本文關(guān)鍵詞： 阿瑞匹坦 化療 惡心 嘔吐 Meta分析　出處：《中國新藥雜志》2017年21期 　論文類型：期刊論文

【摘要】：目的:評價阿瑞匹坦預(yù)防中高度致吐性化療方案所致惡心、嘔吐的療效及安全性。方法:檢索Medline,Cochrane Library,Pubmed,CNKI,CBM,萬方和VIP 7個數(shù)據(jù)庫(建庫起至2016年10月),納入以比較阿瑞匹坦與常規(guī)止吐藥預(yù)防化療相關(guān)性惡心嘔吐(CINV)為目的的隨機對照試驗,結(jié)局判斷指標(biāo)為急性和/或延遲性嘔吐的完全緩解率(CR)、惡心的控制率以及不良反應(yīng)等。結(jié)果:最終納入18項符合標(biāo)準(zhǔn)的高質(zhì)量隨機對照試驗。結(jié)果表明:(1)與對照組相比,阿瑞匹坦組急性嘔吐CR明顯提高(84.5%vs 77.4%,OR=1.60,P0.01),亞組分析顯示順鉑方案化療患者的獲益高于卡鉑及AC方案化療者;但2組對急性惡心控制率差異不大(88.6%vs 85.4%,OR=1.41,P=0.02)。(2)阿瑞匹坦能明顯提高延遲性嘔吐CR:阿瑞匹坦對比5-HT3RA,CR提高了7.8%(62.9%vs 55.1%,OR=1.39,P0.01);阿瑞匹坦對比安慰劑,CR提高了14%(67.4%vs 53.4%,OR=1.85,P0.01);阿瑞匹坦聯(lián)合地塞米松比單用地塞米松CR提高了17.9%(73.2%vs 55.3%,OR=2.22,P0.01)。(3)阿瑞匹坦聯(lián)合地塞米松比地塞米松對延遲性惡心控制率提高了9.3%(74.4%vs 65.1%,OR=1.55,P=0.01)。(4)不良反應(yīng):阿瑞匹坦組疲勞的發(fā)生率高于對照組(P=0.01),而便秘的發(fā)生率低于對照組(P=0.03),頭痛、腹瀉、厭食等發(fā)生率2組無明顯差異。結(jié)論:阿瑞匹坦臨床耐受性好,對延遲性嘔吐、惡心及急性嘔吐改善明顯,尤其是順鉑方案化療患者受益明顯,但對急性惡心癥狀作用不大。臨床上仍需進(jìn)一步觀察阿瑞匹坦對不同化療方案所致CINV的改善情況。
[Abstract]:Objective: to evaluate the effect of aripitan on nausea caused by moderate and high level of emetic chemotherapy. Efficacy and safety of vomiting. Methods: seven databases of Medlinea Cochrane Library Pubmedmedus, Wanfang and VIP were searched (established up to October 2016) and included in a randomized controlled trial aimed at comparing Arepitan with conventional antiemetic drugs in the prevention of chemotherapy-associated nausea and vomiting. The outcome criteria were complete remission rate of acute and / or delayed vomiting, nausea control rate and adverse reactions. Results: 18 high quality randomized controlled trials were included. The CR of acute vomiting in group A was significantly higher than that in group A (84.5 vs 77.4). The subgroup analysis showed that the benefit of cisplatin regimen chemotherapy was higher than that of carboplatin and AC regimen chemotherapy. But there was no significant difference in the control rate of acute nausea between the two groups (88.6 vs 85.40.41) Arepitan significantly increased CRR of delayed vomiting: Arebitam increased 7.8mb 62.9 vs 55.1R 1.39 P0.01M compared with 5-HT3RAC; compared with placebo, the CR increased by 1467.4 vs 53.4% P0.01; Arapitam combined with dexamethasone increased OR 1.85 P0.01; Arepitan versus placebo increased 1467.4 vs 53.4% P 0.01; Arepitan combined with dexamethasone increased 7.80.39 P0.01; Arepitan versus placebo increased 1467.4 vs 53.4% P 0.01; Arepitan combined with dexamethasone increased 7.82.9P 0.01; Dexamethasone CR increased 17.9% 73.2% vs 55.33.00% vs 2.22% P0.01k.3) Arepitan combined with dexamethasone increased the control rate of delayed nausea with dexamethasone 74.4 vs 65.1% OR1.55P0.01 .4) adverse reactions: the incidence of fatigue was higher in the Arepitan group than in the control group, while the incidence of constipation was higher than that in the control group. It was lower than control group (P < 0. 03), headache, There was no significant difference in the incidence of diarrhea and anorexia between the two groups. Conclusion: the clinical tolerance of aripitan is good, and the improvement of delayed vomiting, nausea and acute vomiting is obvious, especially in patients with cisplatin regimen chemotherapy. It is necessary to further observe the improvement of CINV induced by different chemotherapy regimens.
【作者單位】： 北京中醫(yī)藥大學(xué);中日醫(yī)院中西醫(yī)結(jié)合腫瘤科;
【分類號】：R969

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