Abstract:

Objective　To explore the preventive and therapeutic effects of tropisetron versus esomeprazole for chemotherapy related gastrointestinal adverse reactions in patients with colorectal cancer. Methods　One hundred and twenty-four patients with colorectal cancer taking chemotherapy at Nanyang First People's Hospital from January 2020 to January 2022 were selected for the randomized controlled trial. They were divided into groups A and B by lottery, with 62 cases in each group. There were 32 males and 30 females in group A; they were (55.25±5.37) years old. There were 31 males and 31 females in group B; they were (56.07±5.22) years old. Group A took tropisetron and chemotherapy, and group B esomeprazole and chemotherapy. Both groups were followed up for one year. The incidence of gastrointestinal adverse reactions during chemotherapy, the scores of Index of Nausea, Vomiting, and Retching (INVR) on day 1, 7 and 14 of chemotherapy and after one chemotherapy cycle, and the long-term quality of life were compared between the two groups. χ² and t tests were applied. Results　After the treatment with different drugs, the incidence of gastrointestinal adverse reactions during chemotherapy, the acid reflux frequency, the nausea frequency, and the vomiting frequency in group A were lower than those in group B [12.90% (8/62) vs. 30.65% (19/62), (1.16±0.23) times/d vs. (3.44±1.22) times/d, (2.14±0.45) times/d vs. (4.41±1.23) times/d, and (1.27±0.33) times/d vs. (3.11±1.25) times/d; χ²=5.729; t=14.461, 13.647, and 11.207; all P<0.05]. There was no statistical difference in the score of INVR between groups A and B on day 1 of chemotherapy [(20.33±5.41) vs. (21.24±5.18); t=1.272, P>0.05]. The scores of INVR on day 7 and 14 of chemotherapy and after one cycle of chemotherapy in group A were lower than those in group B [(15.11±3.46) vs. (18.61±3.12), (12.33±2.46) vs. (14.24±3.36), and (10.19±1.47) vs. (12.25±2.72); t=5.915, 5.156, and 5.246; all P<0.05]. During the follow-up period, the scores of physiological status, social/family status, emotional status, functional status, sleep status, and compliance status of Functional Assessment of Cancer Therapy of Colorectal (FACT-C) in group A were higher than those in group B [(22.45±5.33) vs. (19.35±5.31), (23.36±5.27) vs. (20.18±5.32), (20.31±5.24) vs. (17.25±5.33), (21.25±5.16) vs. (18.44±5.28), (23.11±5.17) vs. (20.21±5.22), and (23.35±5.25) vs. (20.22±5.32); t=3.244, 3.344, 3.244, 2.997, 3.108, and 3.297; all P<0.05]. Conclusion　Tropisetron is better than esomeprazole in the prevention and treatment of gastrointestinal adverse reactions.

Key words:

Colorectal cancer, Chemotherapy, Gastrointestinal adverse reactions, Tropisetron, Esomeprazole

摘要：

目的　比较托烷司琼和艾司奥美拉唑对结直肠癌患者化疗相关胃肠道不良反应的防治效果。方法　选取2020年1月至2022年1月南阳市第一人民医院收治的124例结直肠癌化疗患者进行随机对照试验。采用抽签法将其分为A组和B组，各62例。A组男32例，女30例，年龄（55.25±5.37）岁。B组男31例，女31例，年龄（56.07±5.22）岁。A组应用托烷司琼配合化疗，B组应用艾司奥美拉唑配合化疗。两组均随访1年。比较两组患者化疗期间胃肠道不良反应发生情况，化疗第1、7、14天时以及1个化疗周期后恶心呕吐干呕症状评估量表（Index of Nausea，Vomiting，and Retching，INVR）评分以及远期生存质量。采用χ²检验和t检验。结果　经不同药物配合治疗后，A组化疗期间胃肠道不良反应发生率、反酸频率、恶心频率、呕吐频率均低于B组［12.90%（8/62）比30.65%（19/62）、（1.16±0.23）次/d比（3.44±1.22）次/d、（2.14±0.45）次/d比（4.41±1.23）次/d、（1.27±0.33）次/d比（3.11±1.25）次/d；χ²=5.729，t=14.461、13.647、11.207，均P<0.05］。A组化疗第1天INVR评分（20.33±5.41）分，B组（21.24±5.18）分，差异无统计学意义（t=1.272，P>0.05）；A组化疗第7、14天和化疗1个周期时INVR评分均低于B组［（15.11±3.46）分比（18.61±3.12）分、（12.33±2.46）分比（14.24±3.36）分、（10.19±1.47）分比（12.25±2.72）分；t=5.915、5.156、5.246，均P<0.05］。随访期间，A组结直肠癌患者生命质量测定量表（Functional Assessment of Cancer Therapy of Colorectal，FACT-C）中生理状况、社会/家庭状况、情感状况、功能状况、睡眠状况、依从状况维度评分均高于B组［（22.45±5.33）分比（19.35±5.31）分、（23.36±5.27）分比（20.18±5.32）分、（20.31±5.24）分比（17.25±5.33）分、（21.25±5.16）分比（18.44±5.28）分、（23.11±5.17）分比（20.21±5.22）分、（23.35±5.25）分比（20.22±5.32）分；t=3.244、3.344、3.244、2.997、3.108、3.297，均P<0.05］。结论　托烷司琼对胃肠道不良反应的防治效果均优于艾司奥美拉唑。

关键词:

结直肠癌, 化疗, 胃肠道不良反应, 托烷司琼, 艾司奥美拉唑