左氧氟沙星为基础的三联疗法补救治疗幽门螺杆菌感染的Meta分析  

Curative Effect of Levofloxacin-based Triple Therapy as Rescue Regimen for Helicobacter pylori: A Meta-analysis

作　　者：吕必华[1] 朱蕙[1] 曾婧[2] 

机构地区：[1]武汉大学中南医院药学部,武汉430071 [2]武汉科技大学医学院公共卫生学院

出　　处：《华西医学》2015年第3期432-437,共6页West China Medical Journal

基　　金：湖北省自然科学基金(2012FFB04904;2013CFB331)~~

摘　　要：目的对以左氧氟沙星为基础的补救治疗幽门螺杆菌感染的疗效和不良反应进行评价,并和传统四联疗法进行比较。方法计算机检索Science Direct、Pub Med、Medline、中国期刊全文数据库、维普中文数据库和万方数据库。收集有关一次或多次根除幽门螺杆菌失败后,以左氧氟沙星为基础的补救疗法(主要是三联疗法)和传统四联疗法的疗效和不良反应的随机对照试验,检索时限均为2000年1月-2013年9月。由2名评价者按照纳入和排除标准独立筛选文献,提取资料和评价质量后,采用Rev Man 5.0软件进行统计分析。结果纳入14篇文献,共1 402例患者,数据经异质性检验为非同质总体,故采用随机效应模型。Meta分析表明,左氧氟沙星组三联疗法组的疗效更好,差异有统计学意义[RR=1.16,95%CI(1.04,1.30),P=0.009];左氧氟沙星组的不良反应发生率更低,差异有统计学意义[OR=0.44,95%CI(0.24,0.81),P=0.008]。结论根除幽门螺杆菌失败后,以左氧氟沙星为基础的补救方案比常用的四联疗法的疗效更好,不良反应更少。Objective To evaluate the ef ectiveness and side-ef ects of levol oxacin-based triple therapy as rescue regimen for Helicobacter pylori, and to compare it with the quadruple therapy. Methods Science Direct, Pub Med, Medline, China National Knowledge Infrastructure（CNKI）, Chinese Social Sciences Citation Index（CSSCI, developed by Chongqing VIP Company）, and Wanfang Database were electronically searched from January 2000 to September 2013. Randomized controlled trials（RCT） were focused on the eradication rate and adverse ef ects of levol oxacin-based regimens and generally recommended quadruple therapy at er failure to eradicate Helicobacter pylorfifor one or more times. Two reviewers independently screened studies according to exclusion and inclusion criteria, extracted data, and assessed the methodological quality. Then, meta-analysis was performed using Rev Man 5.0 sot ware. Results Fourteen literatures involving 1 402 patients were included. Meta-analysis showed that the levol oxacin-based group was better than the quadruple therapy group [RR=1.16, 95%CI（1.04, 1.30）, P=0.009]. In addition, the adverse ef ects of levol oxacin group was less than the quadruple therapy group[OR=0.44, 95%CI（0.24, 0.81）, P=0.008]. Conclusion At er the failure of eradication of Helicobacter pylori, levol oxacin-based rescue regimen is more ef ective and better tolerated than the generally recommended quadruple therapy.

关 键 词：幽门螺杆菌 左氧氟沙星 四联疗法 META分析 

分 类 号：R573[医药卫生—消化系统]