摘要促胃肠动力药是治疗功能性消化不良(FD)、胃食管反流病(GERD)等胃肠疾病的有效药物,但目前比较有效且安全的药物较少.酒石酸西尼必利(西尼必利)是2015年在我国上市的一种促胃肠动力药,属于5-羟色胺受体激动剂,主要用于治疗轻度至中度的FD.多项临床试验结果显示,西尼必利治疗胃肠道功能紊乱、FD和GERD疗效优于甲氧氯普胺和多潘立酮,且安全性良好.西尼必利在肝脏不仅通过细胞色素P450(CYP)3A4代谢,还可通过CYP2C8代谢,发生药物相互作用风险较小,且西尼必利的游离血药浓度远低于西沙必利和多潘立酮,导致心脏毒性的风险较低,是治疗FD和GERD药物的新选择.

abstractsGastrointestinal promotility drugs are effective in treating gastrointestinal diseases such as functional dyspepsia (FD)and gastroesophageal reflux disease (GERD),but there are few effective and safe drugs in the present. Cinitapride hydrogen tartrate (cinitapride)is a gastrointestinal promotility drug that marketed in China in 2015. It belongs to 5-hydroxytryptamine receptor agonist and is mainly used to treat mild to moderate FD. Several clinical trials have shown that cinitapride is superior to metoclopramide or domperidone for treatment of gastrointestinal dysfunction,FD and GERD,and has good safety. Because cinitapride is metabolized not only by cytochrome P450 (CYP)3A4 enzyme but also by CYP2C8,the risk of drug interaction is lower. The free drug concentration of cinitapride is much lower than that of cisapride and domperidone,resulting in a lower risk of cardiotoxicity. So cinitapride is a new choice for treatment of FD and GERD.