Objective To evaluate the clinical effectiveness of helicobacter pylori (HP) eradication in treating functional dyspepsia (FD) patients with HP infection. Methods The randomized controlled trials (RCTs) about HP eradication vs. general treatment for FD patients published by April, 2012 were searched in the following databases: CBM, CNKI, WanFang Data, PubMed, Ovid, EMbase and The Cochrane Library (Issue 1, 2012). According to the inclusion and exclusion criteria, two reviewers independently screened studies, extracted data, and evaluated the methodological quality. Then the meta-analysis was conducted using RevMan 5.1 software. Results The total 14 RCTs were included. Among all 2 665 patients involved in, 1 339 were in the treatment group, while the other 1 326 were in the control group. The results of meta-analysis showed that HP eradication was superior to general treatment for FD patients in clinical effects (RR=3.90, 95%CI 3.08 to 4.94, Plt;0.000 01), symptomatic score (WMD=−1.68, 95%CI −1.88 to −1.47, Plt;0.000 01), and improvement of upper abdominal pain (RR=2.84, 95%CI 2.02 to 3.99, Plt;0.000 01). Conclusion With obviously clinical effects, HP eradication can decrease the symptomatic score of dyspepsia, and especially improve upper abdominal pain. For the quality and quantity limitations of the included studies, more well-designed and double blind RCTs are required to further prove this conclusion.
Objective To provide evidence of the role of helicobacter pylori eradication in the treatment of functional dyspepsia. Methods We searched VIP, CBMdisc, MEDLINE and The Cochrane Library for systematic reviews, meta-analysis, randomized controlled trials and clinical guidelines involving helicobacter pylori and functional dyspepsia, so as to provide the best evidence for clinical practice. Results We included two systematic reviews, one meta-analysis and eleven randomized controlled trials. The evidence identified showed that helicobacter pylori infection was more prevalent in functional dyspepsia than in asymptomatic patients, but the effect of H pylori infection in the pathogenesis of functional dyspepsia remained controversial. H pylori eradication therapy had a relatively weak effect in H pylori positive functional dyspepsia. An economic model suggested that this modest benefit may still be cost-effective, but more studies are needed to assess this. Conclusion According to the current evidence, it can be concluded that helicobacter pylori eradication for the treatment of functional dyspepsia should be individualized.
Objective To assess the efficacy and safety of Chinese herbal medicine for the treatment of functional dyspepsia (FD) and compare the difference of efficacy between Chinese herbal medicine and western medicine. Methods Based on the principles and methods of Cochrane systematic reviews, we searched the Cochrane Central Register of Controlled Trials, MEDLINE, CBMdisc and CNKI from inception to Dec. 2008. And we also handsearched relevant journals and conference proceedings. We evaluated the risk of bias in the included randomized controlled trials(RCTs) according to the Cochrane Handbook for Systematic Reviews. The Cochrane Collaboration’s software RevMan 4.2.8 was used for meta-analysis. Results Seven studies involving 981 patients were identified. The results of meta-analysis showed that: (1) There was no significant difference between Dalitong granule and cisaprid in effective rates (RR=1.03, 95%CI 0.97 to 1.09, P=0.36), piman syndrome (RR=1.06, 95%CI 0.96 to 1.18, P=0.23), gastric emptying function (RR=1.05, 95%CI 0.76 to 1.45, P=0.78), syndromes of TCM (WMD=0.41, 95%CI –1.05 to 1.87, P=0.58), pulse and tongue picture (RR=1.00, 95%CI 0.69 to 1.45, P=0.98), and adverse reaction (RR=1.00, 95%CI 0.69 to 1.45, P=0.46). (2) There was no significant difference between Weishuan pellet and cisaprid on effective rates (RR=1.02, 95%CI 0.96 to 1.07, P=0.53), piman syndrome (RR=1.06, 95%CI 0.97 to 1.15, P=0.19), gastric emptying function (RR=1.05, 95%CI 0.86 to 1.28, P=0.63), syndromes of TCM (WMD=0.70, 95%CI 0.11 to 1.29, P=0.02) and adverse reaction (RR=0.33, 95%CI 0.02 to 5.28, P=0.44). (3) There was no significant difference among Jianpiyiqi prescription (RR=1.16, 95%CI 1.00 to 1.34, P=0.05), Liqifuwei oral liquid (RR=1.00, 95%CI 0.91 to 1.11, P=0.94) and Jianpixiaozhang granules (RR=0.88, 95%CI 0.76 to 1.00, P=0.06) compared with cisaprid in effective rates (Pgt;0.05). (4) There was no significant difference between Hewei Xiaopi Capsule and domperidone on effective rates (RR=1.11, 95%CI 0.87 to 1.41, P=0.42) and piman syndrome (RR=1.07, 95%CI 0.93 to 1.24, P=0.35). Conclusion Chinese herbal medicine has a better clinical cure rate and marks of TCM syndrome on FD than western medicine. But we have no adequate evidence to confirm whether western medicine can be substituted by Chinese herbal medicine for the treatment of FD. Therefore, we need more high quality RCTs to confirm this conclusion.
