Keeley Paul W
Glasgow Royal Infirmary, Glasgow, UK.
BMJ Clin Evid. 2009 Jan 13;2009:2406.
Nausea and vomiting occur in 40-70% of people with cancer, and are also common in other chronic conditions such as hepatitis C and inflammatory bowel disease. Nausea and vomiting become more common as disease progresses.
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for nausea and vomiting occurring either as a result of the disease or its treatment, in adults with cancer? What are the effects of treatments for nausea and vomiting occurring either as a result of the disease or its treatment, in adults with chronic diseases other than cancer? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2008 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
We found nine systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
In this systematic review we present information relating to the effectiveness and safety of the following interventions: 5HT(3) antagonists, antihistamines, antimuscarinics, atypical antipsychotics, benzodiazepines, butyrophenones, cannabinoids, corticosteroids, haloperidol, metoclopramide, NK1 antagonists, phenothiazines, prokinetics, 5HT(3) antagonists plus corticosteroids, and venting gastrostomy.
恶心和呕吐在40%至70%的癌症患者中出现,在其他慢性疾病如丙型肝炎和炎症性肠病中也很常见。随着疾病进展,恶心和呕吐会变得更加常见。
我们进行了一项系统评价,旨在回答以下临床问题:针对癌症成年患者中因疾病或其治疗导致的恶心和呕吐,治疗的效果如何?针对除癌症外的慢性疾病成年患者中因疾病或其治疗导致的恶心和呕吐,治疗的效果如何?我们检索了:截至2008年4月的医学文献数据库(Medline)、荷兰医学文摘数据库(Embase)、考克兰图书馆以及其他重要数据库(《临床证据》综述会定期更新,请查看我们的网站获取本综述的最新版本)。我们纳入了来自美国食品药品监督管理局(FDA)和英国药品及医疗产品监管局(MHRA)等相关机构的危害警示。
我们找到了9项符合我们纳入标准的系统评价、随机对照试验或观察性研究。我们对干预措施的证据质量进行了GRADE评估。
在本系统评价中,我们呈现了以下干预措施的有效性和安全性相关信息:5羟色胺(3)拮抗剂、抗组胺药、抗毒蕈碱药、非典型抗精神病药、苯二氮䓬类、丁酰苯类、大麻素类、皮质类固醇、氟哌啶醇、甲氧氯普胺、神经激肽1拮抗剂、吩噻嗪类、促动力药、5羟色胺(3)拮抗剂加皮质类固醇,以及胃造口术。