The impact of single-prophylactic antibiotic dministration on post-infection and outcome of endovascular aortic repair

Background It is unclear whether the efficacy of single prophylactic antibiotic administration has an impact on infection and death in patients with Aortic Dissection of Stanford B treated by Endovascular Aortic Repair(EVAR). Methods According to whether or not received antibiotics prophylaxis, patients were divided into two groups: the single prophylactic antibiotic group(Group A) and non-prophylactic antibiotic group(Group B). Procalcitonin(PCT) and other clinical data were obtained with follow-up for one year. Results A total of 201 patients were screened. Among which, 70 patients received single antibiotic administration and 131 patients did not.31(44.3%) patients had fever in group A while 81(61.8%) patients had fever in group B after EVAR(P=0.017).The PCT and C-reactive protein(CRP) were significantly different between the two group: 0.18 ± 0.31 vs. 0.76 ±1.18(ng/m L)(P=0. 000), 81.35 ± 31.83 vs. 105.02 ± 60.37(mg/m L)(P=0.000), respectively. By comparison of incidences of postoperative infection, 4(5.7%) patients were infected in Group A while 26(19.8%) patients were infected in Group B(P=0.007). In infected group, the PCT in group A was 1.04±0.82 while that in Group B was2.67±1.28(P=0.015). In non-infected group, the PCT in group A was 0.12±0.14 while that in Group B was 0.29±0.44(P=0.005). Finally, One-year mortality in group A was 2(2.9%) while that in Group B(P=0.037) was 15(11.5%). Conclusion Single prophylactic antibiotic administration can significantly reduce the incidences of postoperative infection and affect the prognosis after EVAR.     

High-fibre diet and Lactobacillus paracasei B21060 in symptomatic uncomplicated diverticular disease

AIM:To investigate in symptomatic uncomplicated diverticular disease the efficacy of symbiotics associated with a high-fibre diet on abdominal symptoms.METHODS:This study was a multicentre,6-mo randomized,controlled,parallel-group intervention with a preceding 4-wk washout period.Consecutive outpatients with symptomatic uncomplicated diverticular disease,aged 40-80 years,evaluated in 4 Gastroenter-ology Units,were enrolled.Symptomatic uncomplicated diverticular disease patients were randomized to two treatment arms A or B.Treatment A(n = 24 patients) received 1 symbiotic sachet Flortec(Lactobacillus paracasei B21060) once daily plus high-fibre diet for 6 mo.Treatment B(n = 21 patients) received high-fibre diet alone for 6 mo.The primary endpoint was regression of abdominal symptoms and change of symptom severity after 3 and 6 mo of treatment.RESULTS:In group A,the proportion of patients with abdominal pain 24 h decreased from 100% at baseline to 35% and 25% after 3 and 6 mo,respectively(P 0.001).In group B the proportion of patients with this symptom decreased from 90.5% at baseline to 61.9% and 38.1% after 3 and 6 mo,respectively(P = 0.001).Symptom improvement became statistically significant at 3 and 6 mo in group A and B,respectively.The proportion of patients with abdominal pain 24 h decreased from 60% to 20% then 5% after 3 and 6 mo,respectively in group A(P 0.001) and from 33.3% to 9.5% at both 3 and 6 mo in group B(P = 0.03).In group A the proportion of patients with abdominal bloating significantly decreased from 95% to 60% after 3 mo,and remained stable(65%) at 6-mo follow-up(P = 0.005) while in group B,no significant changes in abdominal bloating was observed(P = 0.11).After 6 mo of treatment,the mean visual analogic scale(VAS) values of both short-lasting abdominal pain(VAS,mean ± SD,group A:4.6 ± 2.1 vs 2.2 ± 0.8,P = 0.02;group B:4.6 ± 2.9 vs 2.0 ± 1.9,P = 0.03) and abdominal bloating(VAS,mean ± SD,group A:5.3 ± 2.2 vs 3.0 ± 1.7,P = 0.005;group B:5.3 ± 3.2 vs 2.3 ± 1.9,P = 0.006) decreased in both groups,whilst the VAS values of prolonged abdominal pain decreased in the Flortec group,but remained unchanged in the high-fibre diet group(VAS,mean ± SD,group A:6.5 ± 1.5 vs 4.5 ± 2.1,P = 0.052;group B:4.5 ± 3.8 vs 5.5 ± 3.5).CONCLUSION:A high-fibre diet is effective in relievingabdominal symptoms in symptomatic uncomplicated diverticular disease.This treatment may be implemented by combining the high-fibre diet with Flortec.     

