Karunanayake Amaranath, Devanarayana Niranga M, de Silva Asita, Gunawardena Sampath, Rajindrajith Shaman
Department of Physiology, Faculty of Medicine, University of Ruhuna, Galle.
Department of Physiology.
J Pediatr Gastroenterol Nutr. 2018 May;66(5):725-731. doi: 10.1097/MPG.0000000000001819.
The aim of the study was to evaluate the therapeutic effect of domperidone on children with abdominal pain predominant functional gastrointestinal disorders (AP-FGIDs).
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.
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.
Domperidone may be a safe and effective therapeutic modality to achieve a lasting remission of symptoms in children with AP-FGIDs.
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。
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。
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。
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。