中国序贯疗法与三联疗法治疗幽门螺杆菌感染荟萃分析  

Sequential therapy versus standard triple therapy for Helicobacter pylori eradication in Chinese patients:a meta-analysis

作　　者：陈羽[1] 吴礼浩[1] 何兴祥[1] 

机构地区：[1]广东药学院附属第一医院消化内科,广东省广州市510080

出　　处：《世界华人消化杂志》2009年第32期3365-3369,共5页World Chinese Journal of Digestology

摘　　要：目的:系统评价中国序贯疗法与三联疗法治疗幽门螺杆菌(Hpylori)感染的疗效及不良反应的差异.方法:利用中文数据库,根据纳入标准入选中国序贯疗法与三联疗法根除Hpylori的随机对照临床试验.提取患者的基本资料、研究质量、Hpylori根除率和不良反应发生率等相关数据.比较序贯疗法和7日或10日三联疗法的Hpylori根除率和不良反应发生率,计算相对危险度(Relativerisk,RR)和95%CI.运用漏斗图评价出版偏倚.结果:纳入了9项随机对照研究,共835例患者.序贯疗法、7日及10日三联疗法的总Hpylori根除率分别为92.0%、73.7%和84.5%(P=0.002).序贯疗法分别与7日或10日三联疗法比较,RR分别为1.23(95%CI:1.14-1.33)和1.12(95%CI:1.02-1.23).不良反应发生率无明显差异.结论:中国根除Hpylori使用序贯疗法明显优于7日和10日三联疗法,不良反应发生率无差异.AIM：To systematically review the differences in efficacy and incidence of adverse reactions between sequential therapy and standard triple therapy for the eradication of Helicobacter pylori （H pylori）infection in Chinese patients.METHODS：A search of Chinese databases was conducted by two independent reviewers to identify randomized controlled trials（RCT）comparing sequential therapy with standard 7-day and 10-day triple therapies in the treatment of H pylori infection.The patients’clinical data, study quality,H pylori eradication rate and the incidence rate of adverse reactions were compared between sequential therapy and standard 7-day and 10-day standard triple therapies in the treatment of H pylori infection.The relative risk ratio（RR）with 95%confidence intervals（CI） was calculated.The funnel plots was used to estimate publication bias.RESULTS：A total of 9 studies involving 835 subjects were identified.The eradication rates of sequential therapy and standard 7-day and 10-day triple therapies were 92.0%,73.7%and 84.5%,respectively.Pooled estimates showed superiority of sequential therapy over 7-day triple regimen with RR of 1.23（95%CI：1.14-1.33）, and over 10-day triple regimen with RR of 1.12 （95%CI：1.02-1.23）.The incidence rate of adverse reactions was comparable between the two therapies. CONCLUSION：Sequential therapy appears superior to standard triple therapy for eradication of H pylori infection in Chinese patients.No significant difference is noted in the incidence rate of adverse reactions between the two therapies.

关 键 词：幽门螺杆菌 序贯疗法 三联疗法 根除率 荟萃分析 

分 类 号：R573[医药卫生—消化系统] R573.1[医药卫生—内科学]