Background: The incidence of diabetic gastroparesis (DGP) is increasing in recent years, and prokinetic agents may have some effects.The efficacy of mosapride on DGP has been evaluated in several studies but with varying outcomes.Aims: To systematically review the efficacy and safety of mosapride in the treatment of DGP.Methods: Eligible randomized controlled trials (RCT) of mosapride for treating DGP were retrieved through electronic databases.Metaanalysis was performed according to Cochrane Collaboration's recommendation.Results: Twelve trials involving 840 patients were included in this meta-analysis.Total efficacy rate of mosapride was superior to placebo (P=0.0005), but no significant difference was found between mosapride and domperidone (P=0.09); Total efficacy rate of mosapride combined with domperidone or mecobalamin was significantly higher than mosapride alone (P=0.01 or P=0.002).Compared with placebo, mosapride significantly improved gastric emptying time (P=0.04).Mosapride was well tolerated with no serious adverse events.Conclusions: Mosapride is effective and safe in the treatment of DGP.However, the sample sizes of trials available for this meta-analysis are rather small, and the results should be treated cautiously.Large sample size and highquality RCT with strict design are needed for further verification.%背景:糖尿病胃轻瘫(DGP)的发病率逐年增高,促胃肠动力药对其有一定疗效.目前莫沙必利对DGP疗效的研究结果存在差异.目的:系统评价莫沙必利治疗DGP的有效性和安全性.方法:从电子数据库中检索有关莫沙必利治疗DGP的随机对照试验(RCT),应用Cochrane协作网推荐的方法进行荟萃分析.结果:共纳入12项RCT,包括840例患者.莫沙必利的总有效率优于安慰剂(P=0.0005),但与多潘立酮无明显差异(p=0.09);莫沙必利联合多潘立酮或甲钴胺的总有效率亦优于单用莫沙必利(P=0.01或P=0.002).莫沙必利对胃排空时间的改善优于安慰剂(P=0.04).莫沙必利的不良反应轻微,耐受性较好.结论:莫沙必利治疗DGP具有较好的有效性和安全性.但由于纳入试验的样本量较小,应谨慎对待上述结论,并开展设计更为严格的大样本、高质量RCT作进一步验证.
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