Gastroparesis refers to abnormal gastric motility characterized by delayed gastric emptying in the absence of mechanical obstruction. The most common etiologies include diabetes, post-surgical and idiopathic. The most...Gastroparesis refers to abnormal gastric motility characterized by delayed gastric emptying in the absence of mechanical obstruction. The most common etiologies include diabetes, post-surgical and idiopathic. The most common symptoms are nausea, vomiting and epigastric pain. Gastroparesis is estimated to affect 4% of the population and symptomatology may range from little effect on daily activity to severe disability and frequent hospitalizations. The gold standard of diagnosis is solid meal gastric scintigraphy. Treatment is multimodal and includes dietary modification, prokinetic and anti-emetic medications, and surgical interventions. New advances in drug therapy, and gastric electrical stimulation techniques have been introduced and might provide new hope to patients with refractory gastroparesis. In this comprehensive review, we discuss gastroparesis with emphasis on the latest developments; from the perspective of the practicing clinician.展开更多
Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current...Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current guidelines. Methods： We searched the China Health Insurance Research Association （CHIRA） Database to identify patients with cancer who were 〉 18 years old and received either moderately or highly emetogenie chemotherapy （MEC and HEC, respectively） between 2008 and 2012. Patients＇ characteristics as well as usage of specific antiemetic regimens were analyzed using descriptive statistics. Results： Of the 14,548 patients included in the study, 6,477 received HEC while 8,071 were treated with MEC. Approximately 89.9% used antiemetics prophylactically to prevent acute CINV and 71.5% for delayed CINV while 9.0% were prescribed antiemetics as rescue therapy. A significantly lower proportion of patients treated with HEC received prophylactic antiemetic therapy for delayed CINV as compared to those treated with MEC （59.4% vs. 81.3 %; P〈0.001）. The HEC group had a slightly lower proportion of patients using a mixed regimen containing a 5-HT3 antagonist to prevent both acute and delayed CINV than the MEC group （P〈0.012）; however, a higher proportion received a mixed regimen containing eorticosteroids （P≤0.007）. Although more than half of the patients in the HEC group took three antiemeties to prevent acute and delayed CINV, these rates were significantly lower than those of the MEC group （both P〈0.001）. Finally, analysis of the regimens used revealed that there is over-utilization of drugs within the same class of antiemetic. Conclusions： These findings indicate that more attention is needed for treatment of delayed CINV, in terms of both overall use and the components of a typical treatment regimen.展开更多
Objective： To investigate the treatment time dependence of electroacupuncture （EA） on Neiguan （PC6） for preventing postoperative nausea and vomiting （PONV）. Methods： One hundred and seventy-eight patients, who...Objective： To investigate the treatment time dependence of electroacupuncture （EA） on Neiguan （PC6） for preventing postoperative nausea and vomiting （PONV）. Methods： One hundred and seventy-eight patients, who had received intravenous patient-controlled analgesia （PCA） with Fentanyl, were assigned randomly to three groups using random numbers： a pre-operative EA group （PrEA）, a post-operative EA group （PoEA）, and a non-acupuncture control group （NC）. An anesthetist evaluated the incidence and severity of nausea and vomiting for 48 h after surgery blindly. The main outcomes were severity and freguency of PONV, which were measured with a self-reported questionnaire and a confirmation from the anesthetist. The data were analyzed with ANOVA and Z-test. Results： The incidence of nausea and vomiting was significantly lower in the PrEA group than the NC group during 48 h after surgery （P〈0.01, P〈0.05）. The incidence of vomiting was also significantly lower in the PrEA group than the PoEA group （P〈0.05）. The PoEA subjects evidenced no significant differences compared with the NC subjects in terms of the incidence of nausea and vomiting （P〈0.05）. The severity of nausea was significantly lower in the PrEA group than in the NC and PoEA groups （P〈0.05）. Conclusions： EA on PC6 is effective in the prevention of PONV, and pre-operative acupuncture is more effective than post-operative acupuncture.展开更多
目的探讨分级管理方案在乳腺癌患者化疗所致恶心呕吐(chemotherapy induced nausea and vomiting,CINV)中的应用效果。方法采取整群抽样法抽取试验组及对照组各158例,试验组给予CINV分级管理方案,对照组给予CINV常规护理,比较两组CINV...目的探讨分级管理方案在乳腺癌患者化疗所致恶心呕吐(chemotherapy induced nausea and vomiting,CINV)中的应用效果。方法采取整群抽样法抽取试验组及对照组各158例,试验组给予CINV分级管理方案,对照组给予CINV常规护理,比较两组CINV发生情况及CINV对生活质量的影响。结果试验组接受高度、中度致吐风险化疗方案的患者,CINV发生情况明显低于对照组(P<0.05),而接受低度致吐风险化疗方案的两组患者,CINV发生情况差异无统计学意义(P<0.05);试验组接受高度、中度及低度致吐风险化疗方案的患者,呕吐生活功能指数量表评分均明显高于对照组(P<0.05)。结论CINV分级管理方案总体上可降低CINV的发生率及等级,并降低CINV对患者生活质量的影响。展开更多
文摘Gastroparesis refers to abnormal gastric motility characterized by delayed gastric emptying in the absence of mechanical obstruction. The most common etiologies include diabetes, post-surgical and idiopathic. The most common symptoms are nausea, vomiting and epigastric pain. Gastroparesis is estimated to affect 4% of the population and symptomatology may range from little effect on daily activity to severe disability and frequent hospitalizations. The gold standard of diagnosis is solid meal gastric scintigraphy. Treatment is multimodal and includes dietary modification, prokinetic and anti-emetic medications, and surgical interventions. New advances in drug therapy, and gastric electrical stimulation techniques have been introduced and might provide new hope to patients with refractory gastroparesis. In this comprehensive review, we discuss gastroparesis with emphasis on the latest developments; from the perspective of the practicing clinician.
