Jin Man, Mo Yali, Ye Kaisheng, Chen Mingxian, Liu Yi, He Cao
Department of Medicine, Hangzhou Seventh People's Hospital, Zhejiang, China.
Hangzhou Wengjingtang Combination of Chinese Traditional and Western Medicine Clinic, Zhejiang, China.
Arch Med Sci. 2019 Jan;15(1):23-32. doi: 10.5114/aoms.2017.69234. Epub 2017 Jul 31.
Functional dyspepsia (FD) is typically treated with serotonin receptor (5-HT) agonists such as cisapride, mosapride, tegaserod and tandospirone citrate. However, there are conflicting efficacy data, possibly due to significant heterogeneity between studies. In this meta-analysis, we analyzed the efficacy and safety data from studies evaluating the efficacy of serotonin receptor agonists in patients with FD.
Relevant studies were selected from the Medline, Cochrane, EMBASE, and Google Scholar databases. The meta-analysis included 10 RCTs which evaluated the efficacy of serotonin receptor agonists in patients with FD (final total of 892 patients in the serotonin receptor agonist group, and 640 participants in the placebo group). The primary outcomes were the response rates and abdominal symptoms score. The Cochrane Collaboration's tool was used to assess risk. Sensitivity analysis was carried out using the leave-one-out approach.
Patients treated with serotonin receptor agonists had a significantly higher response rate compared to placebo-treated patients (pooled OR = 2.99; 95% CI: 1.15-7.77; = 0.025). Patients treated with serotonin receptor agonists had a significant improvement in symptom scores compared to the placebo group (pooled standardized mean difference = -0.43; 95% CI: -0.83 to -0.04; = 0.031). Sensitivity analysis indicated that the pooled estimates for abdominal symptom score might be affected by the Yeoh (1997) study.
Serotonin receptor agonists had a significantly higher efficacy compared to placebo in the treatment of FD.
功能性消化不良（FD）通常用5-羟色胺受体（5-HT）激动剂治疗，如西沙必利、莫沙必利、替加色罗和枸橼酸坦度螺酮。然而，疗效数据存在冲突，这可能是由于研究之间存在显著异质性。在这项荟萃分析中，我们分析了评估5-羟色胺受体激动剂对FD患者疗效的研究中的疗效和安全性数据。
从Medline、Cochrane、EMBASE和谷歌学术数据库中选择相关研究。该荟萃分析纳入了10项随机对照试验，这些试验评估了5-羟色胺受体激动剂对FD患者的疗效（5-羟色胺受体激动剂组最终共有892例患者，安慰剂组有640例参与者）。主要结局是缓解率和腹部症状评分。使用Cochrane协作工具评估风险。采用逐一剔除法进行敏感性分析。
与接受安慰剂治疗的患者相比，接受5-羟色胺受体激动剂治疗的患者缓解率显著更高（合并比值比=2.99；95%置信区间：1.15-7.77；P=0.025）。与安慰剂组相比，接受5-羟色胺受体激动剂治疗的患者症状评分有显著改善（合并标准化均数差=-0.43；95%置信区间：-0.83至-0.04；P=0.031）。敏感性分析表明，腹部症状评分的合并估计值可能受Yeoh（1997年）研究的影响。
在FD治疗中，5-羟色胺受体激动剂的疗效显著高于安慰剂。
