Hatae M, Nakamura Y, Mitsuo M, Sakurai K, Asano H, Onishi Y, Hokanishi H
Dept. of Obstetrics and Gynecology, Kagoshima Municipal Hospital.
Gan To Kagaku Ryoho. 1990 Aug;17(8 Pt 1):1495-9.
In prospective alternative crossover test, we confirmed significant superiority of a three-drug combination of clonazepam (C) lorazepam (L) and dexamethasone (D) to (L) and (D) to control vomiting induced by 50 mg/m CDDP containing chemotherapy for gynecological malignancies (p less than 0.001). Vomiting frequency in initial 24 hours was 2.28 +/- 2.21 and 6.00 +/- 3.80 times a day respectively. According to this result, clonazepam, dexamethasone, metoclopramide and diphenhydramine (B) were used as a second regimen to control the vomiting in 80 mg/m CDDP containing chemotherapy for ovarian cancer patients. Clonazepam (2 mg 2 times p.o. -4 and 0 hrs before CDDP drip), dexamethasone (8 mg 5 times iv from -3 hrs each 3 hrs), metoclopramide (2.5 mg/kg iv loading from -2 hrs with 0.4 mg/kg/hr continuous infusion for 9 hrs) and diphenhydramine (30 mg/body 2 times im -2.6 hrs) were chosen to control CDDP-induced nausea and vomiting. These four drugs (C+L+D+B) prominently inhibited the chemo-induced vomiting up to 0.44 +/- 1.50 times a day, and 87.5% of courses was completely satisfactory.
在前瞻性交替交叉试验中，我们证实氯硝西泮（C）、劳拉西泮（L）和地塞米松（D）的三联药物组合显著优于（L）和（D），可控制含50mg/m顺铂的化疗方案所致的妇科恶性肿瘤呕吐（P<0.001）。最初24小时的呕吐频率分别为每天2.28±2.21次和6.00±3.80次。根据这一结果，氯硝西泮、地塞米松、甲氧氯普胺和苯海拉明（B）被用作第二种方案，以控制含80mg/m顺铂的化疗方案所致的卵巢癌患者呕吐。选用氯硝西泮（顺铂滴注前4小时和0小时口服2mg，每日2次）、地塞米松（从-3小时开始，每3小时静脉注射8mg，共5次）、甲氧氯普胺（从-2小时开始静脉注射负荷剂量2.5mg/kg，然后以0.4mg/kg/小时持续输注9小时）和苯海拉明（每2.6小时肌肉注射30mg/体，每日2次）来控制顺铂所致的恶心和呕吐。这四种药物（C+L+D+B）显著抑制化疗所致呕吐，降至每天0.44±1.50次，87.5%的疗程完全令人满意。
