普卡必利治疗慢性便秘的疗效及安全性:Meta分析

Efficacy and safety of prucalopride for chronic constipation: A meta-analysis

目的评价普卡必利治疗慢性便秘（cc）的疗效及安全性。方法检索PubMed、EMBASE、WebofScience、The Cochrane Central Register of Controlled Trials、CNKI全文数据库、万方数据库、中国科技期刊数据库中关于普卡必利治疗CC的疗效及安全性的随机对照试验（RCT），采用RevMan5．0对纳人的研究进行Meta分析。结果共1l项RCT包含3278例患者符合入选标准。其中10个为普卡必利与安慰剂的对照试验，另1个为普卡必利与聚乙二醇3350＋电解质对比的对照试验。Meta分析结果显示，普卡必利组治疗CC的有效率（29．2％）明显高于安慰剂组（12．6％，RR=2．37，95％CI2．02—2．79，P〈0．001），但与聚乙二醇3350＋电解质组相似（P〉0．05）。普卡必利组头痛、头晕、腹泻、腹痛、恶心的发生率高于安慰剂组，而腹胀的发生率及对心电图QT间期的影响与安慰剂组比较差异无统计学意义。结论普卡必利是一种治疗CC的有效药物，不良反应少且较轻，对心脏无明显影响。

Objective To evaluate the efficacy and safety of prucalopride in the treatment of chronic constipation （CC）. Methods Articles regarding treatment of constipation were retrieved from PubMed, EMBASE, Web of Science, The Cochrane Central Register of Controlled Trials, Chinese Journals Full-text Database （CNKI, China National Knowledge Infrastructure）, Wan Fang Digital Journal Full-text Database, and Database for Chinese Technical Periodical （VIP） to collect clinical randomized controlled trials for CC treated by prucalopride. Meta analysis was performed by using Review Manager 5.0. Results A total of eleven randomized controlled trials including 3278 patients met the inclusion criteria, and ten of them were analyzed to compare the effect of prucalopride with placebo, and another group of articles were analyzed to compare the effect or prucalopride with that of PEG 3350＋electrolytes. Mete-analysis showed that the efficacy rate was significantly higher in prucalopride group （29.2%） than in the placebo group （12.6%, RR=2.37, 95% CI 2.02-2.79, P〈0.001）, while it was similar to that of PEG 3350＋electrolytes group. The incidence rates of headache, dizziness, diarrhea, abdominal pain, and nausea were higher in the prucalopride group than in the placebo group （P≤ 0.05）. There were no differences in the incidence of flatulence and prolonged Q T interval between the two groups （P〉0.05）. Conclusion Prucalopride is effective in the treatment of CC, with relatively milder and lower incidence of adverse reaction, and it could be a new choice for the treatment of CC.