莫沙必利治療功能性消化不良的系統評價_《中國循證醫學雜志》

作者：

吳宗英 ¹ ,  王一平 ¹ , 曾超 ²

1. 四川大學華西醫院消化內科（成都 610041） 2. 成都市第三人民醫院（成都 610031）;

關鍵詞：

莫沙必利功能性消化不良系統評價 Meta分析

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　系統評價莫沙必利治療功能性消化不良（FD）的療效和安全性。
方法　電子檢索Cochrane圖書館（2006年第2期）、MEDLINE（1978～2006.6）、EMbase（1978～2006.6）、ISI（2000～2006.6）、OVID（1978～2006.6）、中國生物醫學文獻數據庫（1978～2006.6）、維普中刊數據庫（1989～2006.6）、中國期刊全文數據庫（1994～2006.6）、萬方學位論文數據庫（1978～2006.6）。手工檢索《中華消化雜志》等4種相關中文期刊、相關會議論文集及所有檢索到試驗的參考文獻。納入莫沙必利治療FD的所有隨機對照試驗，并逐個進行質量評價和資料提取。統計學分析采用RevMan4.2.8軟件處理。
結果　共納入到18個隨機對照試驗（共2 929例）。Meta分析結果顯示：（1）總體癥狀緩解率：莫沙必利優于胃復安 [RR 1.66, 95%CI (0.82, 3.35)] 及多潘立酮 [RR 1.23, 95%CI (1.12, 1.34)]；（2）單個癥狀的緩解率：1）上腹脹緩解率：莫沙必利優于多潘立酮 [RR 1.35, 95%CI (1.14, 1.60)]，不優于西沙必利 [RR 0.95, 95%CI (0.78, 1.15)]； 2）餐后飽脹緩解率：莫沙必利優于多潘立酮 [RR 2.72, 95%CI (2.02, 3.66)]，不優于西沙必利 [RR 0.99, 95%CI (0.82, 1.18)]； 3）上腹痛緩解率：莫沙必利優于多潘立酮 [RR 1.27, 95%CI (1.07, 1.49)]，不優于西沙必利 [RR 0.94, 95%CI (0.75, 1.17)]； 4）早飽緩解率：莫沙必利優于多潘立酮 [RR 1.42, 95%CI (1.15, 1.76)]，不優于西沙必利 [RR 0.98, 95%CI (0.82, 1.17)]； 5）惡心緩解率：莫沙必利不優于西沙必利 [RR1.07, 95%CI (0.82, 1.39)] 及多潘立酮 [RR 1.12, 95%CI (0.97, 1.28)]； 6）嘔吐緩解率：莫沙必利不優于西沙必利 [P＝0.80] 及多潘立酮 [RR 1.02, 95%CI (0.87, 1.18)]； 7）噯氣緩解率：莫沙必利優于多潘立酮 [RR 1.41, 95%CI (1.17, 1.70)]，不優于西沙必利 [RR 0.85, 95%CI (0.68, 1.05)]； 8）納差緩解率：莫沙必利優于多潘立酮 [RR 1.22, 95%CI (1.20, 1.44)]，不優于西沙必利 [RR 0.88, 95%CI (0.64, 1.19)]；9）反酸緩解率：莫沙必利不優于多潘立酮 [P=0.64] 及西沙必利 [P＝0.32]； 10）燒心緩解率：莫沙必利不優于多潘立酮 [RR 0.97, 95%CI (0.96, 1.10)] 及西沙必利 [RR 1.05, 95%CI (0.90, 1.21)]； 11）上腹不適緩解率：莫沙必利不優于西沙必利 [P=0.64]；（3）藥物不良反應發生率：莫沙必利少于多潘立酮 [RR 0.64, 95%CI (0.47, 0.85)]。
結論　現有有限的證據表明：在改善FD患者總體癥狀方面，莫沙必利優于胃復安、多潘立酮；在改善FD患者單個癥狀方面：莫沙必利在改善上腹脹、早飽、餐后飽脹、噯氣及納差癥狀優于多潘立酮，改善惡心、嘔吐、反酸、燒心癥狀與多潘立酮相似，在改善各種單一癥狀方面與西沙必利相似。此外，莫沙必利的副作用較少。

