枢复宁防止由非顺铂化疗所致呕吐的疗效观察

本文报道用枢复宁十地塞米松与灭吐灵十地塞米松随机对照,控制非顺铂化疗诱发的呕吐。58例病人经随机分组后,28例用枢复宁加地塞米松,30例按本院常用剂量灭吐灵加地塞米松治疗。枢复宁十地塞米松对急性恶心和呕吐的完全控制率均显著高于灭吐灵十地塞米松(分别为87％比72％,P<0.05,94％比67％,P<0.001)。对延缓性呕吐的完全控制。枢复宁十地塞米松也高于灭吐灵十地塞米松,分别为85％—94％比58％—82％(P<0.05)。枢复宁十地塞米松副作用轻,主要有头痛(13％)和便秘(9％),不引起锥体外系反应。因此,枢复宁十地塞米松是一个较为有效的联合止吐方案。

AN COMPARISON OF ONDANSETRON + DEXAMETHASONE WITH METOCLOPRAMIDE+DEXAMETHASONE FOR THE PREVENTION OF EMESIS INDUCED BY NON-CISPLATIN CONTAINING CHEMOTHERAPY REGIMENS

The highly selective 5- HT3- antagonist ondansetron has been shown to possess a considerable antiemetic activity against chemotherapy-induced nausea and vomiting. In this study we evaluated the antiemetic efficacy of a combination of ondansetron and dexametha-sone versus metoclopamide and dexamethasone in patients receiving non-cisplatin-containing chemotherapy regimens. 58 patients were randomized to receive either ondansentron 8mg intravenously immediately before chemotherapy, followed by 8mg orally every 8 hours for 3 to 5 days or metoclopramide at customary doses of 20mg intramuscularly immediately before chemotherapy, followed by 8mg orally every 8 hours for 3 to 5 days. Additionally, all patients received a single 15mg intravenous dose of dexamethasone immediately before chemotherapy . Patients receiving ondansetron plus dexamentasone had a higher rate of complete control of acute emesis (no emetic episodes on day 1, 94%vs 67%, P<0.001), and a higher rate of complete control of acute nausea (no nausea, 89% vs 12% , P < 0.05) than patients receiving metoclopramide plus dexamethasone. In the control of delayed emesis (on day 2 to day 5 ), complete control was achieved in 85-94% and 58-82% of ondansetr-on plus dexamethasone and metoclopramide plus dexamethasone, respectively ( p<0.05). Side effects of the combination of ondansetron and dexamethasone were mild and mainly included headache (13%) and constipation(9%). There were no extrapyramidal reactions. We conclude that ondansetron plus dexamethasone has a highly antiemetic efficacy and is significantly superior to metoclopramide plus dexamethasone for controlling the acute and delayed emesis associated with non-cisplatin chemotherapy.