Hojo Mariko, Nagahara Akihito, Asaoka Daisuke, Takeda Tsutomu, Izumi Kentaro, Matsumoto Kohei, Ueyama Hiroya, Shimada Yuji, Matsumoto Kenshi, Nojiri Shuko, Watanabe Sumio
Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan.
Digestion. 2017;96(1):5-12. doi: 10.1159/000477345. Epub 2017 Jun 13.
BACKGROUND/AIMS: Acotiamide, a prokinetic drug, is used to treat functional dyspepsia (FD), especially postprandial distress syndrome (PDS). However, a treatment for FD patients with PDS and/or epigastric pain syndrome (EPS) has not been established. We investigated the efficacy of famotidine in combination with acotiamide for FD.
Fifty blindly randomized FD patients received placebo with acotiamide, or famotidine with acotiamide, for 4 weeks. Treatment efficacy was assessed by overall treatment effects (OTE), total, PDS and EPS symptom scores, and impairment of quality of life (QOL).
After OTE assessment, patients who felt affected by treatment comprised 40.9 and 57.9% of famotidine and placebo groups, respectively, after 4 weeks' treatment, with no significant difference between groups. A significant decrease was seen in total, PDS, and EPS symptom scores, and in QOL impairment, after 4 weeks' treatment compared with pretreatment scores for famotidine and placebo groups, but was not observed between groups. The proportion of patients showing a ≥50% decrease in EPS symptom scores was greater in the famotidine than that in the placebo group for every observation point, with the greatest difference observed after 2 weeks' treatment.
The effectiveness of famotidine and acotiamide combination therapy in FD was similar to the effectiveness of acotiamide therapy alone.
背景/目的:阿考替胺是一种促动力药物,用于治疗功能性消化不良(FD),尤其是餐后不适综合征(PDS)。然而,针对伴有PDS和/或上腹痛综合征(EPS)的FD患者的治疗方法尚未确立。我们研究了法莫替丁联合阿考替胺治疗FD的疗效。
50例FD患者被随机分为两组,分别接受阿考替胺联合安慰剂或阿考替胺联合法莫替丁治疗,为期4周。通过总体治疗效果(OTE)、总症状评分、PDS和EPS症状评分以及生活质量(QOL)受损情况来评估治疗效果。
经过OTE评估,治疗4周后,分别有40.9%和57.9%的法莫替丁组和安慰剂组患者感觉治疗有效,两组间无显著差异。与治疗前相比,法莫替丁组和安慰剂组治疗4周后总症状评分、PDS和EPS症状评分以及QOL受损情况均显著降低,但两组间无差异。在每个观察点,EPS症状评分下降≥50%的患者比例,法莫替丁组均高于安慰剂组,在治疗2周后差异最大。
法莫替丁与阿考替胺联合治疗FD的效果与单独使用阿考替胺治疗的效果相似。