中国呋喃唑酮初治方案根除幽门螺杆菌效果的Meta分析

Furazolidone-based firstline therapy for Helicobacter pylori infection in China: A meta-analysis

目的评价中国人群以呋喃唑酮为基础的方案在幽门螺杆菌(Helicobacter pylori,H.pylori)初次治疗中的疗效、安全性及溃疡愈合率.方法计算机检索Pub Med(1990-01/2016-05)、E M B A S E(1990-01/2016-05)、万方数据库(1990-01/2016-05)、维普中文科技期刊数据库(1990-01/2016-05),收集中国人群以呋喃酮唑为基础的方案初次治疗H.pylori的随机对照试验(randomized controlled trials,RCT)研究,评价纳入研究质量,用Rev Man5.2.4软件进行统计分析.结果共纳入10个RCT,共包含患者1904例,其中呋喃唑酮组958,对照组946例.呋喃唑酮组与对照组H.pylori根除率的ITT分析分别为84.66%与81.92%,P P分析分别为85.55%与83.07%,其RR=1.04,95%CI:1.00-1.08,RR=1.03,95%CI:0.99-1.07,P值分别为0.08、0.10;呋喃唑酮与对照组不良反应发生率分别为12.73%与12.68%,其RR=1.00,95%CI:0.79-1.25,P=0.97;呋喃唑酮组与对照组溃疡愈合率分别为91.92%、92.78%,其RR=0.99,95%CI:0.96-1.02,P=0.59.结论中国人群以呋喃唑酮为基础的方案在H.p ylori初次治疗疗效与对照组相似,溃疡愈合率、药物不良反应发生率与对照组相近,可作为H.pylori一线治疗方案,但还需高质量的RCT来进一步验证.

AIM To evaluate the efficacy,safety and ulcer healing rate of furazolidone-based first-line therapy for Helicobacter pylori（H.pylori） infection in China.METHODS Randomized controlled trials（RCTs） of furazolidone-based first-line therapy for H.pylori infection were identified from PubMed（1990-01/2016-05）,EMBASE（1990-01/2016-05）,Wanfang Data（1990-01/2016-05） and VIP Data（1990-01/2016-05）.The quality of included RCTs was assessed,and mea-analysis was conducted with RevMan5.2.4 software.RESULTS Among ten included RCTs involving 1904 patients,the H.pylori eradication rate was84.66%in the furazolidone group and 81.92%in the control group（RR = 1.04,95%CI：1.00-1.08）.For the per protocol（PP） analysis,the eradication rates of the furazolidone group and control group were 85.55%and 83.07%,respectively（RR = 1.03,95%CI：0.99-1.07）.The incidence rate of side effects was 12.73%in the furazolidone group and 12.68%in the control group（RR = 1.00,95%CI：0.79-1.25,P = 0.97）.The ulcer healing rates in the furazolidone group and control group were 91.92%and92.78%,respectively（RR = 0.99,95%CI：0.96-1.02,P = 0.59）.CONCLUSION With similar efficacy,safety and the ulcer healing rate as the control group has,the furazolidone-based therapy could be recommended as a first-line therapy for H.pylori infection in China.However,more high quality RCTs are needed to prove our finding.