Effects And Safety Of Medicines In Patients With Functional Dyspepsia: A Meta-analysis

AIM: To evaluate the effects and safety of four groups of drugs commonly used for the treatment of functional dyspepsia(Prokinetics,Acid-inhibitory drugs,Antianxiety and Antidepressant drugs and Gastric mucosal protective drugs)and Helicobacter pylori eradication by Meta-analysis,and compare the effects between the groups through network Meta-analysis.METHODS: The randomized controlled trials,prospective cohort study or cross experiment on the treatment of functional dyspepsia(FD)were searched by Databases of CNKI,Wanfang,MEDLINE,The Cochrane Library and Embase(up to January 2017).The Stata 12.0 software was used to analysis the overall improvement of symptoms,and rate of adverse effects.Relative risk(RR)and 95% confidence interval(CI)were calculated.Sensitivity analysis and publication bias inspection(including funnel plots,Egger's test and the Begg method)were also performed.Meta-regression analysis was used to achieve network Meta-analysis.RESULTS:Twenty-nine studies with a total of 8597 patients were included.Among these studies,5 articles were about helicobacter pylori eradication,9 articles were about Prokinetics,6 articles about acid-inhibitory drugs,6 articles about psychotropic drugs,and 3 articles were about gastric mucosal protective drugs.compared to placebos,overall symptoms of FD were improved on patients using Prokinetics[RR=1.142,95%CI(1.062,1.228),P =0.000],acid-inhibitory drugs[RR=1.397,95%CI(1.091,1.788),P = 0.008],helicobacter pylori eradication[RR=1.654,95%CI(1430,1914),P=0.000]and tricyclic antidepressant(TCAs)[RR=1.515,95%CI(1.215,1.889),P=0.000].To the contrary,no improvement showed on patients using gastric mucosal protective drugs[RR=1.088,95%CI(0.912,1.298),P = 0.348] and Selective serotonin reuptake inhibitors(SSRIs)[RR=0.969,95%CI(0.725,1.297),P=0.834] compared to placebos.Regarding adverse reactions,the rate of adverse reactions increased significantly in the group of Antianxiety and Antidepressant drugs drugs versus placebo[RR=1.423,95%CI(1.068,1.894),P = 0.016],when the rate of adverse reactions of other drugs is similar to a placebo.CONCLUSION: Prokinetics,PPIs,TCAs,helicobacter pylori eradication therapy are effective in the treatment of FD versus placebos.Effects of Prokinetics,PPIs and TCAs were similar.SSRIs,Gastric mucosal protective drugs show no significant differences versus placebos.These drugs to treat FD show no serious adverse reactions in general.