Meta-analysis of Therapeutic Efficacy and Safety of Mirtazapine Combined with Selective Calcium Ch annel Blocker in the Treatment of Irritable Bowel Syndrome
- VernacularTitle:米氮平联合选择性钙通道拮抗剂治疗肠易激综合征有效性与安全性的Meta分析
- Author:
Linkun CAI
1
;
Zhuoyu PENG
2
;
Shi HUANG
3
;
Yalan HUANG
1
;
Lifen TAO
1
;
Siying LAN
1
Author Information
1. Graduate School of Guangxi University of TCM，Nanning 530001，China
2. Dept. of Gastroenterology，the First Affiliated Hospital of Guangxi University of TCM，Nanning 530022，China
3. Dept. of Gastroenterology，Ruikang Hospital Affiliated to Gua ngxi University of T CM，Nanning 530011，China
- Publication Type:Journal Article
- Keywords:
Mirtazapine;
Selective calcium channel blocker;
Pinaverium bromide;
Otilonium bromide;
Irritable bowel syndrome;
Therapeutic efficacy;
Safety;
Meta-analysis
- From:
China Pharmacy
2019;30(18):2563-2570
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE： To systematically review therapeutic efficacy and safety of mirtazapine combined with selective calcium channel blocker （SCCB） in the treatment of irritable bowel syndrome （IBS）， and provide evidence-based reference for clinical medication. METHODS： Retrieved from the Cochrane Library， PubMed， Embase， Medline， CNKI， VIP and Wanfang database， randomized controlled trials （RCTs） about mirtazapine combined with SCCB （trial group） versus SCCB （control group） for IBS were collected. After literature screening and data extraction， quality evaluation was performed by using Cochrane system evaluator manual 5.1.0 recommend bias risk evaluation tool. Meta-analysis was performed by using Stata 14.0 software. RESULTS： A total of 14 RCTs involving 1 005 patients were included. The results of Meta-analysis showed that the total response rate [RR＝1.34，95％CI（1.25，1.44），P＜0.001]，neuropeptide-Y level after treatment [SMD＝0.77，95％CI（0.49，1.05），P＜0.001]， response rate of abdominal pain therapy [RR＝1.32，95％CI（1.06，1.66），P＝0.014] and response rate of treatment for abnormal stool characteristics [RR＝1.75，95％CI（1.36，2.27）， P＜0.001] were significantly higher than control group； the scores of depression scale after treatment [SMD＝－1.87， 95％CI （－2.35， －1.39）， P＜0.001]， anxiety scale after treatment [SMD＝－2.25， 95％CI （－3.35， －1.15）， P＜0.001]， abdominal pain symptom score after treatment [SMD＝－7.41， 95％CI （－8.30，－6.51）， P＜0.001]， diarrhea symptom score after treatment [SMD＝－6.39， 95％CI （－7.96，－4.81）， P＜0.001] were significantly lower than those of the control group. There were no statistical significance in response rate of abdominal distension therapy [RR＝1.07，95％CI（0.90，1.28），P＝0.421] and response rate of abnormal defecation therapy [RR＝1.05，95％CI（0.88，1.26），P＝0.588]， the incidence of abdominal pain [RR＝0.45，95％CI（0.11，1.97）， P＝0.291] and exhaustion [RR＝5.00，95％CI（0.60，41.79），P＝0.137] between 2 groups. CONCLUSIONS： Mirtazapine combined with SCCB can significantly improve therapeutic efficacy of IBS patients， promote clinical symptoms， but do not increase the occurrence of ADR as abdominal pain and exhaustion.
