مقایسه اثرات درمانی و عوارض سایمتدین و متوکلوپرامید در بیماران مبتلا به سوءهاضمه بدون زخم

 Nonulcer dyspepsia (NUD) is one of the most common gastrointestinal disorders. The causes of dyspepsia include gastric acid oversecretion, gastrointestinal dysmotility, Helicobacter pylori infection, some diets and psychologic factors. Many drugs such as H2-blockers and Prokinetics are perscribed in NUD. We designed a randomized clinical trial in Shohadaye Haftome Tir Hospital, Tehran, Iran at 2000 to compare efficacy of cimetidine and Metoclopromide in NUD and their side effects. This study were designed as a double blind randomized clinical trial on 101 patients suffering from NUD in shohadaye Haftome Tir Hospital, Tehran, Iran at 2000. The patients with NUD were selected. The inclusion criteria were having at least one of the symptoms epigastric pain, bloating, heart burn (pyrosis), vomiting nausia, regurgitation, fullness and halitosis for 3 months. Then patients were examined physically and their ESR, CBC, FBS, BUN, Cr, Ca, P, Na, K, SGOT, SGPT, AlkPh, T3RIA, T4RIA, TSH, Stoole Exam(3 times) Abdominal Sonography and Electrocardiography were checked to rule out cardiac, pulmonary, hepatic, panceratic disease and electrolyte disorders. Endoscopy was done for each patient by gastroentrologist to rule out any lesion in esophagus, stomach and deodenum. Finally the patients who had not used any drugs since 2 weeks before and hadn’t had history of psycologic disorders, were selected. After illustration and taking agreement of this patients, they were devided into two groups randomly: group of Cimetidine (50 persons) and group of metoclopramide (51 patients). The drugs were similar in shape and size and color. Cimetidine were from chemidaru company 200mg 4 times daily and metoclopramide from hakim company 10mg 4 times daily. These drugs were administred while 2 weeks in two groups simultaneusly. Complete treatment was defined getting rid of all their symptoms. Partial treatment was defined reminding symptoms to less than 50% and finally no treatment was defined reminding more than 50% of their symptoms. Group of cimetidine included 26 males and 24 females while metoclopromide group 25 males and 26 females. In the cimetidine group, the mean of age was 28.4 with standard deviation of 7.84 years. In the other one, the mean of age was 33.02 years with standard deviation of 10.77 years. There were not any significant differences in age and sex between these two groups. In cimetidine group 14 persons (28%) were completely treated, 23(46%) partially treated and 13 (26%) were not treated while in the metoclopromide group 19 persons (37.3%) were completely treated, 20(39.2) partially treated and 12(23.5%) were not treated. There were not any significant differences in treatment of NUD between these two groups. Also there were not any significant differences in side effects of these drugs except drowsiness that was significantly more in metoclopromide group (P-value=0.01). In the metoclopromide group, Anxiety in females were significantly more than males(P-value=0.02). There were many risk factors in NUD, also there were many drugs with different mechanism for NUD. Therefore we need more studies to know whichone of these drugs are better and have less side effects.