞减少、恶心呕吐为主,经对症处理后可耐受.结论 NP方案与XD方案对治疗应用蒽环类药物治疗失败的乳腺癌患者均有较好疗效,可选择应用.     

中晚期鼻咽癌放化疗与化放疗的疗效比较

目的 探讨中晚期鼻咽癌放疗后加定期化疗的远期疗效。方法 １８４例中晚期鼻咽癌病人中,９１例放疗后定期化（放化组）,９３例放疗前后化疗（化放组）,放疗：用＾６０Ｃｏ加深部Ｘ线照射鼻咽、颅底和颈部三个区域,鼻咽剂量７０～７６Ｇｙ,颈部根治量６５～７０Ｇｙ,残留病灶追加１０Ｇｙ。化疗：放化组放疗后用顺铂（ＤＤＰ）加５－氟脲嘧啶（５－Ｆｕ）方案（ＰＦ方案）化疗２～６疗程;化放组放疗前先用ＰＦ方案化疗１～２     

胃静脉曲张的介入治疗

目的：评价介入治疗在胃静脉曲张治疗中的应用价值。方法：采用经皮经门静脉闭塞术（ＰＴＯ）或球囊阻塞下静脉逆行闭塞术（ＢＲＴＯ）对９例胃静脉曲张破裂或可能破裂的患者进行治疗，其中ＰＴＯ４例、ＢＲＴＯ５例。结果：有效率１００％、止血率１００％、静脉曲张闭塞率５６％，无严重并发症。结论：ＰＴＯ及ＢＲＴＯ操作简单、有效率高，是治疗胃静脉曲张的首选方法。     

肝血管瘤的介入治疗

目的 :探索肝血管瘤的最佳栓塞治疗方案 ,分析比较不同栓塞方法的疗效 ;方法 :45例肝血管瘤患者被分为两组 ,A组 1 6例 ,用平阳霉素碘化油乳剂进行栓塞 ,B组2 9例 ,用平阳霉素碘化油乳剂加明胶海绵微粒进行栓塞 ,比较两组治疗效果 ;结果 :所有病人经栓塞治疗后 6个月开始行CT扫描检查 ,A组中瘤体缩小 5例 ,保持稳定 1 1例 ,B组中瘤体缩小 2 0例 ,保持稳定 9例 ,两组统计学检验差别有显著性 (P <0 .0 5) ;结论 :平阳霉素乳剂治疗肝血管瘤有效 ,而平阳霉素乳剂加明胶海绵微粒的混合性栓塞效果更好     

慢性外阴营养不良综合治疗观察

应用中西药膏剂对外阴病灶部位涂擦、中药煎剂清洗外阴、免疫制剂病灶部位多点注射的方法对４２例慢性外阴营养不良患者进行综合治疗与观察。经统计学处理，结果表明：病变面积越小、病程越短、年龄越小者，其疗效越佳。有效率达８０．９５％，明显高于对照组。此方法在目前众多治疗慢性外阴营养不良的方法中，不失为一种值得推广的好方法。     

