复方嗜酸乳杆菌补救治疗幽门螺杆菌感染作用的Meta分析  

Role of compound Lactobacillus acidophilus in rescue therapy of Helicobacter pylori infection:a Meta-analysis

作　　者：包志贤 杜洁 马小丽 叶玉伟[1,2] 袁浩[1,2] 郑亚 王玉平[1,2] 姬瑞[1,2] BAO Zhi-xian;DU Jie;MA Xiao-li;YE Yu-wei;YUAN Hao;ZHENG Ya;WANG Yu-ping;JI Rui(Gansu Key Laboratory of Gastroenterology,The First Clinical Medical College of Lanzhou University,Lanzhou,Gansu 730000,China)

机构地区：[1]兰州大学第一医院甘肃省胃肠病重点实验室,甘肃兰州730099 [2]兰州大学第一医院消化科,甘肃兰州730099 [3]兰州大学公共卫生学院,甘肃兰州730000

出　　处：《中国微生态学杂志》2023年第1期1-7,15,共8页Chinese Journal of Microecology

基　　金：国家自然科学基金(82160498);甘肃省自然科学基金(20JR5RA347);兰州市人才创新创业项目(2019-RC-33)。

摘　　要：目的系统评价复方嗜酸乳杆菌联合标准疗法补救治疗幽门螺杆菌(Helicobacter pylori,Hp)感染的有效性和安全性。方法检索PubMed、Web of Science、Cochrane Library、Embase、中国知网(CNKI)、万方数据库(WanFang Data)、维普网(VIP)和中国生物医学文献数据库(CBMdisc)等中英文数据库,并手工检索纳入研究的所有参考文献,获取有关复方嗜酸乳杆菌联合标准疗法(试验组)与标准疗法(对照组)补救治疗Hp感染的相关文献,检索时间从建库至2022年2月17日。采用《Cochrane干预措施系统评价手册》中偏倚风险评价工具对纳入的随机对照研究(RCT)进行质量评价。采用Cochrane协作网提供的RevMan 5.4和STATA 16.0软件进行统计学分析。采用Q检验和I2值判断异质性,根据异质性大小,选择不同效应模型进行分析。采用漏斗图及Egger’s检验定性定量分析发表偏倚。结果共纳入9篇文献,10组数据资料(其中1篇文献有2组数据),总计1511例患者。Meta分析结果显示,与标准疗法相比,复方嗜酸乳杆菌联合标准疗法有助于提高补救患者的Hp根除率和临床症状改善率,降低不良反应发生率,亚组分析结果与此结果一致。结论复方嗜酸乳杆菌联合标准疗法具有更好的临床补救效果和更高的安全性,然而上述结论尚需严格设计的随机双盲对照试验加以验证。Objective To evaluate the efficacy and safety of compound Lactobacillus acidophilus(CLA)combined with standard therapy in the rescue treatment of Helicobacter pylori(Hp)infection with previous treatment failure.Methods We searched PubMed,Web of Science,Cochrane Library,Embase,CNKI,WanFang Data,VIP and CBMdisc,and manually searched journals to obtain related literatures published from inception to February 17,2022.All the publications were searched without any restrictions of countries or article types.The reference lists of all included articles were independently screened to identify additional studies left out in the initial search.Meta-analysis was conducted by using the RevMan 5.4 and STATA 16.0.Results A total of 9 literatures and 10 data sets were included,involving a total of 1511patients.Meta-analysis showed that compared with standard therapy,CLA combined with standard therapy increased Hp eradication rate and clinical symptom improvement rate while reduced the incidence of adverse reactions in the patients who failed previous treatment.Conclusion Compound Lactobacillus acidophilus combined with standard therapy has more effective clinical rescue effect and more reliable safety.However,the conclusion should be further confirmed by carefully designed randomized double-blind controlled trials.

关 键 词：复方嗜酸乳杆菌 幽门螺杆菌 补救治疗 META分析 

分 类 号：R573.9[医药卫生—消化系统]