摘要
目的：系统评价质子泵抑制剂与腹腔镜手术治疗胃食管反流病的疗效和经济评价。方法本研究通过计算机检索中国期刊全文数据库（1994~2014．12）、万方数据库（1994~2014．12）、Embase数据库（1995~2014．12）、Pubmed数据库（1994~2014．12）、Cochrane对照试验的中心资料库（2005~2014．12）收集质子泵抑制剂与腹腔镜手术治疗胃食管反流病的随机对照试验。采用Cochrane图书馆RevMan 5．3软件进行Meta分析。结果总共纳入13篇目的文献,共包括患者3623例,质子泵抑制剂组（对照组）1830例,腹腔镜手术组（试验组）1793例。其中A级评价文献为8篇, B级评价文献为5篇。 Meta分析的最终结果显示：腹腔镜手术组治疗胃食管反流病在治疗后不良反应、胃肠道症状评定及生活质量总体幸福指数评估方面与质子泵抑制剂组相比并无统计学差异。合并优势比（OR）分别为5．00（95% CI为0．69~36．09,P=0．11）；-0．20（95% CI为-0．65~0．26, P=0．40）；0．55（95% CI为-0．09~1．18,P=0．09）；对于在经济评价及治疗失败存在统计学差异。OR分别为1．89（95% CI 为0．24~3．53, P =0．02）；1．61（95% CI 为1．06~2．42, P =0．02）。结论腹腔镜手术与质子泵抑制剂对于GERD的治疗在治疗后不良反应；胃肠道症状评定量及患者治疗后的生活质量总体幸福指数评估方面上并无统计学差异,即在治疗胃食管反流病面,质子泵抑制剂和腹腔镜手术治疗影响作用效果无异。
Objective Systematically evaluate for curative effect and economical evaluation of treating gastroes ophageal refulx disease （ GERD ） by proton pump inhibitors （ PPI ） and Laparos copic antireflux surgery （ LARS ） . Methods Collecting RCT of treating GERD by PPI and LARS via computer retrieval in CNKI （ 1944 to 2014. 12 ） , Wanfang Database （ 1994 to 2014. 12 ） , Embase Database （ 1995 to 2014. 12）,Pubmed Database（1994 to 2014. 12）and Cochrane Center Database of Controlled Trial（2005 to 2014. 12）. Carry on Meta-Analysis by software RevMan5. 3 of Cochrane Library. Results 13 purpose literatures are incorporated totally. Including 3 623 cases,PPI group（control group）1830 cases and LARS group（ experiment group ） 1 793 cases. Among which there are 8 literatures of evaluation A-Level and 5 literatures of evaluation B-Level. The final result of Meta-Analysis shows that on the aspect of post treatment untoward effect and Gastrointestinal symptom rating scale and Quality of life general well-being index,there are no statistical differences between LARS group and PPI group when treating GERD. The odds ratios（ RO） are 5. 00（95% CI is 0. 69~36. 09,P=0. 11）and-0. 20（95% CI is 0. 65~0. 26,P=0. 40）and 0. 55（95%CI is 0. 09~1. 18,P=0. 09）respectively. While there exist statistical differences on the aspect of Economic Evaluation 1 year and failure after treatment. The ORs are 1. 89（95% Cl is 0. 24~3. 53,P=0. 02）and 1. 61 （95% Cl is 1. 06~2. 42,P=0. 02）respectively. Conclusion There is no obviously statistical difference of＆amp;nbsp;gastrointestinal symptom rating and untoward effect after treatment and quality of life general well-being index indicates of GERD via LARS and PPI,which means that there is no more advantages of PPI than LARS on treating GRED. The statistical difference appears in economic evaluation and treatment failure.
出处
《中华胃食管反流病电子杂志》
2015年第2期105-113,共9页
Chinese Journal Of Gastroesophageal Reflux Disease(Electronic Edition)
关键词
胃食管反流
质子泵抑制剂
腹腔镜检查
META分析
Gastroesophageal refulx disease
Proton pump inhi bitors
Laparoscopil antireflux sugery
Meta-analysis
