作者：陈景耀1，胡懿芝2，王丹蕊2，郝腾飞1，李明哲1，方素芬1

单位：1.中山大学附属第七医院 消化医学中心， 广东 深圳 518107； 2.中山大学医学院， 广东 深圳 518107

Authors: Chen Jingyao1, Hu Yizhi2, Wang Danrui2, Hao Tengfei1, Li Mingzhe1, Fang Sufen1

Unit: 1.Digestive Medicine Center, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, Guangdong, China；2.Sun Yat-sen University School of Medicine, Shenzhen, 518107, Guangdong, China

摘要：

目的 对比抑酸药物预防恶性肿瘤化疗所致消化道毒副作用的疗效。方法 检索Pubmed、Embase、Cochrane、CMB、万方等数据库中抑酸药物预防恶性肿瘤化疗所致消化道毒副作用疗效的随机对照研究，根据纳入及排除标准筛选文献。从文献中提取数据后，使用RevMan 5.4软件进行分析。结果 共8篇文献859例化疗患者纳入本研究，包括胃癌、结肠癌、乳腺癌、肺癌等，其中接受抑酸药物组484例，未接受抑酸药物组375例。Meta分析结果显示，抑酸药物可改善恶性肿瘤化疗所致恶心（P<0.05,OR=0.31,95%CI为0.17-0.55）、呕吐（P<0.05,OR=0.27,95%CI:0.16～0.47）、上腹痛或烧心（P<0.05,OR=0.37,95%CI:0.20～0.93）及食欲减退（P=0.007,OR=0.26,95%CI:0.10～0.69），但不能改善化疗所致腹泻（P=0.48,OR=0.22,95%CI:0～14.06）。结论 抑酸药物的使用能预防恶性肿瘤化疗患者的恶心、呕吐、上腹痛或烧心、食欲减退等症状的发生，但不能预防化疗所致腹泻。

关键词：恶性肿瘤； 化疗； 抑酸药物； Meta分析

Abstract：

Objective To compare the efficacy of gastric acid suppressants in the prevention of gastrointestinal toxicity caused by chemotherapy for malignant tumors. Method The literature was retrieved from Pubmed, Embase, Cochrane, CMB and Wanfang databases. The literature should be a randomized controlled study comparing the efficacy of gastric acid suppressants in preventing gastrointestinal toxicity caused by chemotherapy for malignant tumors. Literature was screened according to inclusion and exclusion criteria. The data were extracted and analyzed with RevMan 5.4 software. Result A total of 8 articles, including 859 patients with malignant tumor undergoing chemotherapy, were included in the study, including gastric cancer, colon cancer, breast cancer, lung cancer, etc. Among them, 484 patients were treated with gastric acid suppressants and 375 patients were not. Meta analysis results showed that gastric acid suppressants could significantly reduce nausea (P<0.05, OR=0.31, 95% CI: 0.17-0.55), vomiting (P<0.05, OR=0.27, 95% CI: 0.16-0.47), epigastric pain or heartburn(P<0.05, OR=0.37, 95% CI: 0.20-0.93) and loss of appetite (P=0.007, OR=0.26, 95%CI: 0.10-0.69) caused by chemotherapy in malignant tumors, but could not reduce diarrhea (P=0.48, OR=0.22, 95% CI:0-14.06). Conclusion Gastric acid suppressants can prevent nausea, vomiting, epigastric pain or heartburn, loss of appetite in patients with malignant tumor undergoing chemotherapy, but can’t prevent diarrhea caused by chemotherapy.

Key Words:  Malignant tumor; Chemotherapy; Gastric acid suppressants; Meta-analysis