Department of Medicine, University of Louisville.
Department of Medicine, Division of Gastroenterology, Hepatology & Nutrition, University of Louisville.
J Clin Gastroenterol. 2021 Apr 1;55(4):279-299. doi: 10.1097/MCG.0000000000001485.
A comprehensive review of treatments for nausea and vomiting (N/V).
N/V are common symptoms encountered in medicine. While most cases of acute N/V related to a specific cause can be straightforward to manage, other cases of acute N/V such as chemotherapy-induced N/V and especially chronic unexplained N/V can be difficult to control, leading to a significant decline in the patient's quality of life and increased cost of medical care from repeated hospitalizations.
Traditional management has relied on pharmacotherapy which may be inadequate in a certain proportion of these patients. Many of the medications used in the management of N/V have significant side effect profiles making the need for new and improved interventions of great importance.
This review covers a broad review of the pathophysiology of N/V, pharmacotherapy, including safety concerns and controversies with established pharmaceuticals, newer immunotherapies, bioelectrical neuromodulation (including gastric electrical stimulation), behavioral and surgical therapies, and complementary medicine.
On the basis of emerging understandings of the pathophysiology of N/V, improved therapies are becoming available.
全面综述恶心和呕吐(N/V)的治疗方法。
N/V 是医学中常见的症状。虽然大多数与特定病因相关的急性 N/V 病例的治疗较为简单,但其他类型的急性 N/V,如化疗引起的 N/V,尤其是慢性不明原因的 N/V,可能难以控制,导致患者的生活质量显著下降,并因反复住院而增加医疗费用。
传统的治疗方法依赖于药物治疗,但在某些患者中可能不够有效。在管理 N/V 中使用的许多药物都有明显的副作用,因此,非常需要新的和改进的干预措施。
本综述涵盖了对 N/V 的病理生理学、药物治疗的广泛综述,包括与已上市药物相关的安全性问题和争议、新型免疫疗法、生物电神经调节(包括胃电刺激)、行为和手术治疗以及补充医学。
基于对 N/V 病理生理学的新认识,越来越多的改善治疗方法正在出现。