GI Section, Section of Gastroenterology, Department of Medicine, Temple University School of Medicine, Temple University Hospital, 3401 N. Broad Street, Philadelphia, PA, 19140, USA.
Dig Dis Sci. 2014 Jun;59(6):1231-4. doi: 10.1007/s10620-014-3097-3. Epub 2014 Mar 11.
Symptoms of gastroparesis include nausea and vomiting, which can markedly diminish quality of life. Nausea and vomiting can also make treatment with oral antiemetics problematic.
Our aim was to determine whether treatment-resistant nausea and vomiting in patients with gastroparesis improve after granisetron transdermal patch (GTP) therapy.
In an open-label pilot study, patients with gastroparesis and symptoms of nausea and vomiting refractory to conventional treatment were treated with GTP. After 2 weeks, patients were asked to assess their therapeutic response using the Clinical Patient Grading Assessment Scale (CPGAS; +7 = completely better; 0 = no change; -7 = very considerably worse). Responders were defined as CPGAS score >0, non-responders as ≤0.
Patients (n = 36) were treated with GTP. Of these 36 patients, one patient discontinued treatment due to the GTP not adhering to the skin. Of the remaining 35 patients, 18 improved, 15 remained the same, and two worsened. The average CPGAS score was +1.8 ± 0.4 (SEM) (P < 0.05 vs 0). Of the 18 patients with improvement, the average CPGAS score was +3.7 ± 0.3 (SEM), corresponding to "somewhat" to "moderately better" improvement in nausea/vomiting. Side effects occurred in nine patients: four developed constipation, three patients had skin rash, and two reported headaches.
GTP was moderately effective in reducing refractory symptoms of nausea and/or vomiting from gastroparesis in 50% of patients. Mild side effects were reported by 25% of patients. GTP may be an effective treatment for nausea and vomiting in gastroparesis, and further study is warranted.
胃轻瘫的症状包括恶心和呕吐，这会显著降低生活质量。恶心和呕吐也会使口服止吐药的治疗变得困难。
我们旨在确定胃轻瘫患者经格兰司琼透皮贴（GTP）治疗后，是否能改善治疗抵抗性恶心和呕吐。
在一项开放标签的试点研究中，患有胃轻瘫且恶心和呕吐症状对常规治疗无反应的患者接受 GTP 治疗。2 周后，患者使用临床患者分级评估量表（CPGAS；+7=完全改善；0=无变化；-7=明显恶化）评估治疗反应。应答者定义为 CPGAS 评分>0，无应答者定义为≤0。
36 例患者接受 GTP 治疗。在这 36 例患者中，有 1 例因 GTP 未贴附于皮肤而停止治疗。在其余 35 例患者中，18 例改善，15 例无变化，2 例恶化。平均 CPGAS 评分为+1.8±0.4（SEM）（P<0.05 与 0 相比）。18 例改善的患者中，平均 CPGAS 评分为+3.7±0.3（SEM），对应于恶心/呕吐“有些”到“中度改善”。9 例患者出现副作用：4 例便秘，3 例皮疹，2 例头痛。
GTP 可使 50%的胃轻瘫难治性恶心和/或呕吐症状得到中度缓解。25%的患者出现轻度副作用。GTP 可能是胃轻瘫恶心和呕吐的有效治疗方法，需要进一步研究。
