摘要
背景:高剂量双联疗法(HDDT)是一种新型的根除幽门螺杆菌(Hp)感染方案,但其疗效和安全性尚未明确。目的:评估HDDT根除Hp感染的有效性、安全性和依从性。方法:检索PubMed、Embase、The Cochrane Library、Web of Science数据库中有关HDDT根除Hp感染的随机对照试验(RCT),检索时限为建库至2020年10月。按照纳入与排除标准筛选文献,并进行数据提取,采用RevMan 5.2软件进行meta分析。结果:共纳入9项研究、2 627例患者。Meta分析结果显示,HDDT组和对照组的ITT根除率(85.4%对79.8%,RR=1.03,95%CI:0.96~1.10,P=0.40)、PP根除率(88.7%对83.4%,RR=1.01,95%CI:0.95~1.08,P=0.68)和依从性(96.5%对95.9%,RR=1.01,95%CI:0.99~1.02,P=0.37)均无明显差异,但不良事件的发生率明显降低(15.3%对27.0%,RR=0.57,95%CI:0.42~0.76,P=0.000 2)。结论:现有证据表明,HDDT与指南推荐方案在根除率和依从性方面无明显差异,但安全性更高。
Background: High-dose dual therapy(HDDT) is a novel regimen for the eradication of Helicobacter pylori(Hp) infection, however, its efficacy and safety remain unclear. Aims: To evaluate the efficacy, safety and compliance of HDDT for Hp eradication. Methods: Randomized controlled trials(RCTs) on HDDT for eradication of Hp infection were retrieved from PubMed, Embase, The Cochrane Library, Web of Science from the date of database establishment to October 2020. Literatures were enrolled according to the inclusion and exclusion criteria, and the data were extracted. RevMan 5.2 software was used for performing meta-analysis. Results: Nine RCTs including 2 627 patients were included. Meta-analysis results showed that no significant differences in ITT eradication(85.4% vs. 79.8%, RR=1.03, 95% CI: 0.96-1.10, P=0.40), PP eradication(88.7% vs. 83.4%, RR=1.01, 95% CI: 0.95-1.08, P=0.68), and compliance(96.5% vs. 95.9%, RR=1.01, 95% CI: 0.99-1.02, P=0.37) were found between HDDT and the guideline-recommended regimens, however, the incidence of adverse events was significantly decreased in HDDT(15.3% vs. 27.0%, RR=0.57, 95% CI: 0.42-0.76, P=0.000 2). Conclusions: There are no significant differences in eradication rates and compliance between HDDT and the guideline-recommended regimens, however, HDDT is much safer.
作者
郭玲珑
李娟娟
李勉力
李京伟
姜小艳
张春虹
黄彬
GUO Linglong;LI Juanjuan;LI Mianli;LI Jingwei;JIANG Xiaoyan;ZHANG Chunhong;HUANG Bin(The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou510006;Department of Spleen and Stomach,Shenzhen Hospital of Traditional Chinese Medicine,Shenzhen,Guangdong Province)
出处
《胃肠病学》
北大核心
2021年第11期663-670,共8页
Chinese Journal of Gastroenterology
基金
广东省中医药局医疗卫生健康事业发展专项资金(传承发展中医药事业)中医药人才培养类项目(粤中医办函[2020]1号)。