CURRENT STATUS OF DISULFIRAM THERAPY

The effectiveness of disulfiram is linked to the disulfiram-ethanol reaction in the treatment of Alcohol Dependence Syndrome. However disulfiram therapy is associated with various adverse effects and needs a structured and supervised after care program. Relapse rate is very high once disulfiram therapy is discontinued. Keeping these factors in mind disulfiram therapy is used less often today than previously.KEY WORDS: Alcohol Dependence Syndrome (ADS), Adverse drug reaction (ADR), Disulfiram (Antabuse), Disulfiram-ethanol reaction (DER)Disulfiram (antabuse) is used in alcohol rehabilitation because it inhibits aldehyde dehydrogenase and consequently causes the disulfiram-ethanol reaction (vomiting, vertigo, anxiety, cardiovascular effects) after ingestion of alcoholic beverges. However, adverse effects on the central nervous system (psychotic reaction, acute organic brain syndrome, catatonia) may appear as a direct result of the drug itself [1].Although it has been suggested that the effectiveness of disulfiram is only as a placebo, there is evidence for the effectiveness being linked to the disulfiram ethanol reaction (DER) due to the pharmacological action and the operant conditioning model. Hepatitis following use of disulfiram has been reported in many studies. There is a close temporal relationship between the occurrence of symptoms and disulfiram intake. Fulminating hepatitis is a rare but potentially fatal adverse reaction that may occur after the use of disulfiram. Disulfiram toxicity may present different clinical aspects: (1) Cytolytic hepatitis with fatal ovulation in 30% of cases (fulminant hepatitis). (2) Severe optic neuritis. (3) Peripheral neuropathy. (4) Encephalitis [2].Enghusen et al (1992) in their study of Adverse Drug Reaction (ADR) to disulfiram treatment have reported 1 per 2000 treatment year mainly of hepatic neurological, skin and psychiatric reaction in decreasing order of frequency and death 1 per 25000 treatment year [3]. Reports to the WHO collaborating center for Industrial Drug monitoring in Uppsala, Sweden, showed the same ADR profile, although with a higher rate of neurological and psychiatric and a lower rate of hepatic reaction. The latency time from the start of treatment to the manifestation of the ADR differed according to organ. Hepatitis occurred with a distinct peak after 2 months of treatment, skin reaction after 2 weeks and the rate of neurological ADR increased with duration of therapy. Obviously the use of disulfiram as therapeutic agent is not without danger, and it should be attempted only under careful medical supervision. Patient must be warned that as long as they are taking disulfiram, the ingestion of alcohol in any form will make them sick and may endanger their life. Patients must learn to avoid disguised forms of alcohol such as cough syrups, sauces, fermented vinegar and even after shave lotion and back rubs.Murthy KK (1997) in his study of 52 patients of Alcohol Dependence Syndrome on 250 mg disulfiram twice daily after food showed 6 patients developed psychotic symptoms with mood disorder [4]. Psychiatric complications appear to be more common with the use of disulfiram in India than in Western Countries [5].However, there are other studies that add weight to the evidence that disulfiram is not a drug with high incidence of adverse effects [6]. Larson FW et al (1992) reported that in treatment of alcohol dependence, disulfiram is most useful in conjuction with a structured, supervised, aftercare program [7]. The effectiveness of supervised disulfiram therapy was confirmed in a multicentric British study in which supervised disulfiram therapy was compared with vitamin ‘C’ in a sample of chronic alcoholics who had relapsed. The result clearly favoured the disulfiram group with significant reduction in several measures of drinking behaviour including the level of GGT in the disulfiram group compared to no reduction in these measures in the vitamin ‘C’ group. A review of controlled clinical trials with disulfiram concluded that there is unopposed evidence for its effectiveness [8].Comments:

• 1.Pharmacological benefits of disulfiram in the treatment of alcoholism have yet to be clearly demonstrated [9].
• 2.Disulfiram is used in the treatment of alcohol dependence. Its main effect is to produce an unpleasant and potentially dangerous reaction in a person who ingests even a small amount of alcohol while taking disulfiram. However, because of the risk of severe and even fatal disulfiram - alcohol reaction, disulfiram therapy is used less often today than previously. Many clinicians have stopped routinely prescribing the agent, partly in recognition of the dangers associated with the drug itself: mood swings, rare instances of psychosis, the possibility of an increase in peripheral neuropathies and a potentially fatal hepatitis [10].
• (3)Disulfiram can be viewed as a drug with a moderate record of adverse effects. Alcohol dependence, for which it can be helpful treatment, is associated with a high morbidity and mortality [5].
• (4)Relapse rate is very high, Helander A (1998) reported 80% of his patients returned to drinking very soon on discontinuation of disulfiram therapy [11].
• (5)Disulfiram is an aid in the management of selected chronic alcoholic patients who want to remain in a state of enforced sobriety so that supportive and psychotherapeutic treatment may be applied to best advantage.
• 6.Disulfiram is not a cure for alcoholism. When used alone without proper motivation and supportive therapy, it is unlikely that it will have any substantive effect in the drinking pattern of the chronic alcoholic.