·消化系统疾病用药专栏·曲美布汀联合莫沙必利治疗功能性消化不良113例*胡迎宾1,冯觉平2,彭娜1,吕飞1,郭秋霞1(华中科技大学同济医学院附属普爱医院1.消化内科;2.肿瘤内科,武汉430033)摘要目的观察曲美布汀联合莫沙必利治疗功能性消化不良的疗效和安全性。方法将功能性消化不良患者347例,随机分为曲美布汀组(治疗A组)和莫沙必利组(治疗B组)各116例,曲美布汀联合莫沙必利组(联合组)115例。治疗A组给予马来酸曲美布汀片0.2g,tid,饭后服;治疗B组给予枸橼酸莫沙必利片5mg,tid,饭前服;联合组给予马来酸曲美布汀片联合枸橼酸莫沙必利片,其中马来酸曲美布汀片每次0.2g,tid,饭后服,枸橼酸莫沙必利片每次5mg,tid,饭前服。3组患者疗程均为4周。评价各组症状改善指标和不良反应。结果347例入选患者中339例完成治疗和随访。联合组治疗4周后餐后饱胀不适、早饱感、上腹痛、上腹烧灼感、上腹胀和恶心症状总有效率分别为88.4%,76.9%,72.9%,61.8%,86.7%和81.7%,餐后饱胀不适、早饱感、上腹痛、上腹胀和恶心症状改善明显优于治疗A组和治疗B组(P<0.05)。3组上腹部烧灼感症状改善差异无统计学意义(P<0.05)。治疗A组、治疗B组和联合组治疗4周后总体症状总有效率分别为60.2%,61.1%,78.8%,联合组显著优于其他两组(P<0.05)。治疗A组、治疗B组和联合组总不良反应发生率分别为1.8%,0.9%和1.8%(P=0.776),均较轻。结论曲美布汀联合莫沙必利可明显改善功能性消化不良患者的症状,且不良反应少。关键词曲美布汀;莫沙必利;消化不良,功能性中图分类号R57;R975文献标识码A文章编号1004-0781(2014)07-0887-04EfficacyofTrimebutineCombinedwithMosaprideonFunctionalDyspepsiaHUYing-bin1,FENGJue-ping2,PENGNa1,LVFei1,GUOQiu-xia1(1.DepartmentofGastroenterology;2.DepartmentofOncology,thePu'aiHospitalAffiliatedtoTongjiMedicalCollege,HuazhongUniversityofScienceandTechnology,Wuhan430033,China)ABSTRACTObjectiveToevaluatetheefficacyandsafetyoftrimebutinecombinedwithmosaprideonfunctionaldyspepsia.MethodsPatientswithfunctionaldyspepsiawererandomlydividedintothreeclinicalgroups.GroupA(n=116)received0.2gtrimebutineaftermeal,groupthedrugcombinationB(n=116)received5mgmosapridebeforemeal,andthedrugcombinationgroup(n=115)received0.2gtrimebutineaftermealplus5mgmosapridebeforemeal.Allmedicationsweretakenorallythreetimesdailyfor4weeks.Improvementinclinicalsymptomsandadversereactionsineachgroupwereevaluatedattheendofstudy.ResultsAtotalof339patientsamong347enrolleescompletedthetreatmentandfollow-up.Theclinicalefficacyonpostprandialfullness,earlysatiation,epigastricpain,epigastricburning,upperabdominalbloatingandnauseawere88.4%,76.9%,72.9%,61.8%,86.7%and81.7%,respectivelyinthedrugcombinationgroupafter4-weektreatment,whichweresuperiortothoseingroupAorB(P<0.05)exceptforepigastricburning.Thetotaleffectiverateofthedrugcombinationgroupwas78.8%,significantlyhigherthantheothertwogroups(P<0.05).Thetotalincidenceofsideeffectsinthedrugcombinationgroupwas1.8%,similartothatofgroupAandB(1.8%and0.9%,respectively,P=0.776).ConclusionTrimebutinecombinedwithmosaprideissafeandeffectiveforimprovingsymptomsinfunctionaldyspepsia.KEYWORDSTrimebutine;Mosapride;Dyspepsia,functional功能性消化不良(functionaldyspepsia,FD)是指具有餐后饱胀不适、早饱感、上腹痛、上腹烧灼感、上腹胀和恶心等不适症状,经检查排除引起上述症状的器质性疾病的一组临床综合征。目前FD的发病机制尚未清楚,可能与多种因素有关,包括动力障碍、内脏感觉收稿日期2014-01-23修回日期2014-02-25基金项目*武汉市卫生局临床科研项目(WX12C33)作者简介胡迎宾(1978―),男,湖北武汉人,副主任医师,博士,主要从事消化系统疾病和肝病的基础及临床研究。E-mail:huyingbin@163.com。过敏、胃酸分泌、炎症感染、内脏交感神经或副交感神经活动改变以及社会精神心理...
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