与化疗路上的恶心呕吐说再见

Core Viewpoint - The article emphasizes the importance of modern antiemetic strategies in managing chemotherapy-induced nausea and vomiting, highlighting the effectiveness of a preventive approach and combination therapy [1][2][3] Group 1: Mechanism of Nausea and Vomiting - Chemotherapy-induced vomiting is primarily triggered by the activation of the brain's vomiting control system, which can occur through damage to the gastrointestinal mucosa or direct stimulation of the brain's chemoreceptor trigger zone by drugs and their metabolites [1] - The severity of nausea and vomiting is categorized into high, medium, and low risk based on the chemotherapy drugs used, which informs the development of prevention strategies [1] Group 2: Antiemetic Strategies - Modern antiemetic strategies utilize a "prevention first, combination therapy" approach, employing agents like ondansetron, dexamethasone, and NK-1 receptor antagonists to manage both acute and delayed vomiting [1][2] - NK-1 antagonists, such as aprepitant, can effectively block the binding of substance P to the NK-1 receptor, significantly improving the complete control rate of delayed vomiting to over 70% for highly emetogenic chemotherapy [2] Group 3: Clinical Recommendations - The "golden triangle" regimen is commonly used for medium to high emetic risk chemotherapy, involving the pre-chemotherapy use of NK-1 antagonists, 5-HT receptor antagonists, and dexamethasone, followed by continued use post-chemotherapy to cover the high-risk period for delayed vomiting [2] - Additional supportive measures, such as a light diet, small frequent meals, and hydration, are recommended to alleviate gastrointestinal burden, alongside the importance of patient communication and adherence to medical advice [2][3]