Objective To systematically evaluate the effectiveness and safety of itopride vs. mosapride in patients with functional dyspepsia, so as to provide references for clinical practice. Methods According to strict inclusive and exclusive criteria, relevant randomized controlled trials (RCTs) on itopride vs. mosapride for functional dyspepsia were searched in CENTRAL, Medline, Embase, ISI, OVID, CBM, VIP, WanFang Data and CNKI from the date of their establishment to November 2011. Two reviewers independently screened literature, extracted data and evaluated methodological quality. Meta-analyses were conducted using Revman 5.1 software. Results A total of 4 trials involving 363 patients were included and data were coped with meta-analysis. a) About the improvement of overall symptoms: itopride was not superior to mosapride, with no significant difference (OR=1.62, 95%CI 0.53 to 4.93, P=0.4); b) About the improvement of single symptom: itopride was not superior to mosapride in improving single symptom as follows: postprandial fullness, upper abdominal distention, poor appetite, and upper abdominal pain, with no significant difference; and c) About the incidence of adverse events: itopride was similar to mosapride (OR=0.63, 95%CI 0.31 to 1.29, P=0.21). Conclusion Current evidence shows that itopride is similar to mosapride in effectively improving overall symptoms and single symptom, and it has fewer side effects than mosapride does. Due to the low quality of most included studies, more strictly-designed and large-scale RCTs are needed to provide reasonable proofs for clinic.
Objective To determine the effectiveness and safety of mosapride in patients with functional dyspepsia. Methods Trials were located through electronic searches of the Cochrane Central Register of Controlled Trails (CENTRAL) ( Issue 2, 2006), MEDLINE (1978 to Jun. 2006), EMbase (1978 to Jun.2006), ISI (2000 to Jun.2006), OVID Database (1978 to Jun.2006), Chinese Biological Medicine Database (1978 to Jun.2006), Chinese VIP Database (1994 to Jun.2006) and WANFANG Database ( 1978 to Jun.2006). We also checked the bibliographies of retrieved articles and handsearched four kinds of important journals. Results Total of 18 trials involving 2 929 patients were included in the meta-analyses. These showed: (1) remission rate of global symptoms: Mosapride was not superior to placebo (RR 2.72, 95%CI 0.87 to 8.46), but was superior to metoclopramide (RR 1.66, 95%CI 0.82 to 3.35) and domperidone (RR 1.23, 95%CI 1.12 to 1.34); (2) remission rate of individual symptoms: 1) upper abdominal flatulence: Mosapride was superior to domperidone (RR 1.35, 95%CI 1.14 to 1.60), but was not superior to cisapride (RR 0.95, 95%CI 0.78 to 1.15); 2) postprandial fullness: Mosapride was superior to domperidone (RR 2.72, 95%CI 2.02 to 3.66), but was not superior to cisapride (RR 0.99, 95%CI 0.82 to 1.18); 3) upper abdominal pain: Mosapride was superior to domperidone (RR 1.27, 95%CI 1.07 to1.49), but was not superior to cisapride (RR 0.94, 95%CI 0.75 to 1.17); 4) early saciety: Mosapride was superior to domperidone (RR 1.42, 95%CI 1.15 to 1.76), but was not superior to cisapride (RR 0.98, 95%CI 0.82 to 1.17); 5) nausea: Mosapride was not superior to cisapride (RR 1.07, 95%CI 0.82 to 1.39) and domperidone (RR 1.12 ,95%CI 0.97 to 1.28); 6) vomitting: Mosapride was not superior to cisapride (P=0.80) and domperidone (RR 1.02, 95%CI 0.87 to 1.18); 7) eructation: Mosapride was superior to domperidone (RR 1.41, 95%CI 1.17 to 1.70), but was not superior to cisapride (RR 0.85, 95%CI 0.68 to 1.05); 8) anorexia: Mosapride was superior to domperidone (RR 1.22, 95%CI 1.20 to 1.44), but was not superior to cisapride (RR0.88, 95%CI 0.64 to 1.19); 9) sour regurgitation: Mosapride was not superior to domperidone (P=0.64) and cisapride (P=0.32); 10) heartburn: Mosapride was not superior to domperidone (RR 0.97, 95%CI 0.96 to 1.10) and cisapride (RR 1.05, 95%CI 0.90 to 1.21); 11) upper abdominal discomfort: Mosapride was not superior to cisapride (P =0.64); (3) adverse event rate: Mosapride had a good safety profile. Conclusions The limited current evidence shows that, mosapride is not superior to placebo in relieving global symptoms, but is superior to domperidone in relieving upper abdominal flatulence, postprandial fullness, upper abdominal pain, early saciety, erutation and anorexia. Mosapride has a good safety profile.
