Digestive Enzyme for Dyspepsia: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

TANG Huilin , LUAN Rong ,  ZHAI Suodi

Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China;

Corresponding author：

ZHAI Suodi, Email: zhaisuodi@163.com

Keywords：

Digestive enzyme; Dyspepsia; Randomized controlled trial; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.20120116

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the efficacy, safety and economics of digestive enzyme for dyspepsia.
Methods Electronic databases such as PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), CBM, VIP and CNKI were searched from establishment dates of databases to June 2010 to identify the randomized controlled trials (RCTs) of digestive enzyme for dyspepsia. Then studies were identified according to predefined inclusion and exclusion criteria, and their quality was evaluated. The meta-analysis was performed using RevMan 5.0 software.
Results Eight studies involving 1 092 patients were included, 3 of which were Grade B while the rest were Grade C. The results of the meta-analysis showed that the total efficacy rate of oryz-aspergillus enzyme and pancreatin tablet, compound digestive enzymes capsule, and compound azintamide enteric-coated tablet for dyspepsia were better than either placebo or blank intervention, with the results as (OR=49.70, 95%CI 17.16 to 143.96), (OR=7.71, 95%CI 3.88 to 15.33) and (OR=16.27, 95%CI 6.85 to 38.66), respectively. The efficacy for treating loss of appetite, abdominal distension, abdominal pain, diarrhea and belching was superior to either placebo or blank intervention. Oryz-aspergillus enzyme and pancreatin tablet was inferior to compound digestive enzyme capsule in treating dyspepsia following cholecystectomy. No significant difference was observed in treating dyspepsia following chronic pancreatitis between compound azintamide enteric-coated tablet and compound digestive enzymes capsule. Drug-related adverse reactions as well as economic evaluation were not reported in included studies.
Conclusion Digestive enzyme is effective for dyspepsia caused by various diseases. The OR of digestive enzyme versus the placebo/blank-control group shows that oryz-aspergillus enzyme and pancreatin tablet is better than other digestive enzyme drugs.

Citation： TANG Huilin,LUAN Rong,ZHAI Suodi. Digestive Enzyme for Dyspepsia: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2012, 12(6): 714-721. doi: 10.7507/1672-2531.20120116 Copy

1.	中华医学会消化病学分会胃肠动力学组. 中国消化不良的诊治指南（2007大连）. 胃肠病学, 2008, 13(2): 114-117.
2.	Talley NJ. Dyspepsia management in the millennium：the death of teat and treat?. Gastroenterology, 2002, 122(5): 1521-1525.
3.	万晓萍. 消化酶的临床应用. 中国医院用药评价与分析, 2004, 4(6): 378-379.
4.	陈旻湖, 钟碧慧, 李初俊, 等. 广东城镇居民消化不良的流行病学调查. 中华内科杂志, 1998, 37 (5): 312-314.
5.	Ford AC, Moayyedi P. Current guidelines for dyspepsia management. Dig Dis, 2008, 26(3): 225-230.
6.	Graham DY, Rugge M. Clinical practice: diagnosis and evaluation of dyspepsia. J Clin Gastroenterol, 2010, 44(3): 167-172.
7.	冉志华, 袁耀宗, 李兆申, 等. 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. 胃肠病学, 2008,13(12): 713-718.
8.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0［updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
9.	高艳, 丁丽楠, 孟巧稚. 达吉治疗中老年消化不良的临床研究. 中华临床医药, 2003, 4(11): 50-51.
10.	上海市达吉临床研究协作组. 多种消化酶制剂治疗消化不良的多中心、随机、安慰剂、双盲、平行对照研究. 胃肠病学, 2003, 8(2): 79-82.
11.	包海标, 乔樵, 朱曙东, 等. 复方消化酶胶囊治疗胆囊切除术后消化不良102例的疗效观察. 浙江实用医学, 2005, 10(5): 325-326.
12.	上海市泌特临床协作组. 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. 胃肠病学, 2005, 10(2): 83-87.
13.	费昶, 王艳芳, 王卫民, 等. 复方阿嗪米特肠溶片与复方消化酶胶囊治疗腹胀的疗效. 中国新药与临床杂志, 2008, 27(7): 556-558.
14.	钱晶瑶, 高建新, 齐艳荣, 等. 复方阿嗪米特肠溶片治疗慢性胰腺炎化学性消化不良疗效观察. 河北医药, 2010, 32(1): 32-33.
15.	范惠珍, 盛建文, 钟谷平. 复方阿嗪米特治疗胆囊切除术后并发消化不良疗效观察. 河北医药, 2010, 32(1): 62-63.
16.	Tack J, Bisschops R, Sarnelli G. Pathophysiology and treatment of functional dyspepsia. Gastroenterology, 2004, 127(4): 1239-1255.

1. 中华医学会消化病学分会胃肠动力学组. 中国消化不良的诊治指南（2007大连）. 胃肠病学, 2008, 13(2): 114-117.
2. Talley NJ. Dyspepsia management in the millennium：the death of teat and treat?. Gastroenterology, 2002, 122(5): 1521-1525.
3. 万晓萍. 消化酶的临床应用. 中国医院用药评价与分析, 2004, 4(6): 378-379.
4. 陈旻湖, 钟碧慧, 李初俊, 等. 广东城镇居民消化不良的流行病学调查. 中华内科杂志, 1998, 37 (5): 312-314.
5. Ford AC, Moayyedi P. Current guidelines for dyspepsia management. Dig Dis, 2008, 26(3): 225-230.
6. Graham DY, Rugge M. Clinical practice: diagnosis and evaluation of dyspepsia. J Clin Gastroenterol, 2010, 44(3): 167-172.
7. 冉志华, 袁耀宗, 李兆申, 等. 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. 胃肠病学, 2008,13(12): 713-718.
8. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0［updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
9. 高艳, 丁丽楠, 孟巧稚. 达吉治疗中老年消化不良的临床研究. 中华临床医药, 2003, 4(11): 50-51.
10. 上海市达吉临床研究协作组. 多种消化酶制剂治疗消化不良的多中心、随机、安慰剂、双盲、平行对照研究. 胃肠病学, 2003, 8(2): 79-82.
11. 包海标, 乔樵, 朱曙东, 等. 复方消化酶胶囊治疗胆囊切除术后消化不良102例的疗效观察. 浙江实用医学, 2005, 10(5): 325-326.
12. 上海市泌特临床协作组. 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. 胃肠病学, 2005, 10(2): 83-87.
13. 费昶, 王艳芳, 王卫民, 等. 复方阿嗪米特肠溶片与复方消化酶胶囊治疗腹胀的疗效. 中国新药与临床杂志, 2008, 27(7): 556-558.
14. 钱晶瑶, 高建新, 齐艳荣, 等. 复方阿嗪米特肠溶片治疗慢性胰腺炎化学性消化不良疗效观察. 河北医药, 2010, 32(1): 32-33.
15. 范惠珍, 盛建文, 钟谷平. 复方阿嗪米特治疗胆囊切除术后并发消化不良疗效观察. 河北医药, 2010, 32(1): 62-63.
16. Tack J, Bisschops R, Sarnelli G. Pathophysiology and treatment of functional dyspepsia. Gastroenterology, 2004, 127(4): 1239-1255.

Previous Article
Saxagliptin in the Treatment of Type 2 Diabetes: A Meta-Analysis
Next Article
Efficacy and Safety of Benbromarne and Allopurinol for Primary Gout ULT: A Meta-Analysis

Chinese Journal of Evidence-Based Medicine

Digestive Enzyme for Dyspepsia: A Systematic Review

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content