伊托必利对比多潘立酮治疗功能性消化不良的疗效及安全性的Meta分析

发布时间：2018-03-29 12:11

  本文选题：伊托必利　切入点：多潘立酮　出处：《广西医科大学》2015年硕士论文

【摘要】：目的：采用Meta分析的方法,全面探讨伊托必利(itopride)对比多潘立酮(domperidone)治疗功能性消化不良(functional dyspepsia, FD)的疗效及安全性。方法：使用计算机检索PubMed、Cochrane Library、Embase、清华同方数据库(CNKI)、中国生物医学文献数据库(CBM)、维普数据库(VIP)及万方数据库(WANGFANG)2015年2月以前公开发表的期刊文献,选用“功能性消化不良”、“伊托必利”、“多潘立酮”等作为主题词、自由词,全面检索有关伊托必利对比多潘立酮治疗功能性消化不良的随机对照实验(RCT),对一切符合纳入标准的临床研究进行Meta分析。由两个独立的评价人按照Jadad改良法评分标准对所纳入的研究进行方法学质量评价,并对试验组和对照组的各种临床症状缓解情况、胃动力缓解情况、总体缓解率以及总不良反应的发生率等指标进行相应的数据提取,并选用Cochrane协作网提供的Revman 5.2软件对所有提取的数据进行Meta分析。结果：依照制定的纳入、排除标准,共纳入Jadad改良法评分≥4分的13篇高质量RCT,总计2002例FD患者,将患者随机分为给予伊托必利治疗的试验组(1016例)以及给予多潘立酮治疗的对照组(986例)。Meta分析结果显示：伊托必利治疗FD的总有效率[OR=3.26,95%CI(1.91,5.57),P0.0001]、早饱缓解率[OR=2.12,95%CI(1.14,3.95), P=0.02]、上腹饱胀缓解率[OR=1.51,95%CI(1.14,2.02), P=0.005]均高于多潘立酮,且两组之间的差异具有统计学意义。伊托必利治疗FD的恶心[OR=1.74,95%CI(0.71,4.28),P=0.22]、暖气[OR=1.45,95%CI(0.45,2.46), P=0.17]、食欲不振[OR=1.33,95%CI(0.37,4.80), P=0.66]、反酸[OR=1.45,95%CI(0.60,3.46), P=0.41]及上腹疼痛[OR=1.34,95%CI(0.82,2.20), P=0.25]等症状的缓解率及胃肠动力学改善率[OR=1.30,95%CI(0.48,3.49), P=0.61]均高于多潘立酮,但两组之间的差异并无统计学意义。多潘立酮治疗FD的呕吐[OR=0.81,95%CI(0.15,4.31),P=0.81]、上腹不适[OR=0.99,95%CI(0.65,1.52), P=0.98]及烧心[OR=0.91,95%CI(0.41,2.02), P=0.82]等症状的缓解率均高于伊托必利,但两组之间的差异并无统计学意义。伊托必利治疗FD的总不良反应发生率低于多潘立酮,且两组之间的差异具有统计学意义[OR=0.66,95%CI(0.46,0.93),P=0.02]。结论：总体而言,伊托必利治疗功能性消化不良的总有效率优于多潘立酮,且总不良反应的发生率低。对各症状及胃肠动力学而言,伊托必利缓解早饱及上腹饱胀的疗效优于多潘立酮,其余诸如恶心、上腹疼痛、嗳气、呕吐等症状的缓解及胃排空的改善,两者无显著性差异。
[Abstract]:Objective: to adopt the method of Meta analysis, To investigate the efficacy and safety of itopridea versus domperidoneon in the treatment of functional dyspepsia (FDD). Methods: computer search was used to search PubMedan Cochrane Library Embase, Tsinghua Tongfang database CNKIN, Chinese Biomedical Literature Database (CBMCBM), Wiper. Database VIPs and Wanfang Database Wangfag, published before February 2015, Choose "functional dyspepsia", "Itopiride", "domperidone" as the theme words, free words, A randomized controlled trial of itopride versus domperidone in the treatment of functional dyspepsia was searched for Meta analysis of all clinical studies that met the inclusion criteria. Two independent evaluators scored according to the improved Jadad method. Criteria for methodological quality evaluation of included research, The clinical symptoms, gastric motility, the overall remission rate and the incidence of total adverse reactions of the experimental group and the control group were extracted. All the extracted data were analyzed by Meta with Revman 5.2 software provided by Cochrane Cooperative Network. Results: according to the standard of inclusion and exclusion, 13 pieces of high quality Jadad with improved Jadad score 鈮，

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