微生态制剂联合标准三联疗法根除幽门螺杆菌感染Meta分析

Meta-analysis: the effect of probiotics supplement on standard triple therapy for Helicobacter pylori eradication

目的系统评价微生态制剂联合标准三联疗法能否提高H.pylori根除率,减少根除过程中的不良反应。方法从常用电子数据库检索标准三联疗法联合与未联合微生态制剂根除H.pylori的随机对照临床试验,Meta分析各项研究的根除率和不良反应发生率的合并OR值,以漏斗图检测发表偏倚。结果共15项随机临床试验符合纳入标准。三联疗法联合与未联合微生态制剂,根除率分别为79.7%(95%CI:77.1%～82.3%)和69.5%(95%CI:66.5%～72.5%),合并OR值为1.75(95%CI:1.40～2.18),总不良反应发生率分别为27.7%(95%CI:24.5%～30.9%)和53.0%(95%CI:49.4%～56.6%),合并OR值为0.35(95%CI:0.21～0.60)。结论微生态制剂联合标准三联疗法可显著提高H.pylori根除率,降低根除过程中的不良反应发生率。

Objective To systematically evaluate the effect of the probiotics and standard triple therapy on the eradication of H.pylori and the side-effects of anti-H.pylori treatment.Method Frequently used electronic databases were searched for all the randomized placebo controlled clinical trials of standard triple therapies with and/or without combination of probiotics for treatment of H.pylori.The summary odds ratio（OR） of H.pylori eradication rate and side-effects incidence of these trials was meta-analyzed.The publication bias was tested by funnel plot.Result Fifteen randomized clinical trials were included in the analysis.Pooled H.pylori eradication rate was 79.7%（95% CI： 77.1%~82.3%） and 69.5%（95% CI： 66.5%~72.5%） with and without combination of probiotics,respectively;the summary OR was 1.75（95% CI： 1.40~2.18）;the total occurrence of side-effects was 27.7%（95% CI： 24.5%~30.9%） and 53.0%（95%CI： 49.4%~56.6%） in groups with and without probiotics,respectively;the summary OR was 0.35（95% CI： 0.21~0.60）.Conclusion Probiotics supplement is effective in increasing the eradication rate during standard triple therapy for H.pylori eradication.Furthermore,probiotics show a positive impact on H.pylori therapy related side-effects.