序贯治疗根除幽门螺杆菌感染的Meta分析  

Sequential therapy vs triple therapy for eradication of Helicobacter pylori:A metaanalysis

作　　者：缑琼英[1] 喻荣斌[1] 施瑞华[1] 

机构地区：[1]南京医科大学,江苏省南京市210029

出　　处：《世界华人消化杂志》2014年第32期5030-5035,共6页World Chinese Journal of Digestology

摘　　要：目的:评价序贯治疗与传统三联疗法根除幽门螺杆菌(Helicobacter pylori,H.pylori)感染的疗效及两者间发生不良反应的差异.方法:检索常用的电子数据库,纳入比较序贯治疗与三联疗法H.pylori根除率的随机对照试验,提取患者基本资料、研究质量、H.pylori根除率和不良反应的发生率等,荟萃分析各项研究两种疗法的相对危险度(relative risk,RR)及95%可信区间.用漏斗图评价出版偏倚.结果:共26项随机对照临床试验,1806例患者符合纳入标准.Meta分析结果显示10 d序贯治疗比7、10 d的三联疗法具有优越性,其RR=(1.26,95%CI:1.18-1.34)、(1.17,95%CI:1.11-1.24).两种疗法的不良反应发生率差异无统计学意义(P=0.7834).结论:序贯治疗比7、10 d的三联疗法有更高的H.pylori根除率,不良反应差异无统计学意义.AIM： To systematically assess the curative ef- fect of sequential vs standard triple therapy in eradicating Helicobacter pylori （H. pylori） and the risk of adverse events between the two therapies. METHODS： Relevant studies were retrieved by searching electronic databases for studies that evaluated the efficacy of sequential vs traditional triple therapy in eradicating H. pylori. Informa- tion retrieved included the clinical features of patients, quality of study, eradication rate of H. pylori and incidence of adverse events. The pooled relative risk （RR） and 95% confidence intervals （CIs） were calculated, and the publica- tion bias was assessed with funnel plot. RESULTS： A total of 26 included trials involv- ing 1806 patients were included. Meta-analysis demonstrated a distinct superiority of the se- quential therapy over 7-d triple therapy （RR = 1.26, 95%CI： 1.18-1.34） and over 10-d triple ther- apy （RR -- 1.17, 95%Ch 1.11-1.24）. The incidenceof adverse events was similar between the two therapies （P = 0.7834）. CONCLUSION： Sequential therapy is associ- ated with a higher eradication rate of H. pylori, compared with the 7-d and 10-d triple thera- py, without increasing adverse events signifi- cantly.

关 键 词：序贯治疗 三联疗法 幽门螺杆菌 META 分析 

分 类 号：R573[医药卫生—消化系统]