| Objective1.To compare the influence of domperidone and mosapride on clinical symptoms in patients with functional dyspepsia(FD).2.To investigate the influence of domperidone and mosapride on the gastric electrophysiology in patients with FD.3.To explore the indication of prokinetics in the treatment of FD.Methods1.The symptom integral method was used to detect the effects of Domperidone(10mg tid)and Mosapride(5mg tid)on the FD patients.2.The HIT-IMG100 P bioimpedance gastric motility detector was used to detect the electrogastrogram(EGG)and impedance gastric motility(IGM)of FD patient.Results1.According to the Rome III,179 FD patients,at department of gastrointestinal of the First Affiliated Hospital of Chongqing Medical University From Aug.2015 to Dec.2016 were enrolled,aged 22-59 y,M:F=72:107,median age was 43 years.The subtype of EPS(n=55)、DPS(n=53)and DPS+EPS(n=71)were 30.73%,29.61% and 39.66%,respectively.2.After 4,6,8 weeks’ treatment with domperidone,the effective rate were 61.96%,67.39% and 68.48%,which was lower than those in mosapride group(63.22%,68.97%,70.11%),but with no statistical difference(P>0.05).The effective rate of the both groups after 4 weeks’ treatment were significantly increased(P<0.05),but had no statistical difference than those in 6 and 8 weeks’(P>0.05).3.After treatment with domperidone,the 4 weeks’ effective rate of patients in EPS(n=26),PDS(n=30)and EPS+PDS(n=36)were(57.69%,63.33%,63.89%),the 6,8 weeks’ of effective rate were(65.38%,66.67%,69.44%)and(65.38%,70.00,69.44%).The effective rate had no statistical difference among the three subtypes in the same treatment period(P>0.05).After treatment with mosapride,the 4 weeks’ effective rate of patients in EPS(n=29),PDS(n=23)and EPS+PDS(n=35)were(62.07%、65.22%、62.86%),the 6,8 weeks’ of that were(65.52%,69.57%,71.42%)and(68.97%,69.57%,71.42%).The effective rate had no statistical difference among the three subtypes in the same course of treatment(P>0.05).4.After four weeks treatment with domperidone,the percentages of the low frequency of EGG reduced [(32.02±1.55)% vs(36.19±6.06)%],the intermediate frequency[(53.90±1.54)% vs(51.70±5.11)%] and the high frequency[(14.08±3.86)% vs(12.11±3.45)%] was increased(P<0.05).In the 6 weeks treatment course,the percentages of the low frequency[(29.49±1.99)%] of EGG was further decreased,the intermediate frequency[(55.21±1.45)%] and the high frequency[(15.30±1.70)%] was much more increased(P<0.05).The percentages of the low frequency of EGG in mosapride group was significantly decreased [(32.39±1.66)% vs(35.93±5.72)%] after four weeks’ treatment,the intermediate frequency[(53.01±1.73)%vs(51.28±6.52)%] and the high frequency[(14.60±2.82)% vs(12.79±4.52)%] was increased(P<0.05).After treatment with mosapride for 6w,the percentages of the low frequency of EGG [(29.52±1.53)%] was significantly reduced,the intermediate frequency[(54.62±1.26)%] and the high frequency [(15.86±1.23)%] were markedly increased than those of 4w course of treatment(P<0.05).5.After treatment with domperidone for 4w,the percentages of the low frequency significantly reduced [(31.44±1.22)% vs(36.34±4.22)%],intermediate frequency [(53.78±1.78)% vs(50.81±3.81)%] and the high frequency[(14.78±1.12)% vs(12.85±1.33)%] of IGM was markedly increased(P<0.05).After treatment with mosapride for 4w,the percentages of the low frequency[(32.06±1.53)% vs(36.82±5.53)%] reduced,intermediate frequency [(53.56±1.25)% vs(50.46±3.82)%] and the high frequency[(14.38.±1.43)% vs(12.72±3.82)%] of IGM in FD was markedly increased(P<0.05).6.According to the normal reference value of EGG of our previous study,after treatment with domperidone,the 4 weeks’ effective rate of patients in slow EGG group(n=38),normal EGG group(n=21)and fast EGG group(n=33)were 73.68%,57.14%,51.52%;the 6,8 weeks’ of that were(78.95%,61.90%,57.58%),(81.58%,61.90%,57.58%),respectively.After treatment with mosapride,the 4 weeks’ effective rate of patients in slow EGG group(n=39),normal EGG group(n=18)and fast EGG group(n=30)were 76.92%,55.56%,50.00%.The 6,8 weeks’ of that were(82.05%,61.11%,56.67%)and(82.05%,61.11%,60.00%),respectively.The effective rate of slow EGG group were significantly higher than other two groups in the same course of treatment(P<0.05).7.According to the normal reference value of IGM in our previous study,after treatment with domperidone,the 4 weeks’ effective rate of patients in slow IGM group(n=37),normal IGM group(n=22)and fast IGM group(n=33)were 72.97%,54.55%,54.55%.The 6,8 weeks’ of that were(81.08%,59.09%,60.61%),(83.78%,59.09%,60.61%).After treatment with mosapride,the 4 weeks’ effective rate of patients in slow IGM group(n=40),normal IGM group(n=19)and fast IGM group(n=28)were 77.50%,52.63%,50.00%,the 6,8 weeks’ of that were(82.50%,57.89%,57.14%),(85.00%,57.89%,57.14%).The effective rate of slow IGM group were significantly higher than other two groups in the same course of treatment(P<0.05).Conclusion1.Both the domperidone and mosapride can improve the symptoms of FD patients with similar efficacy,regimen of 4w is adequate,and it has no more beneficial to further lengthen the treatment course.2.There was no difference in the effective of domperidone or mosapride among the subgroups of FD,and FD classification of Rome III criteria may has limited value in the choice of prokinetic agents.3.Patients with slow IGM may be an indication of prokinetics in the treatment of FD. |
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