Investigate The Chemotherapy-induced Gastrointestinal Symptoms In Lung Cancer Patients And Identify The Effect Of Relieving Vomiting Of Different Medical Interventions

Objectives:Study the overall prevalance and distribution of chemotherapy induced gastrointestinal symptoms in lung cancer patients; investigate whether active interventions on chemotherapy induced gastrointestinal symptoms before vomiting can effectively prevent the vomiting, and identify the optimal regimens to prevent chemotherapy-induced vomiting.Method:1. In this perspective clinical observation, we analyzed the data of160hospitalized lung cancer patients under venous chemotherapy with self-designed questionnaire of chemotherapy induced gastrointestinal symptoms, which collected by cross-sectional surveying on the gastrointestinal symptoms to learn the prevalence rate, the distribution of different levels of severity, and the number of symptoms one patient have concurrently and the common symptoms combination.2. The optimal clinical preparative regimens were designed to prevent chemotherapy-induced vomiting based on the common symptoms combination. Total466cases receiving chemotherapy were allocated randomly into two groups, the clinical preparative regimens were given in intervention group in addition to antagonist for5-hydroxytryptamine3receptors (5-HT3R), while only5-HT3R antagonists was given in control group. Antiemetic efficacy was divided into four levels, level0and1was defined as response, and level2and3was defined as failure.Results:1. The prevalence of chemotherapy-related gastrointestinal symptoms fluctuates from8.12%to63.75%, the loss of appetite, nausea, dysgeusia, gastrectasia, hiccup, constipation are the top six symptoms with the highest occurrence; and the mild severity is very common in symptoms distribution degrees; we find that2.01±1.62kinds of gastrointestinal symptoms often occur in a patient at the same time, patients with more than2kinds of symptoms account84.37%(135cases), the’loss of appetite+hiccup’,’loss of appetite+nausea’,’loss of appetite+nausea+gastrectasia’ and’loss of appetite+dysgeusia+nausea+constipation’are the top four symptoms combinations.2. The optimal clinical preparative regimens to prevent chemotherapy-induced vomiting based on the common symptoms combination were designed as protocol①’metoclopramide+diphenhydramine+purgatives+medroxyprogesterone’, protocol②’metoclopramide+diphenhydramine+methylprednisolone’, protocol③’metoclopramide+diphenhydramine’and protocol④’metoclopramide’group. Multi-sample rank sum test (Kruskal-Wallis test) results showed that the mean ranks antiemetic effects in protocols of①,②,③,④and the control group were146.04,207.96,229.71,236.82and289.96, the differences between protocol①and②,③,④were61.92(P=0.025),83.67(P＜0.001), and90.78(P<0.001), respectively, protocol②and③presented almost the similar effect (P=0.280), and both were superior to protocol④without statistic difference (P>0.05). The response rates of protocol①was superior to protocol②,③,④with statistic difference (P<0.001).Conclusions:Chemotherapy-induced gastrointestinal symptoms are very common, and often with coexistence of multiple symptoms, the loss of appetite, nausea, dysgeusia, gastrectasia, hiccup, constipation are the most common and serious symptoms, the’ loss of appetite+hiccup’,’loss of appetite+nausea’,’loss of appetite+nausea+gastrectasia’and’loss of appetite+dysgeusia+nausea+constipation’are the most common symptoms combinations, to which more clinical attention and prevention should be payed. Medical intervention on premonitory symptoms can significantly relieve chemotherapy-induced vomiting, improve patient’s quality of life. The effect of relieving vomiting by’metoclopramide+diphenhydramine+mziren capsule+medroxyprogesterone’may be the better and should be recommended as regimen of preventing chemotherapy-induced vomiting when multiple premonitory symptoms occured.