Clinical Research On The Efficacy Of Small Pinellia Tuckahoe Decoction In The Prevention And Treatment Of Delayed Nausea And Emesis Induced By Chemotherapy

Objective: To investigate the clinical efficacy of Tropisetron 、 Dexamethasone combined with Small Pinellia Tuckahoe Decoction,as a preventive antiemetic drug,against delayed nausea and emesis caused by chemotherapy in patients with malignant tumor and its relationship with substance P(hereinafter referred to as SP)in plasma.Methods: Patients(from Jan 1st,2018 to Feb 28 th,2018)who received the first chemotherapy regimen of highly emetogenic drugs in our hospital were selected.Through self-controlled antiemetic observation,patients in the first course of chemotherapy were routinely treated with the combination of Tropisetron and Dexamethasone,among whom suffer I° and above I °delayed nausea and emesis were rendered to the second routine chemotherapy combined with traditional Chinese medicine.During this session,the latent periods,times,degrees and incidence of nausea and emesis were recorded and calculated then clinical efficacy and toxic and side effects on combined Small Pinellia Tuckahoe Decoction treatment of delayed vomiting and nausea caused by chemotherapy were assessed for each process of chemotherapy.While the changes of concentration of SP in serum of patients was observed and detected before and after chemotherapy of 1and 3 days respectively.Results: In the first phase of chemotherapy regimen of highly emetogenic drugs,30 patients suffered delayed nausea and emesis and its incubation period was 62.27±27.0 hours,the number of patients who suffered I °was 15 cases,II °11 cases,III° 2 cases,V ° 2 cases respectively,effective control rate was 50%.In the second routine chemotherapy on the basis of the prior antiemetic therapy,combined with Small Pinellia Tuckahoe Decoction as an adjuvant antiemetic drug,the results of the latency of nausea and emesis in 30 patients was 81.4±36.15 hours,among which I °was 14 cases,II °4 cases,III° nought,IV° 2 cases,effective control rate was 77%;Compared with the first stage,the incubation period was lengthened,which lowered the degree of nausea and vomiting,and significantly increased the effective control rate of delayed nausea and vomiting.While the anti-nausea effect is poorer on the patients who suffered IV °even though Small Pinellia Tuckahoe Decoction had been added,and there was no significant improvement on the degree of nausea and vomiting,but the latent period of vomiting was prolonged and reduced the frequency and incidence of patients’ nausea and vomiting.There was no obvious toxic and side effects during the treatment with Small Pinellia Tuckahoe Decoction.In the first process,the afore-said 30 patients’ concentration of substance P serum was 68.32±13.81 before chemotherapy,74.2±14.60 one day after chemotherapy,70.26±17.36 three days after chemotherapy singly.Serum P concentration in patients 1 and 3 d after chemotherapy showed an increasing trend compared with that before chemotherapy,without statistically significant differences.(P > 0.05);In the second stage of chemotherapy,30 patients were treated with the addition of Small Pinellia Tuckahoe Decoction on the basis of routine anti-emetic treatment,concentration of substance P serum was 91.66±15.34 before chemotherapy,92.94 ±16.48 one day after chemotherapy,101.49±15.37 three days after chemotherapy severally,Serum P concentration in patients 1 and 3 d after chemotherapy showed an increasing trend compared with that before chemotherapy,without statistically significant differences.(P > 0.05);By contrast,The concentration of serum substance P increased at the timing of the second chemotherapy,indicating a statistically significant difference(P < 0.05).Due to the large size of the included patients with lung cancer,subgroup analysis was conducted,demonstrating that the concentration difference of serum P presented no statistically significant differences between the patients undergoing conventional antiemetic therapy and traditional Chinese medicine(TCM)combined with antiemetic therapy 1 and 3 d after chemotherapy and before chemotherapy.In addition,subgroup analysis revealed no obvious differences in the concentration difference of P between the patients undergoing platinumcontaining chemotherapy with conventional antiemetic therapy and TCM combined with antiemetic therapy 1 and 3 d after chemotherapy.Moreover,the concentration difference of serum P 1 and 3 d after chemotherapy and before chemotherapy showed no statistically significant differences between the patients undergoing platinum-containing chemotherapy with conventional antiemetic therapy and TCM combined with antiemetic therapy.Conclusion: The addition of Small Pinellia Tuckahoe decoction to the standard antiemetic regimen improves symptoms and degrees of patients with delayed nausea and vomiting caused by chemotherapy,rendering good safety and tolerance.There was basically no significant change in SP serum before and after chemotherapy.It remains to be further studied whether the treatment of delayed nausea and vomiting has something to do with SP.