摘要
背景:随着幽门螺杆菌(Hp)对抗菌药物耐药性和不良反应发生率的逐渐增高,含质子泵抑制剂的四联疗法很难满足临床实际的治疗需求,因此需要在此基础上寻求另外一种有效的联合治疗方案。近年来,以双歧杆菌三联活菌为代表的微生态制剂以其独特优势在临床上得到广泛重视。目的:系统评价双歧杆菌三联活菌联合四联疗法根除Hp感染的疗效和安全性。方法:通过计算机检索2012年1月—2023年4月中国知网、万方、维普、中国生物医学文献服务系统、PubMed、Web of Science等数据库中关于双歧杆菌三联活菌联合四联疗法根除Hp感染的随机对照试验。根据纳入和排除标准,筛选文献并提取资料。纳入的文献采用Cochrane风险偏倚工具进行质量评价。采用RevMan 5.4软件对数据进行meta分析。结果:共纳入10项随机对照试验、1828例Hp感染患者。Meta分析结果显示双歧杆菌三联活菌联合四联疗法的Hp根除率明显高于单纯四联疗法(RR=1.23,95%CI:1.19~1.29,P<0.00001),而不良反应发生率明显降低(RR=0.37,95%CI:0.28~0.48,P<0.00001)。结论:双歧杆菌三联活菌联合四联疗法可显著提高Hp根除率,同时减少单纯四联疗法引起的药物不良反应,对临床应用的指导具有实际意义。
Background:With the increasing incidence of antibiotic resistance and adverse reactions to Helicobacter pylori(Hp),it is difficult for proton pump inhibitor⁃based quadruple therapy to meet the actual clinical treatment needs,so it is necessary to seek another effective combination therapy for eradication of Hp infection.In recent years,the application of microecological agents represented by Bifid triple viable has been widely valued in clinical practice due to its unique advantages.Aims:To systematically evaluate the efficacy and safety of Bifid triple viable combined with quadruple therapy in the eradication of Hp infection.Methods:The randomized controlled trail on Bifid triple viable combined with quadruple therapy for eradication of Hp infection were retrieved from CNKI,Wanfang,VIP,China Biology Medicine disc,PubMed,Web of Science databases from January 2012 to April 2023 by computer.According to the inclusion and exclusion criteria,literatures were screened and extracted.The quality of literature was evaluated by Cochrane risk bias tool.Meta⁃analysis was conducted by RevMan 5.4 software.Results:Ten randomized controlled trials including 1828 patients with Hp infection were enrolled.Meta⁃analysis results showed that the eradication rate of Hp in Bifid triple viable combined with quadruple therapy was significantly higher than that in quadruple therapy group(RR=1.23,95%CI:1.19⁃1.29,P<0.00001),while the incidence of adverse reactions was significantly decreased(RR=0.37,95%CI:0.28⁃0.48,P<0.00001).Conclusions:Bifid triple viable combined with quadruple therapy can significantly increase the eradication rate of Hp and reduce the adverse reactions,which has practical significance to guide clinical application.
作者
沈严婕
孙橹
徐洲
吕宾
SHEN Yanjie;SUN Lu;XU Zhou;LÜBin(Department of Gastroenterology,the First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine),Hangzhou,310006)
出处
《胃肠病学》
北大核心
2023年第11期650-656,共7页
Chinese Journal of Gastroenterology
