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多潘立酮治疗儿童功能性腹痛价值的随机对照临床试验

Randomized Controlled Clinical Trial on Value of Domperidone in Functional Abdominal Pain in Children.

作者信息

Karunanayake Amaranath, Devanarayana Niranga M, de Silva Asita, Gunawardena Sampath, Rajindrajith Shaman

机构信息

Department of Physiology, Faculty of Medicine, University of Ruhuna, Galle.

Department of Physiology.

出版信息

J Pediatr Gastroenterol Nutr. 2018 May;66(5):725-731. doi: 10.1097/MPG.0000000000001819.

Abstract

OBJECTIVES

The aim of the study was to evaluate the therapeutic effect of domperidone on children with abdominal pain predominant functional gastrointestinal disorders (AP-FGIDs).

METHODS

One hundred children (aged 5-12 years) fulfilling Rome III criteria for AP-FGIDs were randomized into 8 weeks of domperidone or placebo treatment. Primary outcomes defined were cure and patient-reported general improvement. Secondary outcomes were reduction in the severity of abdominal pain and increase in gastric motility. Patients were followed up for 6 months.

RESULTS

Eighty-nine (42 in placebo group, 47 in domperidone group) completed the trial at 8 weeks. Seventy-nine completed the 6-month follow-up. When primary outcomes were assessed at 8 weeks, 37 (74%) in the domperidone group and 25 (50%) in the placebo group showed patient-reported general improvement (P = 0.013), whereas no significant difference was observed in cure (22 [44%] vs 14 [28%] P = 0.09). At 6-month follow-up 30 (60%) in the domperidone group and 19 (38%) in the placebo group reported cure (P = 0.028), whereas 44 (88%) in the domperidone group and 33 (66%) in the placebo group showed patient-reported general improvement (P = 0.009). When assessing secondary outcomes at 8 weeks, the domperidone group reported significant reduction in the severity of abdominal pain (54.1% vs 24.7%, P = 0.008) and an increase in the antral motility index (27.5% vs 7.2%, P = 0.029). None of the patients reported intervention-related adverse effects.

CONCLUSIONS

Domperidone may be a safe and effective therapeutic modality to achieve a lasting remission of symptoms in children with AP-FGIDs.

摘要

目的

本研究旨在评估多潘立酮对以腹痛为主的儿童功能性胃肠病(AP-FGIDs)的治疗效果。

方法

100名符合罗马III标准的AP-FGIDs儿童(年龄5 - 12岁)被随机分为接受8周多潘立酮治疗组或安慰剂治疗组。定义的主要结局为治愈和患者报告的总体改善。次要结局为腹痛严重程度的降低和胃动力的增加。对患者进行6个月的随访。

结果

89名(安慰剂组42名,多潘立酮组47名)在8周时完成试验。79名完成了6个月的随访。在8周时评估主要结局时,多潘立酮组37名(74%)和安慰剂组25名(50%)患者报告总体改善(P = 0.013),而在治愈率方面未观察到显著差异(22名[44%]对14名[28%],P = 0.09)。在6个月随访时,多潘立酮组30名(60%)和安慰剂组19名(38%)报告治愈(P = 0.028),而多潘立酮组44名(88%)和安慰剂组33名(66%)患者报告总体改善(P = 0.009)。在8周时评估次要结局时,多潘立酮组报告腹痛严重程度显著降低(54.1%对24.7%,P = 0.008),胃窦动力指数增加(27.5%对7.2%,P = 0.029)。没有患者报告与干预相关的不良反应。

结论

多潘立酮可能是一种安全有效的治疗方式,可使AP-FGIDs儿童症状得到持久缓解。

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