[大剂量胃复安、苯海拉明、甲基强的松龙和地西泮对妇科恶性肿瘤化疗所致呕吐的止吐疗效]
[Antiemetic efficacy of high-dose metoclopramide, diphenhydramine, methylprednisolone and diazepam on chemotherapy-induced emesis in gynecological malignancy].
作者信息
Hayashi Y, Iwasaka T, Hachisuga T, Fukuda K, Tanaka T, Matsuo N, Sugimori H
机构信息
Department of Obstetrics and Gynecology, Saga Medical School.
出版信息
Nihon Sanka Fujinka Gakkai Zasshi. 1988 Jul;40(7):875-9.
The antiemetic efficacy of high-dose metoclopramide (MCP), diphenhydramine (DPH), methylprednisolone (MPL), and diazepam (DZP) was investigated in 40 gynecologic cancer patients for a total of 98 chemotherapy courses, treated with cisplatin (50 mg/m2). With MPL (500 mg i.v. x 2) plus DZP (5 mg i.m. x 2), no vomiting occurred in 0% and mild emesis (vomiting 1-2 times) occurred in 20% of 25 courses. With MCP (2 mg/kg i.v. x 5) plus DPH (40 mg i.v. x 3), no vomiting occurred in 35% and mild emesis occurred in 10% of 20 courses. With a combination of MCP plus DPH and MPL plus DZP, no vomiting occurred in 51% and mild emesis occurred in 25% of 53 courses. These results indicate that high-dose MCP plus DPH are effective in preventing cisplatin-induced vomiting. Furthermore, the antiemetic efficacy of MCP plus DPH (0-2 vomiting episodes: 45%) was significantly enhanced (p less than 0.05) by the combined use of MPL plus DZP (0-2 vomiting episodes: 76%).
在40例妇科癌症患者中，共进行了98个疗程的化疗，使用顺铂（50mg/m²），研究了大剂量甲氧氯普胺（MCP）、苯海拉明（DPH）、甲泼尼龙（MPL）和地西泮（DZP）的止吐效果。使用MPL（静脉注射500mg×2）加DZP（肌肉注射5mg×2）时，25个疗程中0%的患者未发生呕吐，20%的患者出现轻度呕吐（呕吐1 - 2次）。使用MCP（静脉注射2mg/kg×5）加DPH（静脉注射40mg×3）时，20个疗程中35%的患者未发生呕吐，10%的患者出现轻度呕吐。使用MCP加DPH与MPL加DZP联合用药时，53个疗程中51%的患者未发生呕吐，25%的患者出现轻度呕吐。这些结果表明，大剂量MCP加DPH对预防顺铂引起的呕吐有效。此外，联合使用MPL加DZP可显著增强MCP加DPH的止吐效果（0 - 2次呕吐发作：45%对0 - 2次呕吐发作：76%，p小于0.05）。
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