二联与三联方案治疗恶性肿瘤化疗性恶心呕吐的疗效研究

Efficacy study of dual and triple therapy in treating chemotherapy-induced nausea and vomiting in malignant tumors

摘要:

目的 研究昂丹司琼与地塞米松的二联方案与昂丹司琼、阿瑞匹坦、地塞米松的三联方案在治疗恶性肿瘤化疗性恶心呕吐（CINV）中的疗效。方法 回顾性收集2021年1月—2023年7月西安交通大学第二附属医院接受化疗的120例CINV患者的临床资料，根据治疗方案不同分为二联组与三联组，每组60例。二联组使用昂丹司琼、地塞米松治疗，三联组使用昂丹司琼、阿瑞匹坦、地塞米松治疗。比较两组治疗后的恶心、呕吐症状分级、恶心呕吐功能生活质量量表（FLIE）评分、Karnofsky功能状态（KPS）评分、血清5-羟色胺（5-HT）水平、多巴胺（DA）水平及不良反应发生情况。结果 治疗后，三联组的恶心、呕吐症状严重程度占比均低于二联组（P <0.05）；三联组FLIE评分低于二联组，KPS评分高于二联组（P <0.05）；三联组血清5-HT和DA水平均低于二联组（P <0.05）；两组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 昂丹司琼、阿瑞匹坦、地塞米松组成的三联疗法在治疗恶性肿瘤患者因化疗引发的恶心呕吐方面，其疗效显著优于昂丹司琼与地塞米松组成的二联疗法，且两者在不良反应发生率上保持相似水平。因此，三联疗法在临床应用中展现出更为优越的价值和广阔的前景。

Abstract:

Objective To investigate the efficacy of a dual therapy regimen consisting of ondansetron and dexamethasone versus a triple therapy regimen comprising ondansetron, aprepitant, and dexamethasone in treating chemotherapy-induced nausea and vomiting (CINV) in patients with malignant tumors.Methods A retrospective study was conducted to collect data from 120 CINV patients receiving chemotherapy in the oncology department of our institution between January 2021 and July 2023. The patients were divided into two groups based on the treatment regimen: the two-drug group (60 patients) received ondansetron and dexamethasone, and the three-drug group (60 patients) received ondansetron, aprepitant, and dexamethasone. The severity of nausea and vomiting, the Functional Living Index for Nausea and Vomiting (FLIE) scores, Karnofsky Performance Status (KPS) scores, serum serotonin (5-HT) and dopamine (DA) levels, and the incidence of adverse reactions were compared between the two groups.Results After treatment, the severity of nausea and vomiting symptoms in the triple therapy group was lower than that in the dual therapy group (P < 0.05). The FLIE scores in the triple therapy group were lower, while the KPS scores were higher than those in the dual therapy group (P < 0.05). Additionally, serum levels of 5-HT and DA in the triple therapy group were lower than those in the dual therapy group (P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P > 0.05).Conclusion This study indicates that the triple therapy regimen (ondansetron, aprepitant, and dexamethasone) is significantly more effective than the dual therapy regimen (ondansetron and dexamethasone) in treating chemotherapy-induced nausea and vomiting in cancer patients. Furthermore, the incidence of adverse reactions is similar between the two regimens. Therefore, the triple therapy regimen shows superior clinical value and a broader prospect for clinical application.