埃索美拉唑为基础的三联疗法治疗Hp阳性十二指肠壶腹溃疡的Meta分析

Esomeprazole-based triple therapy for Hp-positive duodenal ampulla ulcer:Meta analysis

目的探讨以埃索美拉唑为基础的三联治疗Hp阳性十二指肠壶腹溃疡的安全性和有效性。方法计算机检索MEDLINE、EMbase、SCIE、Cochrane Library、Cochrane临床对照试验注册资料库、CBM和CNKI等数据库,查找埃索美拉唑与奥美拉唑比较治疗Hp阳性十二指肠壶腹溃疡的随机对照试验(检索时间均从建库至2014年8月),按纳入排除标准选择文献、评价质量和提取有效数据后,采用Rev Man 5.2软件进行Meta分析。结果共纳入19组随机对照试验,患者共2251例。结果埃索美拉唑组溃疡愈合率、Hp清除率不低于奥美拉唑组[OR=1.22,95%CI(0,93,1.60);OR=I.09,95%CI(0.86,1.37)],同时埃索美拉唑短程疗法(1 W)与奥美拉唑标准治疗方案(4 W)比较在溃疡愈合率、Hp清除率方面无组间差异[OR=0.99,95%CI(0,68,1.44);OR=0.85,95%CI(0.62,1.16)]。两组在不良反应方面差异无统计学意义[OR=0.90,95%CI(0.57,1.42)]。结论以埃索美拉唑为基础的三联治疗Hp阳性十二指肠壶腹溃疡疗效与以奥美拉唑为基础的标准方案效果相似,不良反应发生率相似,有望成为一种治疗该病的较好选择。

Objective To explore the safety and effectivenes of esomeprazole-based triple therapy for Hppositive duodenal ampulla ulcers. Methods Authors searched MEDLINE,EMbase,SCIE,Cochrane Library,Cochrane Controlled Trials Register Database,CBM and CNKI such as database for randomized controlled trials of esomeprazole and omeprazole treatment comparison for Hp-positive ampulla duodenal ulcer（averaged retrieval time from the building a database to August 2014）,according to the inclusion and exclusion after the selection criteria,evaluated quality and extracted data effectiveness,by using Rev Man 5.2 software took Meta-analysis. Results A total of 19 randomized controlled trials,a total of 2251 patients were included in the study. Meta-analysis showed that in esomeprazole group ulcer healing rate,Hp clearance rate was not less than omeprazole [OR=1.22,95% CI（0,93,1.60）;OR=I. 09,95% CI（0.86,1.37）],after while short-term therapy with esomeprazole（one week） and omeprazole standard regimen（4 weeks） in the rate of ulcer healing,and Hp clearance rate [OR =0.99,95% CI（0,68,1.44）;OR =0.85,95% CI（0.62,1.16）] there was no statistical difference. The adverse reaction was not statistically significant in difference between the two groups [OR=0.90,95% CI（0.57,1.42）]. Conclusion Esomeprazole-based triple therapy for Hp-positive duodenal ampulla ulcer with a standard regimen is similar to omeprazole-based triple therapy in the effect,the incidence of adverse renction is do.