Clerico M, Bertetto O, Morandini M P, Cardinali C, Giaccone G
Divisione di Oncologia Medica, Ospedale S. Giovanni Antica Sede, Torino, Italy.
Tumori. 1993 Apr 30;79(2):119-22. doi: 10.1177/030089169307900208.
It has been suggested that lorazepam has a definite role as an antiemetic drug in antiemetic cocktails. In this study we examined the antiemetic efficacy of metoclopramide (200 mg) and methylprednisolone (1000 mg) with or without lorazepam.
Sixty patients treated with cisplatin-containing regimens were entered into a randomized, double-blind study with cross-over. Lorazepam 2.5 mg or placebo were administered orally the evening before therapy and just after the beginning of fluid infusion for chemotherapy. Degree of nausea and number of vomiting episodes, together with somnolence, were recorded on a data flow sheet and visual-analogue scales.
100 cycles (50 patients) are evaluable. In 39 cycles there was no nausea and vomiting, in 74 cycles acceptable control of emesis was reached (0-2 episodes of vomiting), without significant differences among the two arms. However, nausea was shorter in lorazepam arm (p < 0.01), and 80% of the patients preferred treatment with lorazepam (p < 0.003). Anxiety was reduced in the patients treated with lorazepam (p < 0.4).
Lorazepam improves tolerability to cisplatin-containing chemotherapy, mainly by influencing the psychological status of the patient and favoring the amnestic process.
有研究表明劳拉西泮在止吐合剂中作为一种止吐药物具有明确作用。在本研究中，我们考察了甲氧氯普胺（200mg）和甲泼尼龙（1000mg）联用或不联用劳拉西泮的止吐疗效。
60例接受含顺铂方案治疗的患者进入一项随机、双盲、交叉研究。在治疗前一晚及化疗开始补液后立即口服2.5mg劳拉西泮或安慰剂。恶心程度、呕吐发作次数以及嗜睡情况记录在一张数据记录表和视觉模拟量表上。
可评估100个周期（50例患者）。39个周期无恶心呕吐，74个周期呕吐得到可接受的控制（呕吐0 - 2次），两组间无显著差异。然而，劳拉西泮组恶心持续时间较短（p < 0.01），80%的患者更倾向于接受劳拉西泮治疗（p < 0.003）。接受劳拉西泮治疗的患者焦虑减轻（p < 0.4）。
劳拉西泮主要通过影响患者心理状态及促进遗忘过程来提高对含顺铂化疗的耐受性。
