瑞巴派特治疗慢性胃炎:Meta分析

Rebamipide for chronic gastritis: a Meta-analysis

目的评价瑞巴派特对存在和不存在幽门螺杆菌(H.pylori)感染的慢性胃炎的治疗效果。方法采用Cochrane系统评价的方法,电子检索并手工检索中文和英文数据库(1980年1月-2014年4月),纳入比较瑞巴派特对慢性胃炎效果的随机对照试验。评价纳入研究的特点和质量,提取有效数据,采用Rev Man 5.0软件进行Meta分析。结果共纳入12个随机对照试验对比瑞巴派特对慢性胃炎的作用,形成15组对照,涉及1 584例患者。在临床效果方面,联合使用瑞巴派特较常规用药(如奥美拉唑、泮托拉唑及法莫替丁)有效率高(RR=1.23,95%CI:1.06~1.41),且效果明显的比例较高(RR=1.37,95%CI:1.09~1.73)。单用瑞巴派特与其他常规药物(如硫糖铝、奥美拉唑等)对比有效率相当(RR=1.04,95%CI:0.95~1.14);治疗效果明显的比例也相当(RR=1.11,95%CI:0.83~1.48)。对比症状积分显示,使用瑞巴派特治疗后症状积分较低,上腹痛WMD=-0.58,95%CI:-0.77^-0.40;上腹胀WMD=-0.91,95%CI:-1.05^-0.77;反酸WMD-0.37,95%CI:-0.66^-0.08;嗳气WMD=-0.29,95%CI:-0.63~0.06,但症状总积分差异无统计学意义(WMD=0.14,95%CI:-0.57~0.85)。在不良反应方面,总体副作用少,瑞巴派特组与对照组比较差异无统计学意义(RR=0.88,95%CI:0.28~2.82)。结论基于随机对照研究的Meta分析显示,常规用药(如奥美拉唑、泮托拉唑及法莫替丁)联合瑞巴派特治疗慢性胃炎在症状改善和临床效果方面有优势,但单用瑞巴派特与其他常规用药(硫糖铝、奥美拉唑等)对比效果无明显差异。

Objective To investigate the efficacy and adverse effects of Rebamipide in the treatment of chronic gas- tritis. Methods Relevant randomized controlled trials of references were retrieved electronically and manually from da- tabases published in English and Chinese from Jan. 1980 to Apr. 2014, Features, the quality of researches and valid data of included studies were extracted, then RevMan 5.0 software was used to conduct a Meta-analysis. Results A to- tal of 12 randomized controlled trials, with 15 comparisons, involving 1 584 cases of patients evaluated the effect of Re- bamipide on chronic gastritis. Compared with regular medicines （such as Omeprazole, Pantoprazole and Famotidine） , combination of Rebamipide showed better effect on effective rate （RR = 1.23, 95 % CI： 1.06 - 1.41 ） , as well as obvi- ous effective rate （RR = 1.37, 95% CI： 1.09 - 1.73 ）. Compared with regular medicines （ such as Sucralfate and Ome- prazole） , Kebamipide alone showed no superior effect on efficacy rate （RR = 1.04, 95% CI： O. 95 - 1.14） ; as well as obvious effective rate （RR = 1.11, 95% CI. O. 83 -1.48）. the symptom scores were lower in Rebamipide group, epi- gastric pain （WMD-- -0.58, 95%CI： -0.77- -0.40）, abdominal bloating （WMD= -0.91, 95%CI： -1.05 -0.77）, nausea （WMD= -0.37, 95%CI： -0.66- -0.08） and belching （WMD= -0.29, 95%CI： -0.63 0.06） , but there was no significance on total symptom scores （ WMD = O. 14, 95% CI： -0.57 -0. 85）. There were few adverse events in Rebamipide group, showed no difference compared with control group （RR =0.88, 95% CI： 0. 28 2.82）. Conclusion Based on the Meta-analysis, combined Rebamipide with regular medicines （such as Ome- prazole, Pantoprazole and Famotidine） has an superior effect for the treatment of chronic gastritis, and Rebamipide a- lone has an equal effect to other conventional medicines （such as Sucralfate and Omeprazole）.