莫沙必利联合质子泵抑制剂治疗胃食管反流病的Meta分析

Meta-analysis on the effects of mosapride combined with proton pump inhibitor for gastroesophageal reflux disease

目的评价莫沙必利治疗胃食管反流病(GERD)的有效性和安全性。方法检索Pub Med、EMBase、中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普信息资源系统(VIP)、万方数据库,从建库至2013年6月,所有莫沙必利联合质子泵抑制剂(PPI)治疗胃食管反流病的随机对照试验。用Cochrane系统评价方法评价后,用Rev Man 5.2软件进行Meta分析。结果共纳入32项研究(2918例患者),治疗组(莫沙必利联合质子泵抑制剂)对GERD临床症状缓解率[OR=4.54,95%CI(3.59,5.75),P<0.01]以及对内镜下胃食管炎症应答率[OR=4.37,95%CI(3.08,6.21),P<0.01]均高于对照组(单用质子泵抑制剂)。治疗组不良反应发生数[OR=1.06,95%CI(0.74,1.53),P>0.05],与对照组比较差异无统计学意义。结论试验组对胃食管反流病的治疗效果优于对照组,安全性与对照组差异无统计学意义。

Objective To investigate the effect and safety of mosapride on gastroesophageal reflux disease （GERD）. Methods The databases of PubMed, EMBase, CNKI, VIP, CBM and Wanfang were searched for randomized controlled trials （RCTs）of mosapride combined with proton pump inhibitor （PPI） for the treatment of GERD. The duration of search was from the building of database to June 2013. Assessing was under - taken according to international Cochrane collaboration, and then Meta - analysis was performed by software RevMan 5.2. Results A total of 32 trials （2918 patients ） were included. The results of meta- analysis showed that the symptomatic response [ OR = 4.54, 95% CI （3.59, 5.75）, P 〈0. 01 ] and the endoscope response [ OR =4. 37, 95% CI （3.08, 6.21 ）, P 〈0. 01 ] in mosapride combined PPI group were all higher than those in PPI group, respectively. However, There was no significant difference in the adverse reactions between two groups. Conclusion The effect of mosapride combined with PPI on the treatment of GERD is more obvious than that of PPI group, but there is no signifi- cant difference in safety.