以枸橼酸铋雷尼替丁为基础的三联疗法根除幽门螺杆菌的系统评价

A systematic review of eradicating helicobacter pylori with ranitidine bismuth citrate

目的评价国产枸橼酸铋雷尼替丁(瑞倍)根除幽门螺杆菌(H.pylori)的疗效。方法检索1995年1月至2008年10月中国生物医学文献数据库(CBM)、手工检索发表与未发表的中文文献,应用国际Cochrane协作网系统评价方法收集比较瑞倍为主的三联方案与质子泵抑制剂(PPI)治疗根除H.pylori的随机对照试验(RCT)。数据采用RevMan 4.2进行统计分析。结果12篇文献共1254例患者满足纳入标准。经meta分析显示,瑞倍根除H.pylori疗效和对照组比较差异无统计学意义(OR1.30,95%CI:0.94～1.81,P=0.12)。试验未发现严重副反应。结论瑞倍为主的三联方案根除H.pylori是一个值得选用的治疗方法。

Objective To systematically review the Helicobacter pylori eradication efficacy with ranitidine bismuth citrate （RBC） and two antibiotics, and to conduct a meta-analysis of randomized clinical trials comparing the efficacy of proton pump inhibitor（PPI） vs RBC with two antibiotics for 1 week. Methods Selection of studies ： studies evaluating RBC plus two antibiotics were considered. For the meta-analysis, randomized controlled trials comparing PPI vs. RBC plus two anti- biotics for 1 week were included. Data Source：RCTs were identified from CBM, handsearching, and personal contact with pharmaceutical companies. Inclusion criteria： data were extracted independently by two reviewers. The methodological quality of trials was assessed by the Jadad-scale. Statistics analysis was managed by using RevMan 4. 2. Results Twelve randomized clinical trials including 1254 patients were included. The meta-analysis showed comparable efficacy with RBC and PPI （OR = 1.30,95% CI：0.94 - 1.81 ,P = 0. 12）. Conclusion The efficacy of RBC and PPI-based triple regimens were comparable.