Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan.
World J Gastroenterol. 2012 May 28;18(20):2517-25. doi: 10.3748/wjg.v18.i20.2517.
To evaluate the efficacy and safety of adjunctive mosapride citrate for bowel preparation before colonoscopy.
We conducted a randomized, double-blind, placebo-controlled study with mosapride in addition to polyethylene glycol (PEG)-electrolyte solution. Of 250 patients undergoing colonoscopy, 124 were randomized to receive 2 L PEG plus 15 mg of mosapride citrate (mosapride group), and 126 received 2 L PEG plus placebo (placebo group). Patients completed a questionnaire reporting the acceptability and tolerability of the bowel preparation process. The efficacy of bowel preparation was assessed by colonoscopists using a 5-point scale based on Aronchick's criteria. The primary end point was optimal bowel preparation rates (scores of excellent/good/fair vs poor/inadequate).
A total of 249 patients were included in the analysis. In the mosapride group, optimal bowel preparation rates were significantly higher in the left colon compared with the placebo group (78.2% vs 65.6%, P < 0.05), but not in the right colon (76.5% vs 66.4%, P = 0.08). After excluding patients with severe constipation, there was a significant difference in bowel preparation in both the left and right colon (82.4% vs 66.7%, 80.8% vs 67.5%, P < 0.05, P < 0.01). The incidence of adverse events was similar in both groups. Among the subgroup who had previous colonoscopy experience, a significantly higher number of patients in the mosapride group felt that the current preparation was easier compared with patients in the placebo group (34/72 patients vs 24/74 patients, P < 0.05).
Mosapride citrate may be an effective and safe adjunct to PEG-electrolyte solution that leads to improved quality of bowel preparation, especially in patients without severe constipation.
评估枸橼酸莫沙必利辅助聚乙二醇（PEG）电解质溶液行结肠镜检查前肠道准备的疗效和安全性。
我们进行了一项随机、双盲、安慰剂对照的研究，在 PEG-电解质溶液中加入枸橼酸莫沙必利。在 250 例行结肠镜检查的患者中，124 例患者被随机分为两组，分别接受 2 L PEG 加 15 mg 枸橼酸莫沙必利（莫沙必利组）和 2 L PEG 加安慰剂（安慰剂组）。患者完成了一份问卷，报告肠道准备过程的可接受性和耐受性。根据 Aronchick 标准，结肠镜医师采用 5 分制评估肠道准备的效果。主要终点是最佳肠道准备率（优秀/良好/一般与差/不充分的评分）。
共有 249 例患者纳入分析。在莫沙必利组，左半结肠的最佳肠道准备率明显高于安慰剂组（78.2%比 65.6%，P < 0.05），但右半结肠无显著差异（76.5%比 66.4%，P = 0.08）。排除严重便秘患者后，左、右半结肠的肠道准备均有显著差异（82.4%比 66.7%，80.8%比 67.5%，P < 0.05，P < 0.01）。两组不良反应发生率相似。在有结肠镜检查史的亚组中，莫沙必利组有更多的患者感觉当前的肠道准备比安慰剂组更容易（34/72 例比 24/74 例，P < 0.05）。
枸橼酸莫沙必利可能是一种有效且安全的 PEG-电解质溶液辅助药物，可改善肠道准备的质量，尤其是在无严重便秘的患者中。