Low-dose amitriptyline combined with proton pump inhibitor for functional chest pain

AIM:To investigate the efficacy of amitriptyline with proton pump inhibitor(PPI)for the treatment of functional chest pain(FCP).METHODS:This was a randomized,open-label trial investigating the addition of low dose amitriptyline(10 mg at bedtime)to a conventional dose of rabeprazole(20 mg/d)(group A,n = 20)vs a double-dose of rabeprazole(20 mg twice daily)(group B,n = 20)for patients with FCP whose symptoms were refractory to PPI.The primary efficacy endpoints were assessed by global symptom score assessment and the total number of individuals with > 50% improvement in their symptom score.RESULTS:The between-group difference in global symptom scores was statistically significant during the last week of treatment(overall mean difference;3.75 ± 0.31 vs 4.35 ± 0.29,the between-group difference;P < 0.001).Furthermore,70.6% of patients in group A had their symptoms improve by > 50%,whereas only 26.3% of patients in group B had a similar treatment response(70.6% vs 26.3%,P = 0.008).Specifically,patients in group A had a significantly greater improvement in the domains of body pain and general health perception than did patients in group B(52.37 ± 17.00 vs 41.32 ± 12.34,P = 0.031 and 47.95 ± 18.58 vs 31.84 ± 16.84,P = 0.01,respectively).CONCLUSION:Adding amitriptyline to a PPI was more effective than a double-dose of PPI in patients with FCP refractory to a conventional dose of PPI.     

Efficacy and safety of pegylated-interferon α-2a in hemodialysis patients with chronic hepatitis C

AIM： To evaluate the efficacy and safety of pegylated- interferon alpha-2a in hemodialysis patients with chronic hepatitis C. METHODS： Thirty-six hemodialysis patients with chronic hepatitis C were enrolled in a controlled and prospective study. All patients were treatment naive, positive tested for anti-HCV antibodies, and positive tested for serum HCV-RNA. Twenty-two patients received 135 μg peglyated-interferon α-2a weekly for 48 wk （group A）. The remaining patients were left untreated, eleven refused therapy, and three were not candidates for kidney transplantation and were allocated to the control group （group B）. At the end of the treatment biochemical and virological response was evaluated, and 24 wk after completetion of therapy sustained virological response （SVR） was assessed. Side effects were monitored.
RESULTS： Of 22 hemodialysis patients, 12 were male and 10 female, with a mean age of 35.2 ± 12.1 years. Virological end-of-treatment response was observed in 14 patients （82.4%） in group A and in one patient （7.1%） in group B （P = 0.001）. Sustained virological response was observed in 11 patients （64.7%） in group A and in one patient in group B （7.1%）. Biochemical response parameters normalized in 10/14 patients （71.4%） at the end of the treatment. ALT levels in group B were initially high in six patients and normalized in one of them （25%） at the end of the 48 wk. In five patients （22.7%） therapy had to be stopped at mo 4 due to complications of weakness, anemia, and bleeding.
CONCLUSION： SVR could be achieved in 64.7% of patients on hemodialysis with chronic hepatitis C by a treatment with peglyated-interferon α-2a. Group A had a significantly better efficacy compared to the control group B, but the side effects need to be concerned.     

Assessment of proximal gastric accommodation in patients with functional dyspepsia

Impaired gastric accommodation is one of the most important etiologic factors in the pathophysiology of functional dyspepsia.Ultrasound is a potential alternative method to study changes in gastric volume as a reflection of gastric accommodation.Ultrasound is suitable for patients because it is a non-invasive,easily repeated and non-radioactive procedure,and a previous study has demonstrated the feasibility of 3-dimensional ultrasound in examining functional dyspepsia.The brief article by Fan et al demonstrated that both the proximal gastric area and volume,measured by 2-and 3-dimensional ultrasound respectively,were significantly smaller in patients with functional dyspepsia than in healthy controls.These results are very interesting,but we raise the relevant point that it should have been mandatory to study both changes in gastric volume and their relationship with upper gastrointestinal symptoms in functional dyspepsia.In fact,the relationship between cardinal symptoms and several pathophysiologic mechanisms in functional dyspepsia remains a matter of debate.Moreover,further evaluation of distal gastric volume that has been previously implicated in the origin of functional dyspeptic symptoms is advisable.Therefore,impaired gastric accommodation does not serve as a clear marker of the cardinal symptoms experienced by patients with functional dyspepsia in daily life.     

