睡前加服H_2-受体拮抗剂抑制夜间酸突破的系统评价  

Additional Bedtime H_2-receptor Antagonist for the Control of Nocturnal Gastric Acid Breakthrough:A Systematic Review

作　　者：潘涛[1] 王一平[2] 刘芙成[1] 吴宗英[2] 

机构地区：[1]成都市第一人民医院消化内科,成都610016 [2]四川大学华西医院消化内科,成都610041

出　　处：《中国循证医学杂志》2006年第6期416-420,共5页Chinese Journal of Evidence-based Medicine

基　　金：纽约中华医学基金会循证医学项目资助(编号:98-680)。

摘　　要：目的继2004年系统评价之后,对睡前加服H2-受体拮抗剂抑制夜间酸突破的疗效和安全性进行再评价。方法计算机检索Cochrane图书馆临床对照试验资料库、MEDLINE、EMbase、中国生物医学文献数据库,手工检索8种相关中文期刊和所获文献的参考文献,全面收集全世界关于睡前加服H2-受体拮抗剂抑制夜间酸突破的临床随机对照试验,并按照Cochrane协作网的方法进行系统评价。结果仅有2篇随机对照交叉试验包括32例受试者符合纳入标准,由于这2个研究在设计及药物的剂量和疗程存在较大差别,无法进行Meta分析,仅进行定性的系统评价。这2个研究对睡前加服H2-受体拮抗剂抑制夜间酸突破的疗效没有一致性的结论。结论基于目前的证据尚不能确定睡前加服H2-受体拮抗剂能有效抑制夜间酸突破的发生,还需要大样本、高质量,且随访时间足够的随机对照试验来提供证据。Objectives To assess the effectiveness and safety of additional bedtime H2-receptor antagonists （H2RAs） in suppressing nocturnal gastric acid breakthrough （NAB）. Methods We identified eligible trials by searching The Cochrane Central Register of Controlled Trials （CENTRAL）, MEDLINE, EMbase and CINAHL. We handsearched the data from the proceedings of correlated conferences, eight kinds of important Chinese journals and references of all included trials. All randomized controlled trials evaluating H2RAs for the control of NAB were eligible for inclusion. The systematic review was conducted using methods recommended by The Cochrane Collaboration. Results Only two randomized crossover studies including 32 participants met the inclusion criteria. Because the design, dosage and duration of the treatment were different between the studies, it was impossible to conduct Meta-analysis. There was no consistent conclusion between the two included studies in evaluating H2RAs for the control of NAB. Conclusion We can not conclude any implications for practice at this stage. Appropriately designed large-scale randomized controlled trials with long-term follow-up are needed to decide the effects of additional bedtime H2RAs in suppressing NAB.

关 键 词：H2-受体拮抗剂 夜间酸突破 COCHRANE系统评价 随机对照试验 

分 类 号：R57[医药卫生—消化系统]