Portincasa Piero, Mearin Fermin, Robert Marta, Plazas M Josep, Mas Marta, Heras Joan
Departamento de Medicina Interna y Salud Pública, Facultad de Medicina, Universidad de Bari, Bari, Italy.
Gastroenterol Hepatol. 2009 Dec;32(10):669-76. doi: 10.1016/j.gastrohep.2009.06.013. Epub 2009 Oct 9.
Functional dyspepsia is a highly common disorder. The physiopathological mechanisms of this entity are not yet completely known and prokinetic drugs seem to be useful. The aim of this study was to evaluate the prokinetic effect of cinitapride in patients with dysmotility-like dyspepsia and delayed gastric emptying.
Nineteen patients were randomized to receive 1mg of an oral solution of cinitapride t.i.d or placebo for 4 weeks in two consecutive periods, following a crossover and double-blind design. The main variable was the mean change from baseline after 4 weeks of treatment in gastric-emptying half-time after a liquid test meal, measured by real-time ultrasonography.
At the end of treatment, the mean gastric-emptying half-time decreased with both treatments, with no statistically significant differences between them (ANOVA, p=0.8720). This decrease was greater for cinitapride than for placebo (ANOVA, p=0.0169) in patients with mild-to-moderate delayed gastric emptying. In this group of patients, cinitapride was also superior to placebo in the percentage AUC of the antral area and the percentage of days free of nausea. Cinitapride was well tolerated, with a safety profile comparable to that of placebo.
Oral cinitapride is safe and effective in improving gastric emptying and symptoms in patients with dysmotility-like dyspepsia and mild-to-moderate delayed gastric emptying.
功能性消化不良是一种非常常见的疾病。该疾病的生理病理机制尚未完全明确,促动力药物似乎有效。本研究旨在评估西尼必利对动力障碍样消化不良和胃排空延迟患者的促动力作用。
19名患者采用交叉双盲设计,连续两个阶段随机接受每日三次、每次1mg西尼必利口服溶液或安慰剂治疗,为期4周。主要变量是液体试验餐后通过实时超声测量的治疗4周后胃排空半衰期相对于基线的平均变化。
治疗结束时,两种治疗方法的胃排空半衰期均下降,两者之间无统计学显著差异(方差分析,p = 0.8720)。在轻度至中度胃排空延迟的患者中,西尼必利导致的下降幅度大于安慰剂(方差分析,p = 0.0169)。在这组患者中,西尼必利在胃窦面积的AUC百分比和无恶心天数百分比方面也优于安慰剂。西尼必利耐受性良好,安全性与安慰剂相当。
口服西尼必利对动力障碍样消化不良和轻度至中度胃排空延迟患者改善胃排空和症状是安全有效的。