Efficacy and safety of ecabet sodium on functional dyspepsia： A prospective, double-blinded, randomized, multi-center controlled trial

AIM: To compare ecabet sodium and cimetidine in relieving symptoms of functional dyspepsia. METHODS: We performed a multi-center, prospective, randomized, double-blinded controlled trial to compare the clinical efficacy of ecabet sodium and cimetidine in patients with functional dyspepsia. Two-hundred and seventy-two patients with dyspeptic symptoms fulfilling the Rome-II criteria were enrolled from 7 centers. In the study group (115 patients), 1.5 g ecabet sodium was given twice a day. In the control group (121 patients), 400 mg cimetidine was given twice a day. Symptoms and parameters of quality of life were analyzed at baseline, 3, 14, and 28 d after initiating the treatment. RESULTS: Two-hundred and thirty-six patients completed the clinical trial. After 4 wk of treatment, the rates of improvement in patients with dyspeptic symptoms were not different between two groups (77.4% in the ecabet group and 79.3% in the cimetidine group, respectively, P > 0.05). Likewise, the rates of symptomatic improvement were not different at 3 d and 14 d. The parameters of quality of life did not change significantly during the study period in both groups. There was no clinically significant adverse event in both groups. CONCLUSION: In patients with functional dyspepsia, ecabet sodium has similar clinical efficacy with cimetidine.     

Capsule oxymatrine in treatment of hepatic fibrosis due to chronic viral hepatitis:A randomized,double blind,placebo-controlled,multicenter clinical study

AIM:To evaluate the efficacy and safety of oxymatrine capsule in treatment of hepatic fibrosis in patients with chronic viral hepatitis. METHODS:It was a randomized,double blind,placebo- controlled,multicenter clinical study.One hundred and forty- four patients were divided into oxymatrine capsule group (group A)and placebo group(group B).The course was 52 wk.Patients were visited once every 12 wk and the last visit was at 12 wk after cessation of the treatment.All patients had liver biopsy before treatment,part of them had a second biopsy at the end of therapy.Clinical symptoms,liver function test,serum markers of hepatic fibrosis were tested.Ultrasound evaluation was performed before,during and at the end of therapy. RESULTS:One hundred and forty-four patients enrolled in the study.Of them 132 patients completed the study according to the protocol,49 patients had liver biopsy twice(25 patients in group A and 24 in group B).At the end of therapy,significant improvements in hepatic fibrosis and inflammatory activity based on Semi-quantitative scoring system(SSS)were achieved in group A.The total effective rate of the treatment was 48.00%,much higher than that of 4.17% in group B (P<0.05).Significant improvement in serum markers of hepatic fibrosis such as hyaluronic acid(HA)and type Ⅲ procollagenic peptide(P Ⅲ P)in group A was seen(P<0.05).The total effective rate of serum markers at the end of therapy in group A was 68.19%,much higher than that of 34.85% in group B(P<0.05).The total effective rate of noninvasive markers at the end of therapy in group A was 66.67%,much higher than that of 30.30% in group B(P<0.05).The rate of adverse events was similar in two groups. CONCLUSION:Oxymatrine capsule is effective and safe in treatment of hepatic fibrosis due to chronic viral hepatitis.     

