益生菌四联疗法对比铋剂四联疗法根除幽门螺杆菌感染的Meta分析  

Probiotics-containing quadruple therapy versus bismuth quadruple therapy for eradication of Helicobacter pylori infection:A Meta-analysis

作　　者：周本刚[1] 王宏志[1] 冯秋曲 杨海燕[2] 张海 张惠芳[1] ZHOU Bengang WANG Hongzhi FENG Qiuqu YANG Haiyan ZHANG Hai ZHANG Huifang(Department of Gastroenterology, Huangshi Central Hospital of Edong Healthcare Group （Affiliated Hospital of Hubei Polytechnic University）, Huangshi, Hubei 435000, Chin)

机构地区：[1]鄂东医疗集团黄石市中心医院(湖北理工学院附属医院)消化内科,湖北黄石435000 [2]遵义医学院附属医院消化内科,贵州遵义563003

出　　处：《中国微生态学杂志》2017年第7期796-800,810,共6页Chinese Journal of Microecology

摘　　要：目的系统评价益生菌四联疗法对比铋剂四联疗法根除幽门螺杆菌(H.pylori)感染的疗效和不良反应。方法计算机检索中英文数据库,收集上述2种方案根除H.pylori感染的随机对照试验(RCT),检索时间均从建库至2016年10月。由2名评价员独立筛选文献、提取资料、评价纳入研究的偏倚风险,采取RevMan 5.3软件进行Meta分析。结果最终纳入12个RCT(共1 687例患者)。Meta分析结果显示:益生菌四联组患者对比铋剂四联组的H.pylori根除率按ITT分析为:80.6%vs81.2%;按PP分析为:81.2%vs 83.7%,差异无统计学意义(ITT分析:RR=0.99,95%CI:0.95~1.04,P=0.76;PP分析:RR=0.97,95%CI:0.93~1.01,P=0.17);益生菌四联组的总不良反应的发生率明显低于对照组(16.0%vs 34.9%),且差异有统计学意义(RR=0.46,95%CI:0.37~0.57,P<0.01)。结论现有证据显示,益生菌四联疗法与铋剂四联疗法的H.pylori根除率相当,但益生菌四联疗法的不良反应低于铋剂四联疗法。由于纳入研究数量有限,质量不高,上述结论有待高质量的研究予以验证。Objective To systematically evaluate the efficacy and safety of probiotics-containing quadruple therapy versus bismuth quadruple therapy for eradication of Helicobacter pylori（H.pylori）infection.Methods Chinese and English databases were searched electronically for randomized controlled trials（RCT）on above two regimens for eradication of H.pyloriinfection from inception to October 2016.Two reviewers independently screened the literatures,extracted data,and assessed the risk of bias of included studies.Meta-analysis was conducted by RevMan5.3software.Results A total of 12 RCTs containing 1 687 patients were finally included.The H.pylori eradication rate of probiotics-containing quadruple therapy versus bismuth quadruple therapy was 80.6% vs 81.2% by ITT analysis（RR=0.99,95%CI：0.95～1.04,P=0.76）,and 81.2% vs 83.7% by PP analysis（RR=0.97,95% CI：0.93～1.01,P=0.17）;there were no significant differences between the two groups.The total incidence of adverse reaction of probiotics-containing quadruple therapy was significantly lower than that of the control group（16% vs 34.9%）（RR=0.46,95%CI：0.37～0.57,P〈0.01）.Conclusion The existing evidences show that probiotics-containing quadruple therapy has comparable H.pylori eradication rate with bismuth quadruple therapy,while its incidence rate of adverse reactions was lower.Due to the limited number of included studies,the above conclusion needs to be verified by more high quality studies.

关 键 词：幽门螺杆菌 益生菌 铋剂 META分析 

分 类 号：R573[医药卫生—消化系统]