铝碳酸镁治疗胆汁反流性胃炎效果的Meta分析

Meta-analysis of the efficacy of the hydrotalcite treating bile reflux gastritis

目的评价铝碳酸镁（商品名：达喜）治疗胆汁反流性胃炎的疗效。方法采用Cochrane系统评价的方法，检索Medline、康健循证医学知识仓库西文生物医学文献数据库、中国生物医学文献数据库（CBMdisk）、维普信息数据庠、中国医院数字图书馆、万方医学文献数据库，评价纳入研究的方法学质量，提取有效数据，对照组为对症支持治疗；研究组采用对症支持治疗联合铝碳酸镁1．0g，3次／d，餐后嚼碎服。采片JRevMan4．2软件进行Meta分析。。结果共纳入11项随机临床对照研究（770例患者）。Meta分析结果显示：研究组与对照组相比，治疗胆汁反流性胃炎临床症状有效率差异有统计学意义，合并效应量比值比为6．18（95％置信区间：3．89～9．81），Z值为7．72，P〈0．01；胆汁反流消失率差异有统计学意义，合并效应量比值比为4．81（95％置信区间：3．25～7．12），Z值为7．85，P〈0．01；发表偏倚分析显示散点多集中分布在图彤左侧，明显不对称，存在发表偏倚．结论本研究结果提示目前研究不支持铝碳酸镁治疗胆汁反流性胃炎临床症状有效率及胆汁反流消失率高于非铝碳酸镁治疗者，有必要补充高质量的文献后亘新进行Meta分析，进一步评价，急需开展高质量的多中心、大样本、前瞻性、随机、双盲临床试验。

Objective To evaluate the efficacy of the hydrotalcite treating bile reflux gastritis. Methods Data front medline, Health knowledge of evidence based medicine warehouse Western biomedical literature database, Wanfang database, CBM disk, VIP information database and china hospital digital libra17 were searched and the references of related studies were checked. The textbooks and meeting reports related to hydrotal- cite were manually searched. The quality of included studies was evaluated. Data was extracted into a specially designed extraction form. Control group adopted symptomatic and supportive treatment; study group had symptomatic and supportive treatment combined with hydrotalcite. The Cochrane enllaboration＇s RevMan4.2 software was used for data analysis. Results Eleven randomly controlled clinical studies involving 770 patients were included. The pooled results showed that there were significant differences of the clinical symptoln efficacy and the bile reflux dis- appear rate of the bile reflux gastritis between the hydrotalcite treatment group and the controlled group（ combined odds ratio was 6.18 （95% confidence intmwal ： 3.89-9.81 ） and 4.81 （ 95% eonfidence interval ： 3.25-7.12 ） respectively. Z value was 7.72 and 7.85 respectively; P value was less than 0. 01 and 0. 01 respectively） ; analysis of publication bias showed that the inverted funnel plot had two dissymmetrical sides. Conclusions Clinical symptom efficacy and the hile reflux disappear rate of the hydrotalcite treatment ate not superior to those of the controlled group in treating bile reflux gastritis. Randomized, prospective, double-blind, multi-center and large-scale samples of clinical trials are needed.