Radiofrequency ablation of hepatocellular carcinoma in difficult locations:Strategies and long-term outcomes

AIM:To investigate the treatment strategies and longterm outcomes of radiofrequency ablation(RFA) of hepatocellular carcinoma(HCC) in difficult locations and to compare the results with non-difficult HCC.METHODS:From 2004 to 2012,a total of 470 HCC patients underwent ultrasound-guided percutaneous RFA.Among these HCC patients,382 with tumors located ≤ 5 mm from a major vessel/bile duct(n = 87),from peripheral important structures(n = 232) or from the liver capsule(n = 63) were regarded as difficult cases.There were 331 male patients and 51 female patients,with an average age of 55.3 ± 10.1 years old.A total of 235 and 147 patients had ChildPugh class A and class B liver function,respectively.The average tumor size was 3.4 ± 1.2 cm.Individual treatment strategies were developed to treat these difficult cases.During the same period,88 HCC patients with tumors that were not in difficult locations served as the control group.In the control group,74 patients were male,and 14 patients were female,with an average age of 57.4 ± 11.8 years old.Of these,62 patients and 26 patients had Child-Pugh class A and class B liver function,respectively.Regular follow-up after RFA was performed to assess treatment efficacy.Survival results were generated from Kaplan-Meier estimates,and multivariate analysis was performed using the Cox regression model.RESULTS:Early tumor necrosis rate in the difficult group was similar to that in the control group(97.6% vs 94.3%,P = 0.080).The complication rate in the difficult group was significantly higher than that in thecontrol group(4.9% vs 0.8%,P = 0.041).The followup period ranged from 6 to 116 mo,with an average of 28 ± 22.4 mo.Local progression rate in the difficult group was significantly higher than that in the control group(12.7% vs 7.1%,P = 0.046).However,the 1-,3-,5-,and 7-year overall survival rates in the difficult group were not significantly different from those in the control group(84.3%,54.4%,41.2%,and 29.9% vs 92.5%,60.3%,43.2%,and 32.8%,respectively,P = 0.371).Additionally,a multivariate analysis revealed that tumor location was not a significant risk factor for survival.CONCLUSION:There was no significant difference in long-term overall survival between the two groups even though the local progression rate was higher in the difficult group.     

Changes in patients' symptoms and gastric emptying after Helicobacter pylori treatment

AIM: To investigate the changes in clinical symptoms and gastric emptying and their association in functional dyspepsia(FD) patients.METHODS: Seventy FD patients were enrolled and divided into 2 groups Helicobacter pylori(H. pylori)-negative group(28 patients), and H. pylori-positive group(42 patients). Patients in the H. pylori-positive group were further randomly divided into groups: H. pylori-treatment group(21 patients) and conventional treatment group(21 patients). Seventy two healthy subjects were selected as the control group. The proximal and distal stomach area was measured by ultrasound immediately after patients took the test meal, and at 20, 40, 60 and 90 min; then, gastric half-emptying time was calculated. The incidence of symptoms and gastric half-emptying time between the FD and control groups were compared. The H. pylori-negative and conventional treatment groups were givenconventional treatment: domperidone 0.6 mg/(kg/d) for 1 mo. The H. pylori-treatment group was given H. pylori eradication treatment + conventional treatment: lansoprazole 30 mg once daily, clarithromycin 0.5 g twice daily and amoxicillin 1.0 g twice daily for 1 wk, then domperidone 0.6 mg/(kg/d) for 1 mo. The incidence of symptoms and gastric emptying were compared between the FD and control groups. The relationship between dyspeptic symptoms and gastric half-emptying time in the FD and control groups were analyzed. Then total symptom scores before and after treatment and gastric half-emptying time were compared among the 3 groups. RESULTS: The incidence of abdominal pain, epigastric burning sensation, abdominal distension, nausea, belching, and early satiety symptoms in the FD group were significantly higher than in the control group(50.0% vs 20.8%; 37.1% vs 12.5%; 78.6% vs 44.4%; 45.7% vs 22.2%; 52.9% vs 15.3%; 57.1% vs 19.4%; all P 0.05). The gastric half-emptying times of the proximal end, distal end, and the whole stomach in the FD group were slower than in the control group(93.7 ± 26.2 vs 72.0 ± 14.3; 102.2 ± 26.4 vs 87.5 ± 18.2; 102.1 ± 28.6 vs 78.3 ± 14.1; all P 0.05). Abdominal distension, belching and early satiety had an effect on distal gastric half-emptying time(P 0.05). Abdominal distension and abdominal pain had an effect on the gastric half-emptying time of the whole stomach(P 0.05). All were risk factors(odds ratio 1). The total symptom score of the 3 groups after treatment was lower than before treatment(P 0.05). Total symptom scores after treatment in the H. pylori-treatment group and H. pylori-negative group were lower than in the conventional treatment group(5.15 ± 2.27 vs 7.02 ± 3.04, 4.93 ± 3.22 vs 7.02 ± 3.04, All P 0.05). The gastric half-emptying times of the proximal end, distal end, and the whole stomach in the H. pylori-negative and H. pylori-treatment groups were shorter than in the conventional treatment group(P 0.05). CONCLUSION: FD patients have delayed gastric emptying. H. pylori infection treatment helps to improve symptoms of dyspepsia and is a reasonable choice for treatment in clinical practice.     