Objective To assess the effect and safety of Dalitong Granule in the treatment of the Piman syndrome (functional dyspepsia). Method The double-blind, double-dummy and randomized controlled method was adopted. 120 patients were randomized to the treatment group (n=90, Dalitong Granule 6 g, tid) and the control group (n=30, treated with cisapride 5 mg, tid). The therapeutic course for both groups was 2 weeks. Results All the results were analyzed on the basis of intention-to-treat and per-protocol population. In the treatment group, the markedly effective rates were 62.37% and 64.45% respectively. The effective rates were 99.55% and 96-67% respectively. In the control group, the markedly effective rates were 58-08% and 60.00% respectively. The effective rates were 90.33% and 93.33% respectively. There was no significant difference between two groups (Pgt;0.05). For effects on Piman syndrome, in the treatment group, the markedly effective rates were 53.76% and 55.56% respectively. The effective rates were 86.02% and 88.89% respectively. In the control group, the markedly effective rates were 48.38% and 50.00% respectively. The effective rates were 80.64% and 83.33% respectively. The results showed no statistical significance difference between two groups (Pgt;0.05). For effects on gastric emptying function (PP population), in the treatment group, the markedly effective rate and effective rate were 72.42% and 79.32%. In the control group those were 64.28% and 64.28%. There was no significant difference between the two groups (Pgt;0.05). ITT and PP analysis revealed similar results. No adverse effect was found in the observation. Conclusions Dalitong granule has the same clinical effect as cisapride with no obvious toxic-adverse effects.
【摘要】 目的 观察莫沙必利联合复方消化酶胶囊治疗功 能性消化不良的临床疗效和安全性。方法 2008年1月—2009年7月对62例功能 性消化不良患者随机分为两组,每组31例,两组均口服莫沙必利片,三餐饭前30 min服用5 mg;试验组加服复方消化酶胶囊,进餐后30 min服用1粒。4周后观察疗 效。结果 试验组治疗总有效率明显优于对照组,分别为87.1%和61.3%(Plt;0 05)。对上腹痛、餐后饱胀、早饱、上腹烧灼感症状改善情况进行比较,试验 组治疗前后的症状总积分及症状改善有效率与对照组比较差异有统计学意义( Plt;005),而且起效时间明显缩短。两组患者均未发现严重不良反应。结论 莫沙必利联合复方消化酶胶囊治疗功能性消化不良安全有效，其疗效明显优于 单用促动力药莫沙必利。
ObjectiveTo systematically review the efficacy and safety of Deanxit for functional dyspepsia (FD).MethodsCBM, WanFang Data, CNKI, PubMed, LWW and Web of Science databases were electronically searched to collect randomized controlled trials (RCTs) on Deanxit for FD from inception to June 30th, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed using StataSE 12.0 software.ResultsA total of 53 RCTs were included. The results of meta-analysis showed that compared with conventional gastrointestinal drugs, combined with Deanxit had higher total effective rate (RR=1.30, 95%CI 1.21 to 1.39, P<0.01) and higher incidence of adverse reactions (RR=1.23, 95%CI 1.03 to 1.47, P=0.026).ConclusionsThe current evidence shows that, compared with conventional gastrointestinal drugs or placebo alone, combined with Deanxit have higher total effective rate and higher incidence of adverse reactions. Due to limited quality of the included studies, more high quality studies are required to verify above conclusions.