基金supported by MSD Holding Co.,Ltd.The funding was only for the payment of using CHIRA database
文摘Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current guidelines. Methods： We searched the China Health Insurance Research Association （CHIRA） Database to identify patients with cancer who were 〉 18 years old and received either moderately or highly emetogenie chemotherapy （MEC and HEC, respectively） between 2008 and 2012. Patients＇ characteristics as well as usage of specific antiemetic regimens were analyzed using descriptive statistics. Results： Of the 14,548 patients included in the study, 6,477 received HEC while 8,071 were treated with MEC. Approximately 89.9% used antiemetics prophylactically to prevent acute CINV and 71.5% for delayed CINV while 9.0% were prescribed antiemetics as rescue therapy. A significantly lower proportion of patients treated with HEC received prophylactic antiemetic therapy for delayed CINV as compared to those treated with MEC （59.4% vs. 81.3 %; P〈0.001）. The HEC group had a slightly lower proportion of patients using a mixed regimen containing a 5-HT3 antagonist to prevent both acute and delayed CINV than the MEC group （P〈0.012）; however, a higher proportion received a mixed regimen containing eorticosteroids （P≤0.007）. Although more than half of the patients in the HEC group took three antiemeties to prevent acute and delayed CINV, these rates were significantly lower than those of the MEC group （both P〈0.001）. Finally, analysis of the regimens used revealed that there is over-utilization of drugs within the same class of antiemetic. Conclusions： These findings indicate that more attention is needed for treatment of delayed CINV, in terms of both overall use and the components of a typical treatment regimen.
文摘Objective： To investigate the treatment time dependence of electroacupuncture （EA） on Neiguan （PC6） for preventing postoperative nausea and vomiting （PONV）. Methods： One hundred and seventy-eight patients, who had received intravenous patient-controlled analgesia （PCA） with Fentanyl, were assigned randomly to three groups using random numbers： a pre-operative EA group （PrEA）, a post-operative EA group （PoEA）, and a non-acupuncture control group （NC）. An anesthetist evaluated the incidence and severity of nausea and vomiting for 48 h after surgery blindly. The main outcomes were severity and freguency of PONV, which were measured with a self-reported questionnaire and a confirmation from the anesthetist. The data were analyzed with ANOVA and Z-test. Results： The incidence of nausea and vomiting was significantly lower in the PrEA group than the NC group during 48 h after surgery （P〈0.01, P〈0.05）. The incidence of vomiting was also significantly lower in the PrEA group than the PoEA group （P〈0.05）. The PoEA subjects evidenced no significant differences compared with the NC subjects in terms of the incidence of nausea and vomiting （P〈0.05）. The severity of nausea was significantly lower in the PrEA group than in the NC and PoEA groups （P〈0.05）. Conclusions： EA on PC6 is effective in the prevention of PONV, and pre-operative acupuncture is more effective than post-operative acupuncture.
文摘目的探讨分级管理方案在乳腺癌患者化疗所致恶心呕吐(chemotherapy induced nausea and vomiting,CINV)中的应用效果。方法采取整群抽样法抽取试验组及对照组各158例,试验组给予CINV分级管理方案,对照组给予CINV常规护理,比较两组CINV发生情况及CINV对生活质量的影响。结果试验组接受高度、中度致吐风险化疗方案的患者,CINV发生情况明显低于对照组(P<0.05),而接受低度致吐风险化疗方案的两组患者,CINV发生情况差异无统计学意义(P<0.05);试验组接受高度、中度及低度致吐风险化疗方案的患者,呕吐生活功能指数量表评分均明显高于对照组(P<0.05)。结论CINV分级管理方案总体上可降低CINV的发生率及等级,并降低CINV对患者生活质量的影响。
