摘要
尽管多潘立酮的l临床疗效已得到广泛评价，但很多研究样本量较小，缺乏代表性，且尚未明确以何种给药途径和给药剂量为宜。目的：对多潘立酮的临床应用进行系统评价。方法：联机检索Evidence-BasedMedicineReviews、BIOSISPrevieWs、EMBASEDrugs＆Pharmacology、OvidMEDLINE、CBM、CJFD、VIP、ChinaInfo和中国学位论文全文数据库．检索截止至2007．12．纳入比较多潘立酮与安慰剂的平行随机对照试验。应用RevMan4．2．8软件行荟萃分析。结果：共14篇文献进入本系统综述。荟萃分析显示多潘立酮改善总体症状的疗效优于安慰剂（RR=1．77，95％Ch1．30-2．42，P=O．0003），敏感性分析结果一致。亚组分析显示，多潘立酮改善功能性消化不良症状（RR=2．75，95％CI：1．27。5．95，P=0．叭）和婴幼儿恶心呕吐（RR=10．60，95％Ch3．17。35．46，P=-O．0001）的疗效优于安慰剂，但对预防术后恶心呕吐效果不佳（RR=1．12，95％CI：O．86。1．45，P!O．41）；口服给药（RR=2．51，95％CI：1．50-4．20，P=0．0005）优于静脉给药（RR=1．12，95％CI：0．86-1．45，P=0．41），大剂量El服给药（20mgtid。RR=4．67，95％Ch2．30-9．48，P〈0．0001）优于小剂量口服给药（10ingtid．RR=2．20，95％CI：O．77-6．27，P=0．14）。结论：本系统综述提示多潘立酮临床疗效肯定．以大剂量（20mgtid）口服给药为佳，但最适剂量仍值得商榷。
Although the clinical efficacy of domperidone has been widely evaluated, most studies have few samples and lack of representation, and the best medication approach and dosage are still uncertain. Aims： To systematically review the clinical application of domperidone. Methods： Databases including Evidence-Based Medicine Reviews, BIOSIS Previews, EMBASE Drugs ＆ Pharmacology, Ovid MEDLINE, CBM, GJFD, VIP, Chinalnfo, and Dissertation of China were retrieved electronically to identify the parallel design randomized controlled trials （RCTs）, which compared domperidone with placebo up to Dec. 2007. Meta-analysis was conducted with RevMan 4.2.8 software. Results： Fourteen RCTs fulfilling the criteria were involved. Meta-analysis indicated that domperidone was effective in ameliorating overall symptoms （RR=l.77, 95% CI： 1.30-2.42, P=0.0003）, and the result was confirmed by sensitivity analysis. [n subgroup analysis, it was demonstrated that domperidone could ameliorate functional dyspepsia symptoms （RR=2.75, 95% CI： 1.27-5.95, P=0.01） and infant nausea and vomiting （RR=10.60, 95% CI： 3.17-35.46, P=0.0001）, but had no effect on postoperative nausea and vomiting （RR=I.12, 95% CI： 0.86-1.45, P=0.41）. Oral administration （RR=2.51, 95% CI： 1.50- 4.20, P=0.0005） was better than intravenous administration （RR=I.12, 95% CI： 0.86-1.45, P=0.41）, and high dose （20 mg tid, RR=4.67, 95% CI： 2.30-9.48, P〈0.0001） was better than low dose （10 mg tid, RR=2.20, 95% CI： 0.77-6.27, P=0.14）. Conclusions： This systematic review confirmed the remarkable clinical efficacy of domperidone. Although the optimal medication dosage remains to be defined, oral administration of a higher dose （20 mg tid） might be a better choice.
出处
《胃肠病学》
2011年第4期226-230,共5页
Chinese Journal of Gastroenterology
基金
"十一五"国家科技支撑计划项目(2007BAI04B01)
杨森科学研究基金资助