复方阿嗪米特治疗消化不良的自身对照多中心临床研究

目的 观察复方阿嗪米特肠溶片治疗消化不良的疗效和安全性.方法 观察北京8家医院消化科门诊的180例多潘立酮(10 mg/次,3次/d)治疗2周症状积分下降<30%的消化不良患者,根据引起消化不良症状的基础疾病分成胃肠疾病相关的消化不良(A组)和胆系疾病相关的消化不良(B组),使用复方阿嗪米特肠溶片治疗(2片/次,3次/d)2周,观察治疗前、后上腹胀、上腹痛或不适、食欲不振积分变化,计算有效率,同时观察记录不良事件.结果 A、B两组患者治疗后上腹胀、上腹痛或不适、食欲不振积分及总症状积分明显下降(P<0.01),各单项症状及总症状有效率均在84.9%和92.5%以上.1例患者于复方阿嗪米特治疗14 d时出现皮疹伴有瘙痒,3 d后皮疹消退,未遗留其他不适及检验异常.结论 复方阿嗪米特肠溶片可以有效缓解多潘立酮治疗无效的消化不良患者的上腹胀、上腹痛或不适、食欲不振症状,且安全性较好.     

黛力新联合复方阿嗪米特治疗功能性消化不良63例分析

目的观察黛力新联合复方阿嗪米特治疗功能性消化不良的临床疗效。方法将142例功能性消化不良患者随机分为两组:观察组63例,接受黛力新联合复方阿嗪米特治疗;对照组79例,仅接受复方阿嗪米特治疗。结果观察组治疗总有效率为100.0%;对照组为78.5%;观察组疗效显著优于对照组(P<0.01);两组不良反应发生率差异无统计学意义(P>0.05)。结论黛力新联合复方阿嗪米特治疗功能性消化不良疗效好,无明显不良反应,值得临床推广应用。     

复方阿嗪米特肠溶片治疗消化不良的多中心、随机、双盲、安慰剂平行对照临床研究

背景:复方阿嗪米特肠溶片(商品名:泌特)含阿嗪米特和多种消化酶,国外用于治疗慢性消化不良已有多年,但迄今为止在国内尚无多中心、随机、安慰剂平行对照研究.目的:评价应用复方阿嗪米特肠溶片治疗慢性消化不良的临床疗效、安全性和依从性.方法:采用多中心、随机、双盲、安慰剂平行对照临床研究.上海市11个临床中心共纳入消化不良患者203例,随机分为两组,资料完整并纳入统计分析者191例,治疗组86例,对照组105例.餐后分别立即服用复方阿嗪米特肠溶片或安慰剂2片,每日3次,疗程2周.治疗前后和治疗期间每天分别评估各消化不良症状的积分、药物副作用和患者的依从情况.结果:两组消化不良患者的年龄、性别、疾病类别和消化不良症状积分均有较好的匹配性,且均完成了研究规定的疗程.与对照组相比,治疗组治疗1周后各消化不良症状积分均小于对照组,腹胀、嘈杂和总症状积分显著下降(P<0.05);治疗2周后,除便秘症状(P=0.214)外,治疗组食欲不振、腹胀、腹痛、嗳气、恶心、嘈杂、腹泻症状和症状总积分均显著低于对照组(P均＜0.05).治疗1周和2周后,治疗组各消化不良症状积分和症状总积分改善率均显著高于对照组(P<0.0001).结论:复方阿嗪米特肠溶片治疗各种病因相关性消化不良安全有效,依从性好,无严重不良反应.     

