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目的:评价胃复安在胶囊内镜检查中的作用。方法:计算机检索中国知网(2004年1月至2015年9月)、维普(2004年1月至2015年9月)、万方(2004年1月至2015年9月)、Pub Med(2004年1月至2015年9月)、Cochrane Library(2004年1月至2015年9月)、EMbase(2004年1月至2015年9月)数据库,按照纳入和排除标准选取文献、评价质量并提取资料后用Rev Man5.3软件进行Meta分析。结果:纳入8例随机对照实验,共627例患者。Meta分析显示:在全小肠检查完成率和诊断率方面,胃复安组与对照组相比没有统计学差异(RR=1.11,95%CI=0.99~1.23,P=0.070;RR=1.10,95%CI=0.95~1.27,P=0.210);在胃通过时间和小肠通过时间方面,胃复安组要短于对照组,差异有统计学意义(SMD=-0.32,95%CI=-0.48~-0.16,P=0.000;SMD=-0.35,95%CI=-0.65~-0.06,P=0.020)。结论:现有证据显示,胃复安尚不能作为提高胶囊内镜全小肠检查完成率和诊断率的方法,且因为缩短小肠通过时间,不利于小肠病变的检查。但由于纳入研究的文献存在一定的缺陷,可能影响到结果的准确性,因此上述结论还需要更多的多中心、随机、双盲试验来验证。
Objective: To evaluate the effect of metoclopramide in capsule endoscopy. Methods: We searched CNKI (January 2004 to September 2015), VIP (January 2004 to September 2015), Wanfang (January 2004 to September 2015), Pub Med (2004) January-September 2015), Cochrane Library (January 2004-September 2015), EMbase (January 2004-September 2015) database, select articles by inclusion and exclusion criteria, evaluate quality and extract Data were analyzed using RevMan5.3 software. Results: Eight randomized controlled trials were enrolled in this study, with a total of 627 patients. Meta-analysis showed that there was no significant difference between metoclopramide group and control group in the rate of complete small intestine examination and diagnosis (RR = 1.11, 95% CI = 0.99-1.23, P = 0.070; RR = 1.10, 95 % CI = 0.95-1.27, P = 0.210). In the course of gastric passage and passage of small intestine, the metoclopramide group was shorter than the control group, with significant difference (SMD = -0.32, 95% CI = -0.48 ~ -0.16, P = 0.000; SMD = -0.35, 95% CI = -0.65 -0.06, P = 0.020). CONCLUSION: The available evidence shows that metoclopramide can not be used as a method to improve the rate of complete small intestine examination and diagnosis rate, and shorten the passage of small intestine, which is not conducive to the examination of small intestinal lesions. However, due to the deficiencies in the included literature, which may affect the accuracy of the results, the above conclusion still needs more multi-center, randomized, double-blind tests to verify.