托烷司琼联合舒必利对顺铂方案化疗所致恶心、呕吐的影响

目的探讨托烷司琼联合舒必利治疗顺铂方案化疗所致恶心、呕吐的疗效和安全性，进一步探讨对胃动素及胃泌素的影响。方法将84例接受顺铂方案治疗并出现恶心、呕吐的患者按随机排列表法分为研究组（44例）和对照组（40例），两组患者都给予盐酸托烷司琼静脉推注，研究组同时口服舒必利。观察两种治疗方案的疗效、不良反应及对胃动素和胃泌素的影响。结果研究组和对照组防治化疗所致的急性恶心的完全控制率分别为59．09％（26／44）和37．50％（15／40），有效率分别为90．91％（30／44）和72．50％（29／40），差异均有统计学意义（P〈0．05）；研究组和对照组防治化疗所致的急性呕吐的完全控制率分别为61．36％（27／44）和37．50％（15，40），有效率分别为88．64％（39／44）和67．50％（27／40），差异均有统计学意义（P〈0．05）；研究组和对照组防治化疗所致的延迟性恶心的完全控制率分别为54．54％（24／44）和32．50％（13／40），有效率分别为79．55％（35／44）和57．50％（23／40），差异均有统计学意义（P〈0．05）；研究组和对照组防治化疗所致的延迟性呕吐的完全控制率分别为45．45％（20／44）和22．50％（9／40），有效率分别为75．00％（33／44）和52．50％（21／40），差异均有统计学意义（P〈0．05）。研究组和对照组治疗后血浆胃动素较治疗前明显降低（308．35±14．59）ng/L比（370．59±15．72）ng/L和（341．87±18．38）ng，L比（365．36±23．72）ng/L]，血浆胃泌素较治疗前明显升高（206．97±12．29）ng／L比（164．56±14．17）ng/L和（171．58±13．53）ng/L比（158．42±17．29）ng/L]，差异有统计学意义（P〈0．05），且两组治疗后比较差异有统计学意义（P〈0．05）。两组药物不良反应发生率比较差异无统计学意义（P〉0．05）。结论托烷司琼联合舒必利能比常规使用托烷司琼获得更好的止吐效果。

The effect of tropisetron combined with sulpiride on chemotherapy-induced cisplatin program nausea and vomiting

Objective To investigate the efficacy and safety of tropisetron combined with sulpiride in treatment of chemotherapy-induced cisplatin program nausea and vomiting, so as to explore the effect to motilin and gastrin. Methods A total of 84 patients with chemotherapy-induced cisplatin program nausea and vomiting were divided into study group （44 cases） and control group （40 cases） by random digits table method, the patients in two groups were given tropisetron hydrochloride intravenous injection, and the study group was added sulpiride. The efficacy and side effects and effect to motilin and gastrin were observed. Results The fully control rate and efficient rate in acute nausea was 59.09% （26/44）,37.50% （15/40）, and 90.91% （30/44）, 72.50 % （29/40） in study group and control group, and there was signifiCant difference （P 〈 0.05 ）. The fully control rate and efficient rate in acute vomiting was 61.36 % （27/44）, 37.50 % （15/40）, and 88.64% （39/44） ,67.50% （27/40） in study group and control group, and there was significant difference （P 〈0.05）. The fully control rate and efficient rate in delayed nausea was 54.54% （24/44）,32.50% （13/40）, and 79.55 % （35/44）, 57.50 % （23/40） in study group and control group, and there was significant difference （P 〈 0.05）. The fully control rate and efficient rate in delayed vomiting was 45.45% （20/44）, 22.50% （9/40）,and 75.00% （33/44）,52.50% （21140） in study group and control group, and there was significant difference （P 〈 0.05 ）. The plasma motilin after treatment was lower than that before treatment in study group and control group （308.35 ± 14.59） ng/L vs.（370.59 ± 15.72） ng/L and（341.87 ± 18.38） ng/L vs. （365.36 ± 23.72） ng/L] ,gastrin was higher than that before treatment in study group and control group （206.97 ± 12.29） ng/L vs. （ 164.56 ± 14.17） ng/L and （ 171.58 ± 13.53） ng/L vs. （ 158.42 ± 17.29） ng/L], and there was significant difference （P 〈 0.05）. There was significant difference in the plasma motilin and gastrin after treatment between two groups（P 〈 0.05 ）. There was no significant difference in the occurrence of adverse drug reactions between two groups （P 〉 0.05）. Conclusion Tropisetron combined with sulpiride than the routine use of tropisetron can obtain the better the antiemetic effect.