荆花胃康胶丸对功能性消化不良疗效的观察

背景:功能性消化不良(FD)的发病机制还不十分清楚,目前尚缺乏令人满意的治疗方法。目的:评价荆花胃康胶丸对FD的治疗效果。方法:采用开放、随机、对照试验,60例FD患者随机分为两组,每组30例,分别予口服荆花胃康胶丸160mg,3次/d和多潘立酮10mg,3次/d。根据治疗前后胃排空试验结果和消化不良症状(上腹不适、餐后饱胀、早饱、上腹痛、烧心、反酸、嗳气、食欲不振)积分的比较,评估荆花胃康胶丸的疗效和安全性。结果:治疗后两组患者餐后2h胃排空率均有所提高,治疗前后胃排空率差异有统计学意义(荆花胃康胶丸组,P<0.05;多潘立酮组,P<0.01)。两组比较,多潘立酮组治疗后胃排空率较荆花胃康胶丸组显著提高,差异有统计学意义(P<0.05)。治疗后两组患者的症状总积分均较治疗前显著下降(P<0.01)。通过两组差值的比较,荆花胃康胶丸组餐后饱胀、上腹痛、嗳气的改善程度尤其优于多潘立酮组(P<0.01)。结论:荆花胃康胶丸治疗FD具有一定的疗效,在改善消化不良症状方面优于多潘立酮,并具有良好的安全性。     

舒肝解郁胶囊联合马来酸曲美布丁胶囊、复方阿嗪米特肠溶片治疗功能性消化不良疗效观察

目的 观察舒肝解郁胶囊联合马来酸曲美布丁、复方阿嗪米特肠溶片治疗功能性消化不良的疗效及安全性.方法 将确诊为功能性消化不良的120例患者随机分为2组,每组60例.治疗组给予口服舒肝解郁胶囊2粒,bid,马来酸曲美布丁胶囊100 mg,tid,复方阿嗪米特肠溶片100 mg,tid;对照组给予口服马来酸曲美布丁胶囊100...     

吗丁啉缓解消化不良症状的疗效观察——全国多中心、开放、前瞻性研究

目的评价吗丁啉（多潘立酮）2周治疗缓解消化不良症状的疗效，统计各种消化不良症状在门诊患者中的发生率；了解治疗过程中各种不良事件的发生率。方法选取2006年7月～2006年12月全国31个中心具有消化不良症状的门诊患者2067例，给予吗丁啉10mg，tid，餐前15～30min服用，连续用药2周。治疗1周、2周后对消化不良症状进行评分，记录治疗期间的合并用药、不良事件。结果患者基线时临床症状总积分为（14．49±6．70）分，中位数为14分。治疗1周和2周后总积分分别为（5．87±5．00）分和（1．97±3．08）分，中位数分别为5分和2分（P〈0．0001）。治疗1周和2周后的显效率分别为26．12％和71．65％，治疗2周效果优于1周，治疗2周末的总有效率为92．55％。患者主要症状的消失时间平均为4～8d（中位数），其中恶心和呕吐为4d，依次为食欲不振、上腹痛、早饱、嗳气、上腹胀。上腹胀的发生率最高，为90．37％，并且以中、重度者居多。其次是暖气（70．49％），以轻、巾度居多；依次为早饱（65．3％）、上腹痛（57．80％），食欲不振（48．99％）、恶心（33．37％）和呕吐（8．62％），均为轻度者居多。本研究共有26例受试者出现不良事件，占总例数的1．26％，其中23例为相关不良事件。在发生的23例相关不良事件中有5例为头晕，4例为溢乳。结论吗丁啉能够显著改善消化不良各项症状。2周治疗疗效显著优于1周治疗，提示消化不良促动力治疗应维持不少于2周。吗丁啉治疗消化不良安全性良好，不良事件发生率低。     

复方阿嗪米特联合莫沙必利对老年胃肠疾病相关性消化不良的疗效探讨

[目的]探讨复方阿嗪米特联合莫沙必利治疗老年胃肠疾病相关性消化不良的效果以及安全性。[方法]采用临床随机对照试验,将128例门诊就医的老年胃肠疾病相关性消化不良患者纳入本研究并分为复方阿嗪米特联合莫沙必利组(治疗组,66例),莫沙必利组(对照组,62例),2组疗程均为4周,观察2组治疗前后消化不良症状的改善以及药物副作用的情况。[结果]2组药物对改善消化不良症状均有疗效,治疗组疗效优于对照组(P0.01),2组均未观察到严重的药物相关性不良反应。[结论]复方阿嗪米特联合莫沙必利治疗老年胃肠疾病相关性消化不良疗效明显,安全性好,可在临床上推广使用。     

