质子泵抑制剂联合莫沙必利对胃食管反流病疗效的Meta分析

Meta-analysis of the Efficacy of Proton Pump Inhibitor Combined with Mosapride on Gastroesophageal Reflux Disease

目的 在胃食管反流病(Gastroesophageal reflux disease,GERD)中,莫沙必利对质子泵抑制剂(proton pump inhibitor,PPI)的累加作用仍存在争议,本文比较了PPI联合莫沙必利与单独应用PPI治疗胃食管反流病的疗效。方法 计算机检索PubMed、MEDLINE、EMBASE、CNKI及万方数据库系统,查找莫沙必利联合PPI治疗GERD随机对照试验的相关文献。由两名研究者独立完成文献的纳入与排除、质量评价及数据提取,应用Cochrane协作网提供的Review Manager 5.4分析软件对数据进行统计分析。结果 共纳入14篇文献,荟萃分析结果显示,与单用PPI相比,莫沙必利联合PPI可以有效提高GERD患者的治疗应答率,差异有统计学意义(OR=2.22,95%CI:1.53~3.22,P<0.001),可提高反流性食管炎患者的黏膜愈合率,差异有统计学意义(OR=1.76,95%CI:1.23~2.51,P=0.002),且不良反应无显著增加。结论 莫沙必利联合PPI可以显著改善胃食管反流病患者症状。

Objective The additive effect of mosapride on proton pump inhibitors(PPI) in gastroesophageal reflux disease(GERD) remains controversial. This article compared the efficacy of PPI combined with mosapride and PPI alone in the treatment of gastroesophageal reflux disease.Methods PubMed, MEDLINE, EMBASE, CNKI and Wanfang database system were searched by computer to find the relevant literature on the randomized controlled trials of mosapride combined with PPI in the treatment of GERD. Two researchers independently completed the inclusion and exclusion of literature, quality assessment and data extraction, and the data were statistically analyzed using Review Manager 5.4 analysis software provided by the Cochrane Collaboration. Results A total of 14 articles were included. The meta-analysis showed that compared with PPI alone, mosapride combined with PPI could effectively improve the treatment response rate of GERD patients, and the difference was statistically significant(OR=2.22, 95%CI: 1.53-3.22, P<0.001), could improve the mucosal healing rate in patients with reflux esophagitis, and the difference was statistically significant(OR=1.76, 95%CI: 1.23-2.51, P=0.002), and there was no significant increase in adverse reactions. Conclusion Mosapride combined with PPI can significantly improve the symptoms of gastroesophageal reflux disease patients.