Yamada Takeshi, Kanazawa Yoshikazu, Uchida Eiji, Yokoi Kimiyoshi
Dept. of Surgery, Nippon Medical School, Japan.
Gan To Kagaku Ryoho. 2012 Oct;39(10):1517-21.
Nausea and vomiting are common side effects due to opioid therapy, and may greatly impede the quality of life of cancer patients. A preventive method for nausea and vomiting has not yet been established. We developed a clinical pathway(CP) for cancer pain management in which prochlorperazine is used for the prevention of nausea and vomiting caused by opioids. We have shown that this CP is effective for relieving cancer pain. In this study, we investigated the efficacy prochlorperazine has for preventing nausea and vomiting caused by opioids in patients treated with the CP. The incidence of nausea and vomiting of those patients was 15. 8% which was lower than the results of other previous clinical trials. However, we could not show the effectiveness of prochlorperazine. Prochlorperazine, which is a dopamine D2 receptor antagonist, may show limited utility for the prevention of nausea and vomiting; however, in opioid therapy, histamine receptor(H1)prevention is also important.
恶心和呕吐是阿片类药物治疗常见的副作用，可能会极大地影响癌症患者的生活质量。目前尚未确立预防恶心和呕吐的方法。我们制定了一条癌症疼痛管理的临床路径（CP），其中使用氯丙嗪预防阿片类药物引起的恶心和呕吐。我们已经证明这条CP对缓解癌症疼痛有效。在本研究中，我们调查了氯丙嗪在接受CP治疗的患者中预防阿片类药物引起的恶心和呕吐的疗效。这些患者恶心和呕吐的发生率为15.8%，低于以往其他临床试验的结果。然而，我们未能证明氯丙嗪的有效性。氯丙嗪作为一种多巴胺D2受体拮抗剂，在预防恶心和呕吐方面可能效用有限；然而，在阿片类药物治疗中，组胺受体（H1）预防也很重要。
