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目的探讨雷贝拉唑的抑酸活性对提高胃癌化疗的效果以及其最佳给药时间。方法将30例胃癌患者随机分为对照组、试验A组和试验B组,每组10例。对照组予以口服2000 mg·m-2·d-1卡培他滨,每日2次,第1~14天加静脉滴注130 mg·m-2·d-1奥沙利铂,第1天;试验A组在对照组的基础上,加用口服雷贝拉唑20 mg,每天1次,第1~14天;试验B组在对照组的基础上,加用口服雷贝拉唑20 mg,每天1次,第-7~13天(即在化疗药开始前7天即开始使用)。3组患者均接受2个周期的治疗,每个周期21 d。比较3组患者治疗后的临床疗效和不良反应发生率。结果对照组、试验A组、试验B组的有效率分别为25.00%,33.33%和30.00%,疾病控制率分别为62.50%、77.78%和70.00%,组间比较差异无统计学意义(P>0.05),但试验组的有效率和疾病控制率较对照组呈增高的趋势。治疗期间,3组患者的主要不良反应为消化道反应、血液学毒性和手足综合征,但组间比较差异无统计学意义(P>0.05)。试验A组与试验B组的雷贝拉唑血药浓度比较差异无统计学意义(P>0.05)。结论卡培他滨联合奥沙利铂的临床疗效较好,不良反应较轻,雷贝拉唑提前1 d给药即可达稳态。
Objective To investigate the inhibitory effect of rabeprazole on gastric cancer chemotherapy and its optimal administration time. Methods Thirty patients with gastric cancer were randomly divided into control group, experimental group A and group B, with 10 in each group. The control group was given capecitabine 2000 mg · m-2 · d-1 orally, twice a day, intravenous infusion of oxaliplatin 130 mg · m-2 · d-1 on days 1 to 14, Day; experimental group A in the control group, plus oral rabeprazole 20 mg, 1 day, 1 to 14 days; experimental group B in the control group, plus oral rabeprazole 20 mg, once daily, days -7 to 13 (ie 7 days prior to the start of the chemotherapy drug). Three groups of patients received two cycles of treatment, each cycle of 21 d. Three groups of patients after treatment compared the clinical efficacy and incidence of adverse reactions. Results The effective rates of control group, experimental group A and experimental group B were respectively 25.00%, 33.33% and 30.00%, and the disease control rates were 62.50%, 77.78% and 70.00%, respectively. There was no significant difference between the two groups (P> 0.05), but the test group’s efficiency and disease control rate was higher than the control group. During the treatment, the main adverse reactions of the three groups were digestive tract reaction, hematological toxicity and hand-foot syndrome, but there was no significant difference between the two groups (P> 0.05). There was no significant difference in rabeprazole plasma concentration between experimental group A and experimental group B (P> 0.05). Conclusion Capecitabine combined with oxaliplatin has good clinical efficacy and mild side effects. Rabeprazole can reach steady state 1 d before administration.