引用本文： 吳宗英,王一平,曾超. 莫沙必利治療功能性消化不良的系統評價. 中國循證醫學雜志, 2006, 06(11): 790-803. doi: 復制

1.	覃業宏. 莫沙必利治療功能性消化不良的臨床觀察. 現代醫藥衛生, 2004; 20(11): 968~969.
2.	許建明, 胡乃中, 謝惠君, 等. 枸櫞酸莫沙必利片治療功能性消化不良的隨機對照雙盲臨床試驗評價. 基礎醫學與臨床, 2001; 21(增刊): 54.
3.	達四平, 趙曉晏, 李宜輝, 等. 口服莫沙必利治療功能性消化不良的隨機對照試驗. 第三軍醫大學學報, 2001; 23(5): 593~595.
4.	李國恩, 賀聰霞. 貝絡納治療功能性消化不良的臨床觀察. 河南大學學報(醫學科學版), 2003; 22(1): 40~41.
5.	黃詠東, 苻林梅. 貝絡納治療功能性消化不良的臨床觀察. 華西藥學雜志, 2001; 16(4): 317.
6.	王振華, 達四平, 龔能平, 等. 莫沙必利治療功能性消化不良多中心雙盲對照研究. 中國新藥與臨床雜志, 2000; 19(5): 363~366.
7.	趙曉紅, 胡建國, 白東莉. 枸櫞酸莫沙必利治療功能性消化不良的臨床觀察. 寧夏醫學院學報, 2003; 25(6):431~432.
8.	馬嵐清. 莫沙必利和嗎叮啉治療功能性消化不良的療效和安全性-隨機對照試驗(未發表). 2004年四川大學學位論文數據庫.
9.	陳世耀, 王吉耀, 朱疇文, 等. 莫沙必利治療功能性消化不良的隨機雙盲對照研究. 中華流行病學雜志, 2004; 25(2): 165~168.
10.	徐建舫, 呂文, 吳緬. 莫沙必利治療功能性消化不良28例. 杭州醫學高等專科學校學報, 2002; 23(4): 158~159.
11.	李兆申, 鄒多武, 許國銘, 等. 枸櫞酸莫沙必利片治療功能性消化不良的臨床研究. 第二軍醫大學學報, 2002; 23(4): 387~390.
12.	傅永平, 陳龍根. 莫沙必利與西沙必利治療功能性消化不良的療效觀察. 紹興文理學院學報, 2003; 23(8): 25~27.
13.	馮常煒, 趙影影, 李振峰, 等. 枸櫞酸莫沙必利治療功能性消化不良臨床雙盲對照研究. 鄭州大學學報 (醫學版), 2004; 39(6): 1054~1056.
14.	李見春, 安保國, 許崇德, 等. 莫沙必利治療功能性消化不良. 中國新藥與臨床雜志, 2001; 20(2): 150~151.
15.	郭煥偉. 莫沙必利治療非潰瘍性消化不良療效觀察. 山東醫藥, 2003; 43(1): 67.
16.	徐麗姝, 麥韻萍, 張瑛華. 莫沙必利治療老年人功能性消化不良200例療效分析. 實用醫學雜志, 2004; 20(7): 842~843.
17.	許國銘. 非潰瘍性消化不良專題研討會紀要. 解放軍醫學雜志, 1992; 17(1): 68.
18.	陳墾, 梁堅, 麥海妍, 等. 莫沙必利治療功能性消化不良102例. 醫藥導報, 2003; 22(6): 394~396.
19.	Xu GM. Summary of the symposium on non-ulcer dyspepsia. Medical Journal of Chinese People’s Liberation Army, 1992; 17(1): 68.
20.	Talley NJ, Svanghellini V, Heading KC, et al. Functional gastroduodenal disorders. Gut, 1999; 45(suppl Ⅱ): 37–42.
21.	Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 4.2.4 [updated March 2005]. In: The Cochrane Library, Issue 2, 2005.
22.	Chen K, Liang J, Mai HY, et al. Treatment of 102 cases of functional dyspepsia with mosapride. Herald of Medicine, 2003; 22(6): 394–396.
23.	Tan YH. The clinical observation of mosapride for functional dyspepsia. Morden Medicine and Health, 2004; 20(11): 968–969.
24.	Xu JM, Hu NZ, Xie HJ, et al. A randomized controlled double-blind trial of mosapride for functional dyspepsia. Basic Medical Sciences and Clinics, 2001; 21(sup): 54.
25.	Da SP, Zhao XY, Li YH, et al. RCT on the therapautical effect of mospride citrate in functional dyspepsia. Acta Academiae Medicinae Militaris Tertiae, 2001; 23(5): 593–595.
26.	Li GN, He CX. The clinical observation of mosapride for functional dyspepsia. Journal of Henan University (Medical Science), 2003; 22(1): 40–41.
