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1
Managing women with nausea and vomiting of pregnancy. Canadian consensus.孕期恶心呕吐的女性管理。加拿大共识。
Can Fam Physician. 2000 Feb;46:299-301.
2
Evaluation of the efficacy and safety of bi-daily combination therapy with pyridoxine and doxylamine for nausea and vomiting of pregnancy.每日两次联合使用维生素B6和多西拉敏治疗妊娠恶心和呕吐的疗效及安全性评估。
Isr Med Assoc J. 2013 Jan;15(1):23-6.
3
Effectiveness of delayed-release doxylamine and pyridoxine for nausea and vomiting of pregnancy: a randomized placebo controlled trial.延迟释放 doxylamine 和 pyridoxine 治疗妊娠恶心和呕吐的有效性：一项随机安慰剂对照试验。
Am J Obstet Gynecol. 2010 Dec;203(6):571.e1-7. doi: 10.1016/j.ajog.2010.07.030. Epub 2010 Sep 16.
4
Critical appraisal of drug therapy for nausea and vomiting of pregnancy: II. Efficacy and safety of diclectin (doxylamine-B6).妊娠恶心和呕吐药物治疗的批判性评价：II. 多西拉敏 - B6（Diclectin）的疗效和安全性
Can J Clin Pharmacol. 2000 Autumn;7(3):138-43.
5
Diclegis for nausea and vomiting of pregnancy.用于治疗妊娠恶心和呕吐的 Diclegis。
Med Lett Drugs Ther. 2013 Aug 5;55(1422):61-2.
6
Diclectin therapy for nausea and vomiting of pregnancy: effects of optimal dosing.用于治疗妊娠恶心和呕吐的 Diclectin 疗法：最佳剂量的效果。
J Obstet Gynaecol Can. 2003 Oct;25(10):830-3. doi: 10.1016/s1701-2163(16)30673-9.
7
Maternal safety of the delayed-release doxylamine and pyridoxine combination for nausea and vomiting of pregnancy; a randomized placebo controlled trial.用于治疗妊娠恶心和呕吐的缓释多西拉敏与吡哆醇组合药物的产妇安全性；一项随机安慰剂对照试验。
BMC Pregnancy Childbirth. 2015 Mar 18;15:59. doi: 10.1186/s12884-015-0488-1.
8
The safety of higher than standard dose of doxylamine-pyridoxine (Diclectin) for nausea and vomiting of pregnancy.高于标准剂量的多西拉敏-吡哆醇（Diclectin）用于治疗妊娠恶心和呕吐的安全性。
J Clin Pharmacol. 2001 Aug;41(8):842-5. doi: 10.1177/00912700122010735.
9
The pharmacologic management of nausea and vomiting of pregnancy.妊娠恶心和呕吐的药物治疗
J Fam Pract. 2014 Feb;63(2 Suppl):S31-7.
10
Determinants of adherence to delayed-release doxylamine and pyridoxine in patients with nausea and vomiting of pregnancy.妊娠恶心呕吐患者服用延迟释放 doxylamine 和 pyridoxine 依从性的决定因素。
Ther Drug Monit. 2012 Oct;34(5):569-73. doi: 10.1097/FTD.0b013e31826e7997.

孕期恶心呕吐的女性管理。加拿大共识。

Managing women with nausea and vomiting of pregnancy. Canadian consensus.

出版信息

Can Fam Physician. 2000 Feb;46:299-301.

PMID:10690484
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1987693/
Abstract

QUESTION

I have a 30-year-old pregnant patient who is asthmatic and is taking prednisone. Whenever she decreases her prednisone dose, her nausea increases tremendously even though she is taking two tablets of doxylamine and pyridoxine combination (Diclectin) daily. She is already at 26 weeks' gestation, and I really do not want her to continue the prednisone beyond what is needed for her asthma, but two attempts to taper prednisone off failed because of unbearable nausea.

ANSWER

Several controlled trials show the efficacy of prednisone for nausea and vomiting of pregnancy (NVP), but your case is fascinating in proving the point by challenge-rechallenge. You should try to decrease the prednisone while increasing doxylamine and pyridoxine to its recommended dose of two tablets before sleep, one in the morning, and on in the afternoon.

摘要

问题

我有一位30岁的哮喘孕妇，正在服用泼尼松。每当她减少泼尼松剂量时，她的恶心感就会大幅增加，尽管她每天服用两片多西拉敏和吡哆醇组合药物（迪克莱汀）。她现在已经怀孕26周了，我真的不想让她在哮喘所需剂量之外继续服用泼尼松，但由于无法忍受的恶心，两次尝试逐渐减少泼尼松剂量都失败了。

答案

多项对照试验表明泼尼松对妊娠恶心和呕吐（NVP）有效，但你的病例通过反复试验来证明这一点很有意思。你应该尝试在减少泼尼松剂量的同时，将多西拉敏和吡哆醇增加到推荐剂量，即在睡前服用两片，早上一片，下午一片。