益生菌四联对比铋剂四联疗法补救根除幽门螺杆菌感染的Meta分析
Probiotics-containing Quadruple Therapy Versus Bismuth Quadruple Therapy as a Rescue Regimen for the Eradication of Helicobacter Pylori Infection: A Meta-analysis
周本刚 1冯秋曲 1李仕宇 2张海 1王宏志1
作者信息
- 1. 鄂东医疗集团黄石市中心医院(湖北理工学院附属医院)消化内科,湖北黄石435000
- 2. 遵义市第一人民医院(遵义医学院第三附属医院)消化内科,贵州遵义563000
- 折叠
摘要
目的 系统评价益生菌四联疗法(PQT)对比铋剂四联疗法(BQT)补救根除幽门螺杆菌(Helicobacter pylori,Hp)感染的疗效和安全性.方法 检索关于PQT对比BQT补救根除Hp感染的临床试验,检索时限均为建库至2016年10月.由2名评价员,根据纳入与排除标准筛选文献、提取资料,依据改良Jadad量表评价纳入研究的方法学质量,采用RevMan5.3软件进行meta分析.结果 最终纳入9个临床试验,共875例患者,结果显示:补救治疗中PQT的Hp根除率高于BQT,但差异无统计学意义(RR=1.03,95％CI:0.97～1.10,P=0.36);按PP分析,PQT与BQT的Hp根除率相当,但差异无统计学意义(RR=1.00,95％CI:0.94～1.07,P=0.90).PQT的不良反应发生率明显低于BQT,且差异有统计学意义(RR=0.31,95％CI:0.23～0.41,P＜0.000 01).结论 与BQT相比,补救治疗中PQT的不良反应发生率更低,但Hp的根除率无差异,该结论有待大样本高质量的研究验证.
Abstract
OBJECTIVE To systematically review the efficacy and safety of probiotics containing quadruple therapy(PQT)as a rescue regimen for the eradication of Helicobacter pylori (Hp) infection.METHODS To search clinical trials about PQT versus bismuth quadruple therapy(BQT) as a rescue regimen for the eradication of Hp infection from inception to October 2016.Two reviewers independently screened literature,extracted data,and assessed the methodological quality of included studies by revised Jadad scale.The meta-analysis was performed by RevMan5.3 software.RESULTS A total of 9 clinical trials containing 875 patients were finally included.The results of meta-analysis showed that:according to ITT analysis,the Hp eradication rate of PQT as a rescue regimen was higher than that of BQT,but the difference was not statistically significant (RR=1.03,95％CI:0.97-1.10,P=0.36);according to PP analysis,the Hp eradication rate of PQT versus BQT was considerable,but the difference was not statistically significant (RR=1.00,95％CI:0.94-1.07,P=0.90).The incidence of adverse reactions of PQT was significantly lower than that of the control group,and the difference was statistically significant (RR=0.31,95％CI:0.23-0.41,P＜0.000 01).CONCLUSION Compared with BQT,the incidence of adverse reactions of PQT is lower,but there is no significant difference in Hp eradication rate between the two therapies.More large-scale and high-quality studies are needed to confirm the above conclusions.
关键词
幽门螺杆菌/益生菌/铋剂/Meta分析/系统评价Key words
Helicobacter pylori/probiotics/bismuth/meta-analysis/systematic review引用本文复制引用
出版年
2017
NETL
NSTL
维普
万方数据