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目的探讨旋复花代赭石汤联合甲氧氯普胺和氟哌啶醇对肿瘤恶病质恶心呕吐的效果。方法采用前瞻性随机对照试验,将286例肿瘤恶病质恶心呕吐患者随机分为甲旋二联组(n=73)、甲氟二联组(n=75)、甲氟旋三联组(n=68)和对照组(甲氧氯普胺组,n=70)。采用WHO抗癌药副作用恶心呕吐分级标准、恶心呕吐及干呕指数评价量表(INVR)和多维度疲乏症状量表-简表(MFSI-SF)分别对患者用药前、2周、8周进行跟踪测评。结果三联组在用药2、8周时止吐作用有效率分别为76.5%和94.1%,显著高于对照组和二联组(P<0.05);三联组在用药2周时INVR评分显著低于对照组和甲旋二联组(P<0.05),但与甲氟二联组无统计学差异;三联组在用药8周时INVR和MFSI-SF评分均显著低于对照组和二联组(P<0.05)。结论旋复花代赭石汤联合西药三联用药方案对肿瘤恶病质恶心呕吐患者,显示了长期稳定的止吐效果,且能有效改善患者疲乏,值得临床推广。
Objective To investigate the effect of Xuanfuhuadai Ocher Decoction combined with metoclopramide and haloperidol on nausea and vomiting of tumor cachexia. Methods A prospective randomized controlled trial of 286 patients with cachexia and nausea and vomiting was randomly divided into two groups: n = 73, n = 75, n = 75, n = 68 ) And control group (metoclopramide group, n = 70). Adopting WHO classification of adverse reactions of anticancer drugs nausea and vomiting, nausea and vomiting and retching index (INVR) and multi-dimensional fatigue symptom scale (MFSI-SF) for patients before medication, 2 weeks, 8 weeks Tracking evaluation. Results The effective rates of antiemetic in the triad group were 76.5% and 94.1% at 2 and 8 weeks respectively, which were significantly higher than those in the control group and the diadipine group (P <0.05). The INVR score of the triad group was significantly lower than that of the triad group (P <0.05), but there was no significant difference between the two groups (P <0.05). The score of INVR and MFSI-SF in triadic group was significantly lower than that in control group and bipolar group P <0.05). Conclusion Xuanfuhuayanhengtang combined with Western medicine triad regimen shows long-term antiemetic efficacy for patients with tumor cachexia and can effectively improve the patient’s fatigue, which is worthy of clinical promotion.