奥美拉唑与其它质子泵抑制剂治疗胃食管反流病疗效比较的系统评价

Meta-Analysis for Efficacy of Gastroesophageal Reflux Disease Treatment by Omeprazole or other Proton Pump Inhibitors

目的对奥美拉唑与其它质子泵抑制剂治疗胃食管反流病疗效比较的文献资料进行系统评价,为临床用药提供参考。方法检索国内外已公开发表的关于埃索美拉唑、泮托拉唑、雷贝拉唑、兰索拉唑(治疗组)与奥美拉唑(对照组)比较治疗胃食管反流病的随机对照试验文献,主要以食管炎的治愈率和症状(灼烧感)缓解率为评价指标,并用Cochrane协作网提供的软件RevMan4.2进行Meta分析。结果共有6篇公开发表文献符合入选标准,胃食管炎治愈总例数6825例,其中治疗4周后胃食管炎治疗组治愈3430例,对照组治愈3395例,优势比1.32,95%可信区间为(1.00,1.73),P=0.05,差异有统计学意义;治疗8周后治疗组治愈3430例,对照组治愈3395例,优势比1.25,95%可信区间为(0.74,2.10),P>0.05,差异没有统计学意义;治疗后症状(灼伤感)缓解总例数为5642例,其中治疗组为2826例,对照组为2816例,优势比1.43,95%可信区间为(1.28,1.59),P<0.05,差异有统计学意义。结论治疗4周后食管炎的治愈率和症状(主要为灼烧感)缓解率,埃索美拉唑、泮托拉唑、雷贝拉唑疗效比奥美拉唑好;治疗8周后食管炎治愈率,埃索美拉唑、泮托拉唑、雷贝拉唑疗效与奥美拉唑相当。

Objective Evaluation of other proton pump inhibitor （PPI） is made by comparing with Omeprazole on the efficacy of the treatment of gastroesophageal reflux disease（GERD）, and providing the evidence-based for clinic use of drug. Method Search the clinical randomized controlled trials references of Esomeprazole, Pantoprazole, Rabeprazole, Lansoprazole compared with Omeprazole on treatment of GERD published home and abroad, mainly in the cure rate of Esophagitis and symptoms （mainly heartburn） remission rate for the evaluation of indicators, and use meta-analysis software RevMan4.2 in Cochrane Collaboration to data processing and analysis. Result Totally 6 pieces of reference paper selected. Analysis of results showed that the total sample size cure of rate of gastric esophagitis surpassed 6 825, in which the treatment group for 3 430, the control group for 3 395, after 4 weeks： P=0.05, statistically significant, odds ratio OR= 1.32, 95% confidence interval for （1.00, 1.73）; after 8 weeks： P〉0.05, not statistically significant, odds ratio OR=1.25, 95% confidence interval for （0.74,2.10）; treatment symptoms （mainly heartburn） remission rate of the total sample size for 5 642, one of the treatment group for 2 826, the control group for 2 816, P〈0.05, statistically significant, odds ratio OR=1.43, 95% CI （1.28,1.59）. Conclusions In the treatment of Esophagitis after 4 weeks the cure rate and post-treatment symptoms （mainly heartburn） remission rate, other PPI had better efficacy than Omeprazole; and 8 weeks later, the treatment of the recovery rates of other PPI and Omeprazole were similar in terms of efficacy.