Allicin as add-on therapy for Helicobacter pylori infection: A systematic review and meta-analysis  

作　　者：Xiao-Bei Si Xu-Min Zhang Shuai Wang Yu Lan Shuo Zhang Lin-Yu Huo 

机构地区：[1]Department of Gastroenterology,Beijing Jishuitan Hospital,Beijing 100035,China [2]Department of Cardiology,Fu Wai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences,Beijing 100037,China [3]Department of Neurology,Beijing Haidian Hospital,Beijing 100080,China

出　　处：《World Journal of Gastroenterology》2019年第39期6025-6040,共16页世界胃肠病学杂志（英文版）

基　　金：Supported by BeiJingJiShuiTan Hospital Foundation for Young Scholars,No.QN-201906

摘　　要：BACKGROUND Allicin(2-propene-1-sulfinothioic acid S-2-propenyl ester,diallyl thiosulfinate)extracted from garlic,has proven activity against Helicobacter pylori(H.Pylori)infection.In recent years,clinical trials have explored its utility as an add-on therapy with variable outcomes reported.AIM To perform a systemic review of allicin as an add-on treatment for H.Pylori infection and assess its efficacy in randomized controlled trials(RCTs).METHODS Electronic databases including MEDLINE,EMBASE,the Web of Science,the Cochrane Database,the China National Knowledge Infrastructure Database,Chinese VIP Information Databases,Chinese Medical Databases,and the Wan-Fang Database were searched for keywords including“allicin”,“Helicobacter pylori”,“randomized clinical trials”,and their synonyms.A meta-analysis was performed using the fixed-effects model for low heterogeneity and the randomeffects model for high heterogeneity with sensitivity analysis.Bias was evaluated using Egger’s tests.Trial sequential analysis(TSA)was used to evaluate information size and treatment benefits.The Grading of Recommendations Assessment,Development and Evaluation(GRADE)was used to assess the level of quality,and studies were classed as“high quality”,“moderate quality”,“low quality”,and“very low quality”.RESULTS A total of eight RCTs consisting of 867 participants(435 from the allicin group and 432 from the control group)were included.Eradication rate in the allicin group(93.33%,406/435)was significantly higher than that of the control group(83.56%,361/432)[I2=0%,odds ratio(OR)=2.75,95%confidence interval(CI):1.74-4.35,P<0.001].The healing rate of ulcers following H.pylori therapy in the allicin group(86.17%,349/405)was significantly higher than that of the control group(75.87%,305/402)[I2=0%,OR=2.05,95%CI:1.39-3.03,P<0.001].The total remission rate of peptic ulcers across all allicin groups was 95.99%,which was significantly higher than that of controls[95.99%(359/374)vs 89.25%(332/372),I2=0,heterogeneity P=0.84,OBACKGROUND Allicin(2-propene-1-sulfinothioic acid S-2-propenyl ester, diallyl thiosulfinate)extracted from garlic, has proven activity against Helicobacter pylori(H. Pylori)infection. In recent years, clinical trials have explored its utility as an add-on therapy with variable outcomes reported.AIM To perform a systemic review of allicin as an add-on treatment for H. Pylori infection and assess its efficacy in randomized controlled trials(RCTs).METHODS Electronic databases including MEDLINE, EMBASE, the Web of Science, the Cochrane Database, the China National Knowledge Infrastructure Database,Chinese VIP Information Databases, Chinese Medical Databases, and the WanFang Database were searched for keywords including "allicin", "Helicobacter pylori", "randomized clinical trials", and their synonyms. A meta-analysis was performed using the fixed-effects model for low heterogeneity and the randomeffects model for high heterogeneity with sensitivity analysis. Bias was evaluated using Egger’s tests. Trial sequential analysis(TSA) was used to evaluate information size and treatment benefits. The Grading of Recommendations Assessment, Development and Evaluation(GRADE) was used to assess the level of quality, and studies were classed as "high quality", "moderate quality", "low quality", and "very low quality".RESULTS A total of eight RCTs consisting of 867 participants(435 from the allicin group and 432 from the control group) were included. Eradication rate in the allicin group(93.33%, 406/435) was significantly higher than that of the control group(83.56%, 361/432) [I^2 = 0%, odds ratio(OR) = 2.75, 95% confidence interval(CI):1.74-4.35, P < 0.001]. The healing rate of ulcers following H. pylori therapy in the allicin group(86.17%, 349/405) was significantly higher than that of the control group(75.87%, 305/402) [I^2 = 0%, OR = 2.05, 95%CI: 1.39-3.03, P < 0.001]. The total remission rate of peptic ulcers across all allicin groups was 95.99%, which was significantly higher than that of controls [95.99%(359/374) vs 89.25

关 键 词：ALLICIN HELICOBACTER PYLORI RANDOMIZED controlled trials ADD-ON therapy Systematic review META-ANALYSIS 

分 类 号：R57[医药卫生—消化系统]