27.	Huang YD, Fu LM. The clinical observation of mosapride for functional dyspepsia. West China Journal of Pharmaceutical Sciences, 2001; 16(4): 317.
28.	Wang ZH, Da SP, Gong NP, et al. Mosapride in treating functional dyspepsia: a multicenter, double-blind study. Chinese Journal of New Drugs and Clinical Remedies, 2000; 19(5): 363–366.
29.	Zhao XH, Hu JG, Bai DL. The clinical study of mosapride citrate for functional dyspepsia. Journal of Ningxia Medical College, 2003; 25(6): 431–432.
30.	Ma LQ. Mosapride and domperidone for functional dyspepsia: a randomized controlled trial (unpublished). 2004 Sichuan University Dissertation Database.
31.	Chen SY, Wang JY, Zhu CW, et al. A randomized controlled multi-center clinical trial on mosapride in the treatment of functional dyspepsia. Chinese Journal of Epidemiology, 2004; 25(2): 165–168.
32.	Hallerback BI, Bommelaer G, Bredberg E, et al. Dose finding study of mosapride in functional dyspepsia: a placebo-controlled, randomized study. Aliment Pharmacol Ther, 2002; 16: 959–967.
33.	Xu JF, Lv W, Wu M. 28 cases with functional maldigestion treated with mosapride. Journal of Hangzhou Medical College, 2002; 23(4): 158–159.
34.	Li ZS, Zou DW, Xu GM, et al. Effect of mosapride citrate on functional dyspepsia. Academic Journal of Second Military Medical University, 2002; 23(4): 387–390.
35.	Fu YP, Chen LG. Efficacy of mosapride and cisapride for functional dyspepsia. Journal of Shaoxing University, 2003; 23(8): 25–27.
36.	Feng CW, Zhao YY, Li ZF, et al. Double-blind clinical study on mosapride treatment to functional dyspepsia. Journal of Zhengzhou University (Medicine Sciences), 2004; 39(6): 1054–1056.
37.	Li JC, An BG, Xu CD, et al. Mosapride for functional dyspepsia. Chinese Journal of New Drug and Clinical Remedies, 2001; 20(2): 150–151.
38.	Guo HW. The efficacy of mosapride for non-ulcer dyspepsia. Shandong Medical Journal, 2003; 43(1): 67.
39.	Xu LZ, Mai YP, Zhang YH. 200 cases of senile functional dyspepsia treated with mosapride. Journal of Practical Medicine, 2004; 20(7): 842–843.
40.	Dobrilla G, Comberlato M, Steele A, et al. Drug treatment of functional dyspepsia. J Clin Gastroenterol, 1989; 11(2): 169–177.
41.	Finney JS, Kinnersley N, Hughes M, et al. Meta-analysis of antiseceretory and gastrokinetic compounds in functional dyspepsia. J Clin Gastroenterol, 1998; 26(4): 312–320.
42.	Velhuyzen van Zanten SJO, et al. Drug treatment of functional dyspepsia: a systematic analysis of trial methodology with recommendations for design of future trials. Am J Gastroenterol, 1996; 91: 660–671.

