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引用本文:周本刚,冯秋曲,李仕宇,张海,王宏志.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[J].中国现代应用药学,2017,34(12):1751-1755.
ZHOU Bengang,FENG Qiuqu,LI Shiyu,ZHANG Hai,WANG Hongzhi.Probiotics-containing quadruple therapy Versus Bismuth Quadruple Therapy as a Rescue Regimen for the Eradication of Helicobacter Pylori Infection:A Meta-analysis[J].Chin J Mod Appl Pharm(中国现代应用药学),2017,34(12):1751-1755.
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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
周本刚1, 冯秋曲1, 李仕宇2, 张海1, 王宏志1
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
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RevMan 5.3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。
关键词:  幽门螺杆菌  益生菌  铋剂  Meta分析  系统评价
DOI:10.13748/j.cnki.issn1007-7693.2017.12.024
分类号:R969.4
基金项目:
Probiotics-containing quadruple therapy Versus Bismuth Quadruple Therapy as a Rescue Regimen for the Eradication of Helicobacter Pylori Infection:A Meta-analysis
ZHOU Bengang1, FENG Qiuqu1, LI Shiyu2, ZHANG Hai1, WANG Hongzhi1
1.Department of Gastroenterology, Huangshi Central Hospital of Edong Healthcare Group, Affiliated Hospital of Hubei Polytechnic University, Huangshi 435000, China;2.Department of Gastroenterology, The first people's hospital of Zunyi, The third Affiliated Hospital of Zunyi Medical College, Zunyi 563000, China
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.
Key words:  Helicobacter pylori  probiotics  bismuth  meta-analysis  systematic review
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