目的:系统评价复方嗜酸乳杆菌联合四联疗法治疗消化性溃疡的安全性和有效性.方法:系统检索Embase、Cochrane Library、PubMed、Web of Science、维普资讯、中国知网、万方数据库(2010 年 1 月～2023 年 4月),收集复方嗜酸乳杆菌联合四联疗法治疗消化性溃疡的随机对照试验(RCT);提取资料后采用Cochrane Risk of Bias tool进行文献质量评价,采用Revman 5.4软件进行Meta分析.结果:最终纳入8项RCT,共766例患者.从Meta分析结果上看,在标准四联疗法的基础上,联合复方嗜酸乳杆菌能提高总有效率(OR=4.95,95％CI=3.08～7.95,Z=6.60,P＜0.000 01),提高 Hp 根除率(OR=3.66,95％CI=2.35～5.68,Z=5.77,P＜0.000 01),降低恶心呕吐率(OR=0.54,95％CI=0.31～0.96,Z=2.09,P=0.04),降低总不良反应率(OR=0.31,95％CI=0.20～0.46,Z=5.54,P＜0.000 01),差异均有统计学意义.结论:对于幽门螺杆菌引起的消化性溃疡,复方嗜酸乳杆菌联合四联疗法的有效率高于标准四联疗法,可降低标准四联疗法的不良反应发生率,其中恶心呕吐不良反应发生率显著降低,安全性更好.
Meta-analysis of the safety and efficacy of compound Lactobacillus acidophilus combined with quadruple therapy in the treatment of peptic ulcer
Objective:To systematically evaluate the safety and efficacy of compound Lactobacillus acidophilus combined with quadruple therapy in the treatment of peptic ulcer.Methods:Embase,Cochrane Library,PubMed,Web of Science,VIP,CNKI and Wanfang database(January 2010-April 2023)were systematically searched to collect randomized controlled trials(RCTs)of compound Lactobacillus acidophilus combined with quadruple therapy in the treatment of peptic ulcer.After data extraction,Cochrane Risk of Bias tool was used to evaluate the quality of the literature,and Revman 5.4 software was used for meta-analysis.Results:A total of 8 RCTs involving 766 patients were included.From the results of Meta-analysis,on the basis of standard quadruple therapy,combined with compound Lactobacillus acidophilus can improve the total effective rate(OR=4.95,95％CI=3.08～7.95,Z=6.60,P＜0.000 01),improve Hp eradication rate(OR=3.66,95％CI=2.35～5.68,Z=5.77,P＜0.000 01),reducing the rate of nausea and vomiting(OR=0.54,95％CI=0.31～0.96,Z=2.09,P=0.04),reduce the total adverse reaction rate(OR=0.31,95％CI=0.20～0.46,Z=5.54,P＜0.000 01),the differences were statistically significant.Conclusion:For peptic ulcer disease caused by Helicobacter pylori,the effective rate of compound Lactobacillus acidophilus combined with quadruple therapy is higher than that of standard quadruple therapy,and it could reduce the incidence of adverse reactions of standard quadruple therapy,in which the incidence of adverse reactions of nausea and vomiting is significantly reduced,and the safety is better.
万方数据