1. 覃業宏. 莫沙必利治療功能性消化不良的臨床觀察. 現代醫藥衛生, 2004; 20(11): 968~969.
2. 許建明, 胡乃中, 謝惠君, 等. 枸櫞酸莫沙必利片治療功能性消化不良的隨機對照雙盲臨床試驗評價. 基礎醫學與臨床, 2001; 21(增刊): 54.
3. 達四平, 趙曉晏, 李宜輝, 等. 口服莫沙必利治療功能性消化不良的隨機對照試驗. 第三軍醫大學學報, 2001; 23(5): 593~595.
4. 李國恩, 賀聰霞. 貝絡納治療功能性消化不良的臨床觀察. 河南大學學報(醫學科學版), 2003; 22(1): 40~41.
5. 黃詠東, 苻林梅. 貝絡納治療功能性消化不良的臨床觀察. 華西藥學雜志, 2001; 16(4): 317.
6. 王振華, 達四平, 龔能平, 等. 莫沙必利治療功能性消化不良多中心雙盲對照研究. 中國新藥與臨床雜志, 2000; 19(5): 363~366.
7. 趙曉紅, 胡建國, 白東莉. 枸櫞酸莫沙必利治療功能性消化不良的臨床觀察. 寧夏醫學院學報, 2003; 25(6):431~432.
8. 馬嵐清. 莫沙必利和嗎叮啉治療功能性消化不良的療效和安全性-隨機對照試驗(未發表). 2004年四川大學學位論文數據庫.
9. 陳世耀, 王吉耀, 朱疇文, 等. 莫沙必利治療功能性消化不良的隨機雙盲對照研究. 中華流行病學雜志, 2004; 25(2): 165~168.
10. 徐建舫, 呂文, 吳緬. 莫沙必利治療功能性消化不良28例. 杭州醫學高等專科學校學報, 2002; 23(4): 158~159.
11. 李兆申, 鄒多武, 許國銘, 等. 枸櫞酸莫沙必利片治療功能性消化不良的臨床研究. 第二軍醫大學學報, 2002; 23(4): 387~390.
12. 傅永平, 陳龍根. 莫沙必利與西沙必利治療功能性消化不良的療效觀察. 紹興文理學院學報, 2003; 23(8): 25~27.
13. 馮常煒, 趙影影, 李振峰, 等. 枸櫞酸莫沙必利治療功能性消化不良臨床雙盲對照研究. 鄭州大學學報 (醫學版), 2004; 39(6): 1054~1056.
14. 李見春, 安保國, 許崇德, 等. 莫沙必利治療功能性消化不良. 中國新藥與臨床雜志, 2001; 20(2): 150~151.
15. 郭煥偉. 莫沙必利治療非潰瘍性消化不良療效觀察. 山東醫藥, 2003; 43(1): 67.
16. 徐麗姝, 麥韻萍, 張瑛華. 莫沙必利治療老年人功能性消化不良200例療效分析. 實用醫學雜志, 2004; 20(7): 842~843.
17. 許國銘. 非潰瘍性消化不良專題研討會紀要. 解放軍醫學雜志, 1992; 17(1): 68.
18. 陳墾, 梁堅, 麥海妍, 等. 莫沙必利治療功能性消化不良102例. 醫藥導報, 2003; 22(6): 394~396.
19. Xu GM. Summary of the symposium on non-ulcer dyspepsia. Medical Journal of Chinese People’s Liberation Army, 1992; 17(1): 68.
20. Talley NJ, Svanghellini V, Heading KC, et al. Functional gastroduodenal disorders. Gut, 1999; 45(suppl Ⅱ): 37–42.
21. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 4.2.4 [updated March 2005]. In: The Cochrane Library, Issue 2, 2005.
22. Chen K, Liang J, Mai HY, et al. Treatment of 102 cases of functional dyspepsia with mosapride. Herald of Medicine, 2003; 22(6): 394–396.
23. Tan YH. The clinical observation of mosapride for functional dyspepsia. Morden Medicine and Health, 2004; 20(11): 968–969.
24. Xu JM, Hu NZ, Xie HJ, et al. A randomized controlled double-blind trial of mosapride for functional dyspepsia. Basic Medical Sciences and Clinics, 2001; 21(sup): 54.
25. Da SP, Zhao XY, Li YH, et al. RCT on the therapautical effect of mospride citrate in functional dyspepsia. Acta Academiae Medicinae Militaris Tertiae, 2001; 23(5): 593–595.
26. Li GN, He CX. The clinical observation of mosapride for functional dyspepsia. Journal of Henan University (Medical Science), 2003; 22(1): 40–41.
27. Huang YD, Fu LM. The clinical observation of mosapride for functional dyspepsia. West China Journal of Pharmaceutical Sciences, 2001; 16(4): 317.
