益生菌辅助含左氧氟沙星的补救方案治疗幽门螺杆菌感染疗效的Meta分析  

The efficacy of probiotics supplementation on anti-Helicobacter pylori levofloxacinbased rescue therapy: A Meta analysis

作　　者：刘沁 何平[1] 曾波[1] 李月[1] 田文广[2] Liu Qin;He Ping;Zeng Bo;Li Yue;Tian Wen-guang(Department of Gastroenterology, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160;Department of Infectious Disease, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160)

机构地区：[1]重庆医科大学附属永川医院消化内科,重庆402160 [2]重庆医科大学附属永川医院感染科,重庆402160

出　　处：《中国抗生素杂志》2019年第4期503-509,共7页Chinese Journal of Antibiotics

基　　金：重庆市永川区自然科学基金(No.Ycstc,2016nc5002)

摘　　要：目的系统评价益生菌在辅助含左氧氟沙星补救治疗根除幽门螺杆菌(Hp)感染的疗效和安全性。方法计算机检索Pubmed、Embase、Cochrane Library、CNKI、VIP、CBM和Wan Fang Data,收集2017年3月1日前国内外公开发表的关于益生菌辅助含左氧氟沙星的补救方案治疗Hp感染疗效的随机对照试验,所有研究对象给予含左氧氟沙星补救治疗方案抗Hp治疗,试验组在此基础上再给予益生菌制剂辅助治疗,对照组未给予益生菌制剂治疗,随访过程并追踪结局。两名研究者独立完成文献筛选、资料提取、质量评价(采用PEDro量表进行评价)工作后,运用RevMan5.2进行统计分析。结果最终纳入6个随机对照研究,包括益生菌联合治疗组(试验组)430例,无益生菌治疗组(对照组)380例。Meta分析结果显示:益生菌组及非益生菌组Hp根除率PP分析结果(OR=2.11,95%CI=1.47~3.02,P<0.0001);益生菌组及非益生菌组Hp根除率ITT分析结果(OR=2.01,95%CI=1.43~2.81,P<0.0001);益生菌组及对照组治疗过程中出现不良反应情况(OR=0.63,95%CI=0.40~0.99,P=0.05),均有统计学意义。结论含益生菌能有效提高含左氧氟沙星补救疗法的Hp根除率,改善临床症状且减少药物的副作用。Objective To assess the efficacy and safety of probiotics supplementation on anti-Helicobacter pylori levofloxacin-based second-line rescue therapy. Methods All relevant controlled trials (RCT) of probiotics reuteri supplementation on anti-Helicobacter pylori levofloxacin-based second-line therapy published before March 1, 2017 were collected by searching Pubmed, Embase, the Cochrane Library, CNKI, VIP, CBM and Wan Fang Data. All subjects were treated with anti-Helicobacter pylori levofloxacin-based rescue therapy. The experimental group was treated with probiotics at the same time, while the control group was treated without probiotics, and the process and the outcome of both groups were followed up. Two researchers used RevMan 5.2 to perform statistical analysis on the basis of literature screening, data extraction and quality evaluation (PEDro). Results Six RCTs included 430 patients with probiotics (experimental group) and 380 patients without probiotics (control group). The results of Meta-analysis: the PP-analysis results about the rate of Hp eradication of the groups with and without probiotics (OR=2.11, 95%CI=1.47~3.02, P<0.0001);the ITT-analysis results about the rate of Hp eradication of the groups with and without probiotics (OR=2.01, 95%CI=1.43~2.81, P<0.0001) and the comparative results of adverse reactions about the two groups (OR=0.63, 95%CI=0.40~0.99, P=0.05) were all statistically significant. Conclusion The probiotics reuteri supplementation on anti-Helicobacter pylori levofloxacin-based second-line therapy can effectively improve the rate of Hp eradication and reduce the side effects of the drugs.

关 键 词：益生菌 幽门螺杆菌 左氧氟沙星 补救治疗 META分析 系统评价 随机对照试验 

分 类 号：R978.1[医药卫生—药品]