Allescher H D, Böckenhoff A, Knapp G, Wienbeck M, Hartung J
II. Medizinische Klinik und Poliklinik, Technischen Universität München, Germany.
Scand J Gastroenterol. 2001 Sep;36(9):934-41. doi: 10.1080/003655201750305440.
Dyspeptic symptoms are commonly reported complaints in clinical practice and are mostly the result of functional disorders. Empirical treatment with histamine H2-receptor blockers or gastroprokinetics for 2-4 weeks has frequently been proposed as first line management of these patients. The clinical trials which support the use of these agents, show a high variation in clinical success rate and benefit of these treatments.
The available clinical trials were evaluated, pooled where appropriate and subjected to a meta-analysis with the principal goal to provide valid treatment recommendations for patients with non-ulcer dyspepsia. In the present meta-analysis 19 studies on gastroprokinetics (cisapride, domperidone) and 10 studies on histamine H2-receptor antagonists (cimetidine, ranitidine) were included.
Based on these studies, a total of 1540 patients were evaluated for histamine H2-receptor antagonists (verum n = 786, placebo n = 754) and 1235 patients for gastroprokinetics (verum n = 616, placebo n = 619). The probability for treatment success compared to placebo was 0.2026 (0.1261; 0.2791) for histamine H2-receptor antagonists and 0.4029 (0.3042; 0.5069) for gastroprokinetics.
Based on these data both treatments are significantly more effective than placebo in the symptomatic treatment of non-ulcer dyspepsia, with gastroprokinetics (cisapride, domperidone) being more effective than histamine H2-receptor antagonists (cimetidine, ranitidine).
消化不良症状是临床实践中常见的主诉，大多是功能紊乱的结果。组胺H2受体阻滞剂或促胃肠动力药进行2 - 4周的经验性治疗常被提议作为这些患者的一线治疗方法。支持使用这些药物的临床试验显示，这些治疗的临床成功率和益处差异很大。
对现有的临床试验进行评估，在适当情况下进行汇总，并进行荟萃分析，主要目的是为非溃疡性消化不良患者提供有效的治疗建议。本次荟萃分析纳入了19项关于促胃肠动力药（西沙必利、多潘立酮）的研究和10项关于组胺H2受体拮抗剂（西咪替丁、雷尼替丁）的研究。
基于这些研究，共有1540例患者接受了组胺H2受体拮抗剂评估（试验组n = 786，安慰剂组n = 754），1235例患者接受了促胃肠动力药评估（试验组n = 616，安慰剂组n = 619）。与安慰剂相比，组胺H2受体拮抗剂治疗成功的概率为0.2026（0.1261；0.2791），促胃肠动力药为0.4029（0.3042；0.5069）。
基于这些数据，两种治疗方法在非溃疡性消化不良的对症治疗中均显著优于安慰剂，促胃肠动力药（西沙必利、多潘立酮）比组胺H2受体拮抗剂（西咪替丁、雷尼替丁）更有效。
