黛力新联合莫沙必利治疗功能性消化不良疗效的系统评价

Systematic evaluation deanxit and mosapride vs mosapride for functional dyspepsia

目的 系统评价黛力新联合莫沙必利（治疗组）与莫沙必利（对照组）治疗功能性消化不良（FD）的临床疗效和安全性.方法 计算机检索PubMed、Ovid、EMbase和the Coehrane Library（2013年第1期）、CNKI、WanFang Da-ta、CBM,检索时间为2007年1月～2013年3月,根据纳入标准筛选合格文献,应用Jadad评分法进行质量评价并提取数据后,运用异质性检验、Meta分析、漏斗图分析等方法进行统计.结果 共纳入13个随机对照试验,1341例患者.Meta分析结果显示,在总体有效率、显效率方面,治疗组优于对照组,总有效率[OR=5.42,95％ CI（4.02,7.29）,P＜0.001];显效率[OR=3.16,95％CI（2.49,4.01）,P＜0.001];在复发率方面,治疗组的复发率低于对照组[OR=0.27,95％CI（0.12,0.61）,P=0.002];在药物不良反应发生率方面,治疗组与对照组相当[OR=1.18,95％CI（0.77,1.19）,P=0.44].漏斗图分析显示存在发表性偏倚.结论 目前有限证据表明,黛力新联合莫沙必利治疗FD在总体有效率、显效率均优于莫沙必利,复发率低于莫沙必利,不良反应率相似.但纳入研究的质量普遍较低,可能会影响结果的真实性,因而上述结论仍需要日后开展设计更为严格的大样本多中心的RCT加以证实.

Objective To systematically evaluate the efectiveness and safety of Deanxit and mosapride vs.mosapride in patients with functional dyspepsia.Methods All randomized controlled trials （RCTs） published from Jan 2007 to May 2013 were collected in the following databases：PubMed,Ovid,EMbase,the Cochrane Library,CNKI,Wanfang Data and CBM.The relevant literature was collected based on the inclusion criteria,and the Jadad scale was used to rate the quality of the trials.Statistical analyses were performed using the test for heterogeneity,meta-analysis,and funnel plot analysis.Results 13 trials involving 1341 patients were included and data were coped with meta-analysis.The total effective rate （OR=5.42,95％CI（4.02,7.29）,P＜0.001） and obvious effective rate （OR=3.16,95％CI（2.49,4.01）,P＜0.001） for the Deanxit treatment group were significantly better than those for the control group （only mosapride group）.The relapse rate for the treatment group was significantly lower than that for the control group（OR=0.27,95 ％ CI（0.12,0.61）,P=0.002）.while there was no significant difference in the adverse reaction rate between the two groups （OR=1.18,95 ％CI（0.77,1.19）,P=0.44）.Funnel plot analysis indicates the existence of publication bias.Conclusion Current evidence shows that Deanxit and mosapride is significantly better to mosapride in The total effective rate and obvious effective rate,and it has lower The relapse rate than mosapride does.while there is similar in the side effects between the two groups.Due to the low quality of most included studies,more strictly-designed and large-scale RCTs are needed to provide reasonable proofs for clinic.