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目的:比较国家基本药物目录中3种止吐药治疗尿毒症呕吐的临床疗效和安全性。方法:将480例尿毒症患者随机均分为6组,分别采用甲氧氯普胺、氯丙嗪、昂丹司琼单用及两两联用治疗尿毒症引起的呕吐,观察6组患者的临床疗效、平均起效时间、不良反应发生情况及治疗成本。结果:甲氧氯普胺+昂丹司琼组的总有效率最高,为96.25%,且该方案起效时间也最迅速,为(5.1±1.2)min。单用甲氧氯普胺组的总有效率和平均起效时间仅次于甲氧氯普胺+昂丹司琼组,但不良反应最少,发生率为8.75%,而甲氧氯普胺+昂丹司琼组为18.75%。3种基本药物治疗1 d的成本从小到大依次为甲氧氯普胺、氯丙嗪和昂丹司琼。结论:综合考虑临床疗效、起效时间、不良反应和治疗成本等因素,甲氧氯普胺单用可作为治疗尿毒症呕吐的首选;甲氧氯普胺+昂丹司琼联用或甲氧氯普胺+氯丙嗪联用的方案可在单独用药治疗无效后权衡使用。
OBJECTIVE: To compare the clinical efficacy and safety of three kinds of antiemetic drugs in the treatment of uremia and vomiting in the national essential medicines list. Methods: 480 patients with uremia were randomly divided into 6 groups, respectively, metoclopramide, chlorpromazine, ondansetron alone and in combination treatment of uremia vomiting caused by two to observe the 6 groups of patients Clinical efficacy, average onset time, adverse reactions and treatment costs. Results: The total effective rate of metoclopramide + ondansetron group was the highest (96.25%), and the onset time was the fastest (5.1 ± 1.2) min. The total effective rate and mean effective time of metoclopramide group were the second only to metoclopramide plus ondansetron group, with the least adverse reactions, the incidence was 8.75%, while metoclopramide + Ondansetron group was 18.75%. The cost of the three basic drugs for 1 day followed by metoclopramide, chlorpromazine and ondansetron. CONCLUSION: Metoclopramide alone can be the first choice for treatment of vomiting of uremia by comprehensive consideration of clinical efficacy, onset time, adverse reactions and treatment costs. Metoclopramide plus ondansetron or methoxy The combination of chloramuria and chlorpromazine can be weighed out after treatment is discontinued.