28. Wang ZH, Da SP, Gong NP, et al. Mosapride in treating functional dyspepsia: a multicenter, double-blind study. Chinese Journal of New Drugs and Clinical Remedies, 2000; 19(5): 363–366.
29. Zhao XH, Hu JG, Bai DL. The clinical study of mosapride citrate for functional dyspepsia. Journal of Ningxia Medical College, 2003; 25(6): 431–432.
30. Ma LQ. Mosapride and domperidone for functional dyspepsia: a randomized controlled trial (unpublished). 2004 Sichuan University Dissertation Database.
31. Chen SY, Wang JY, Zhu CW, et al. A randomized controlled multi-center clinical trial on mosapride in the treatment of functional dyspepsia. Chinese Journal of Epidemiology, 2004; 25(2): 165–168.
32. Hallerback BI, Bommelaer G, Bredberg E, et al. Dose finding study of mosapride in functional dyspepsia: a placebo-controlled, randomized study. Aliment Pharmacol Ther, 2002; 16: 959–967.
33. Xu JF, Lv W, Wu M. 28 cases with functional maldigestion treated with mosapride. Journal of Hangzhou Medical College, 2002; 23(4): 158–159.
34. Li ZS, Zou DW, Xu GM, et al. Effect of mosapride citrate on functional dyspepsia. Academic Journal of Second Military Medical University, 2002; 23(4): 387–390.
35. Fu YP, Chen LG. Efficacy of mosapride and cisapride for functional dyspepsia. Journal of Shaoxing University, 2003; 23(8): 25–27.
36. Feng CW, Zhao YY, Li ZF, et al. Double-blind clinical study on mosapride treatment to functional dyspepsia. Journal of Zhengzhou University (Medicine Sciences), 2004; 39(6): 1054–1056.
37. Li JC, An BG, Xu CD, et al. Mosapride for functional dyspepsia. Chinese Journal of New Drug and Clinical Remedies, 2001; 20(2): 150–151.
38. Guo HW. The efficacy of mosapride for non-ulcer dyspepsia. Shandong Medical Journal, 2003; 43(1): 67.
39. Xu LZ, Mai YP, Zhang YH. 200 cases of senile functional dyspepsia treated with mosapride. Journal of Practical Medicine, 2004; 20(7): 842–843.
40. Dobrilla G, Comberlato M, Steele A, et al. Drug treatment of functional dyspepsia. J Clin Gastroenterol, 1989; 11(2): 169–177.
41. Finney JS, Kinnersley N, Hughes M, et al. Meta-analysis of antiseceretory and gastrokinetic compounds in functional dyspepsia. J Clin Gastroenterol, 1998; 26(4): 312–320.
42. Velhuyzen van Zanten SJO, et al. Drug treatment of functional dyspepsia: a systematic analysis of trial methodology with recommendations for design of future trials. Am J Gastroenterol, 1996; 91: 660–671.

《中國循證醫學雜志》

莫沙必利治療功能性消化不良的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

《中國循證醫學雜志》

莫沙必利治療功能性消化不良的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料