胃力康治疗功能性消化不良疗效观察

目的:观察胃力康治疗功能性消化不良(FD)的疗效.方法:50例符合FD患者随机分成胃力康(治疗)组26例和多潘立酮(对照)组24例,分别给予胃力康颗粒和多潘立酮,观察服药后2周和4周两组患者的疗效和不良反应.结果:2周时治疗组的显效率和有效率明显优于对照组(P＜0.01),4周时治疗组的显效率和有效率亦优于对照组(P＜0.05).治疗组在治疗过程中仅极少数患者出现大便次数增多或大便稀溏的现象,未发现肝肾功能损害和外周血象变化.结论:胃力康可作为治疗FD的常规用药,尤其适合于FD并发慢性便秘患者的治疗.     

多潘立酮联合阿米替林治疗功能性消化不良的meta分析

目的对多潘立酮联合阿米替林治疗功能性消化不良的疗效及安全性进行评价。方法计算机检索1991年01月01日至2014年06月01日中国学术期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方数据库(WANFANGDATA)、中国生物医学文献数据库(CBMdisc)、Pubmed数据库、Google Book Search等有关多潘立酮联合阿米替林治疗功能性消化不良的随机对照试验(RCT)文献,补充手工检索文献。应用Rev Man5.2软件对入选试验进行Meta分析。结果共8项随机对照试验符合入选标准,共743例功能性消化不良患者,其中接受多潘立酮联合阿米替林治疗共372例患者(试验组),371例患者单用多潘立酮治疗(对照组)。Meta分析结果显示试验组总体有效率(92.5%)明显高于对照组(74.9%,RR:1.23,95%CI:1.16~1.32,P0.000 01),上腹痛腹胀、恶心呕吐、烧心反酸等症状显效率(64.8%)也明显高于对照组(42.0%,RR:1.54,95%CI:1.34~1.77,P0.000 01)。两组不良反应发生率无统计学差异(RR:1.40,95%CI:0.71~2.78,P=0.33)。结论多潘立酮联合阿米替林治疗功能性消化不良疗效优于单用多潘立酮,安全性好,可以成为临床治疗功能性消化不良的一种较佳治疗方案。     

米曲菌胰酶片治疗消化不良症状的多中心、随机、安慰剂交叉对照临床研究

背景：米曲菌胰酶片是含有米曲菌酶和胰酶的口服双层包膜复合消化酶制剂，在国外用于治疗消化不良已有数十年．然而目前国内尚无米曲菌胰酶片治疗消化不良症状疗效和安全性的资料。目的：评价米曲菌胰酶片对中国人群消化不良症状的疗效和安全性。方法：采用多中心、随机、安慰剂交叉对照试验设计，在上海地区7个临床中心，对有消化不良症状的门诊患者先予安慰剂治疗1周，症状积分改善〈50％者中共有151例[男76例，女75例，年龄22～67岁，平均（44．67±6．46）岁]完成疗效观察研究，79例随机进入流程A（予米曲菌胰酶片2片tid，餐后立即服用，治疗2周；1周药物清洗期；再予安慰剂2片tid，餐后立即服用，治疗2周），72例进人流程B（予安慰剂2片tid，餐后立即服用，治疗2周；1周药物清洗期；再予米曲菌胰酶片2片tid，餐后立即服用，治疗2周）。分别于研究流程的第1、8、22、29和43d评估消化不良症状积分。结果：经米曲菌胰酶片治疗2周，患者消化不良症状总积分下降幅度与安慰剂相比差异有统计学意义（从27．64±1．77降至9．72±1．33对从23．99±1．28降至22．03±1．40，P〈0．01）。根据症状积分改善幅度．米曲菌胰酶片改善消化不良症状的效果依次为腹胀、腹泻、嗳气、腹痛、食欲不振和上腹部烧灼感。米曲菌胰酶片治疗消化不良症状的总有效率显著优于安慰剂（89．6％对21．7％，P〈0．01）。研究过程中无与研究药物相关的不良反应发生。结论：米曲菌胰酶片用于治疗中国人群的消化不良症状安全、有效。