莫西沙星三联疗法治疗幽门螺杆菌感染有效性及安全性的系统评价  

Efficacy and safety of Moxifloxacin-based triple therapy for eradication of Helicobacter pylori infection: A systematic review

作　　者：周本刚[1,1,2,3] 肖政[1,2,3] 汪成琼 刘梅[1] 陈银[1] 陈安海[1] 

机构地区：[1]遵义医学院附属医院,贵州遵义563003 [2]遵义医学院循证医学中心 [3]循证医学教育部网上合作研究中心遵义医学院分中心

出　　处：《山东医药》2015年第39期19-22,共4页Shandong Medical Journal

基　　金：贵州省科技厅社会发展攻关基金资助项目(SY20113056)

摘　　要：目的系统评价莫西沙星三联疗法治疗幽门螺杆菌（Hp）感染的有效性和安全性。方法计算机检索中国生物医学文献数据库、中国知网、万方医药期刊数据库、维普数据库、Cochrane Central Register of Controlled Trials、Pub Med、Embase数据库,收集国内关于莫西沙星三联疗法治疗Hp感染的随机对照试验,检索时限均为建库至2015年5月。根据纳入与排除标准筛选文献、提取资料、评价偏倚风险后,采用Rev Man5.3软件进行Meta分析。结果最终纳入7篇文献,共593例患者,其中观察组（采用以莫西沙星为基础的三联疗法）297例、对照组（采用以克拉霉素为基础的标准三联疗法）296例。观察组Hp根除率为88.9%,对照组Hp根除率为71.39%,两组差异有统计学意义（RR=1.25,95%CI为1.15~1.35,P〈0.000 01）。观察组总不良反应发生率低于对照组（RR=0.56,95%CI为0.36~0.89,P=0.01）。本Meta分析结果较稳定。纳入文献无明显发表偏倚。结论莫西沙星三联疗法治疗Hp感染Hp根除率较高,总不良反应发生率较标准三联疗法低。Objective To systematically evaluate the efficacy and safety of Moxifloxacin-based triple therapy for the eradication of Helicobacter pylori（ Hp）. Methods CBM,CNKI,Wan Fang Data,VIP Data,Cochrane Central Register of Controlled Trials（ CENTRAL）,Pub Med and Embase database were electronically searched from inception to May 2015 for all the relevant randomized controlled trials（ RCTs） of Moxifloxacin-based triple therapy for the eradication of Hp. Two reviewers independently screened literature,extracted data,and assessed the risk of bias of included studies. Then meta-analysis was performed by using Rev Man 5. 3 software. Results A total of 7 RCTs of 593 patients,including 297 patients in the Moxifloxacin-based triple therapy（ observation group） and 296 patients in the Clarithromycin-based standard triple therapy（ control group） were included. The results of meta-analysis showed that： the Hp eradication rates of the observation group and control group were 88. 9% and 71. 39%,respectively（ RR = 1. 25,95% CI： 1. 15-1. 35,P〈0. 00 001）.Compared with the control group,the incidence of total adverse reaction of the observation group was lower（ RR = 0. 56,95% CI： 0. 36-0. 89,P = 0. 01）. The results of our meta-analysis were stable. There was no evidence of substantial publication bias of the included studies. Conclusion Moxifloxacin-based triple therapy had high Hp eradication rate and low adverse reaction rate for Hp infection as compared with Clarithromycin-based standard triple therapy.

关 键 词：幽门螺杆菌感染 莫西沙星 克拉霉素 META分析 

分 类 号：R573[医药卫生—消化系统]