多西环素根除幽门螺杆菌感染有效性和安全性的meta分析
Efficacy and Safety of Doxycycline in Eradicating Helicobacter pylori Infection:A Meta-analysis
杨成海 1伍乐乐 1陈烨1
作者信息
- 1. 南方医科大学深圳医院整合微生态诊疗中心(518101)
- 折叠
摘要
背景:多西环素可用于根除幽门螺杆菌(Hp)感染,但尚缺乏大样本研究证实其有效性和安全性.目的:探讨多西环素根除Hp感染的有效性和安全性.方法:检索中国知网、万方、维普和PubMed、Embase、Web of Science、Cochrane Library等数据库,收集比较多西环素和其他抗菌药物根除Hp感染的相关文献,检索时间均为建库至2023年10月.采用RevMan 5.3软件行meta分析.结果:最终纳入19篇文献、共3 686例Hp感染患者.含多西环素方案的意向性治疗(ITT)根除率(82.51%对73.65%;OR=1.72,95%CI:1.42～2.07,P<0.000 01)和按方案治疗(PP)根除率(88.96%对78.06%;OR=1.63,95%CI:1.28～2.06,P<0.000 1)均显著高于非多西环素方案.含多西环素方案的不良反应发生率显著低于非多西环素方案(8.35%对15.01%;OR=0.55,95%CI:0.42～0.71,P<0.000 01).亚组分析显示含多西环素方案的Hp根除率与含阿莫西林方案(OR=1.09,95%CI:0.78～1.52,P=0.61)、含四环素方案(OR=0.87,95%CI:0.33～2.26,P=0.77)相比无明显差异,但显著高于含克拉霉素方案(OR=2.67,95%CI:1.84～3.88,P<0.000 01)和含左氧氟沙星方案(OR=2.20,95%CI:1.50～3.22,P<0.000 1).结论:含多西环素方案的Hp根除率显著高于非多西环素方案,且不良反应发生率低,值得临床推广应用.
Abstract
Background:Doxycycline can be used in the eradication of Helicobacter pylori(Hp)infection,but there is a lack of large sample study to confirm its efficacy and safety.Aims:To explore the efficacy and safety of doxycycline in the eradication of Hp infection.Methods:Literatures on doxycycline and other antibiotics in the eradication of Hp infection were retrieved from CNKI,Wanfang data,VIP,PubMed,Embase,Web of Science,and Cochrane Library from the date of database establishment to October 2023.Meta-analysis was conducted by RevMan 5.3 software.Results:Nineteen literatures including 3 686 patients with Hp infection were enrolled.Both intention-to-treat(ITT)eradication rate(82.51%vs.73.65%;OR=1.72,95%CI:1.42-2.07,P<0.000 01)and per-protocol(PP)eradication rate(88.96%vs.78.06%;OR=1.63,95%CI:1.28-2.06,P<0.000 1)of doxycycline-based regimen were significantly higher than those of non-doxycycline regimens.The adverse reaction rate of doxycycline-based regimen was significantly lower than that of non-doxycycline regimens(8.35%vs.15.01%;OR=0.55,95%CI:0.42-0.71,P<0.000 01).Subgroup analysis showed that Hp eradication rate of doxycycline-based regimen was significantly higher than that of clarithromycin-based regimen(OR=2.67,95%CI:1.84-3.88,P<0.000 01)and levofloxacin-based regimen(OR=2.20,95%CI:1.50-3.22,P<0.000 1),however,no significant difference in Hp eradication rate was found between doxycycline-based regimen and amoxicillin-based regimen(OR=1.09,95%CI:0.78-1.52,P=0.61)and tetracycline-based regimen(OR=0.87,95%CI:0.33-2.26,P=0.77).Conclusions:The eradication rate of doxycycline-based regimen in the eradication of Hp is significantly higher than that of non-doxycycline regimens,and the adverse reaction rate is low,which is worthy of clinical application.
关键词
多西环素/幽门螺杆菌/治疗/安全性/Meta分析Key words
Doxycycline/Helicobacter pylori/Therapy/Safety/Meta-Analysis引用本文复制引用
基金项目
国家自然科学基金(82270581)
深圳市科技计划项目(JCYJ20220530154012028)
深圳市宝安区医疗卫生科研项目(2023JD240)
出版年
2024
NETL
NSTL
万方数据