质子泵抑制剂预防化疗所致胃肠道反应临床效果的Meta分析

Proton-pump inhibitors preventing the gastrointestinal reaction caused by chemotherapy:a meta analysis

目的:评价质子泵抑制剂(PPI)预防化疗所致胃肠道不良反应的临床疗效和安全性。方法:通过检索Cochane Database、Pubmed、EMbase、CNKI、VIP、CBM及万方数据库,收集关于质子泵抑制剂预防化疗所致胃肠道反应临床疗效的随机对照实验,检索时限均为建库至2020年5月,对符合质量标准RCT进行Meta分析,统计学分析采用RevMan5.2软件。结果:共纳入21篇随机对照试验研究,涉及2106例患者。PPI组的药物包括泮托拉唑、奥美拉唑、兰索拉唑联合常规止呕方案;对照组药物为常规止呕方案。Meta分析结果显示:PPI组预防化疗所致恶心、呕吐、食欲不振等胃肠道反应有效率显著高于对照组(均P<0.05)。在不良反应发生率上,两组比较差异无统计学意义(P>0.05)。结论:质子泵抑制剂联合常规止呕方案能有效预防化疗所致恶心、呕吐、食欲不振等胃肠道反应,安全性较好。

Objective:To evaluate the clinical efficacy and safety of proton-pump inhibitors(PPI)on preventing gastrointestinal adverse reactions caused by chemotherapy.Methods:Randomized controlled experiments(RCTs)on the clinical efficacy of proton-pump inhibitors in preventing gastrointestinal reactions caused by chemotherapy were collected via the Cochane library,Pubmed,EMbase,CNKI,VIP,CBM and Wanfang databases.The search time limit was from the establishment of the database to May 2020.RCTs that met the quality standards was included.RevMan5.2 software was used for meta analysis.Results:Twenty-one randomized controlled trial studies were included,with a total of 2,106 patients.The regimen in the PPI group included pantoprazole,omeprazole and lansoprazole combined with routine antiemetic regimen,the control group was administrated with routine antiemetic regimen.Meta analysis showed that the effective rate of preventing chemotherapy-induced nausea,vomiting,anorexia and other gastrointestinal reactions in PPI group was significantly higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the PPI group and control group.Conclusion:PPI combined with conventional anti-vomiting regimen can effectively prevent gastrointestinal reactions such as nausea and vomiting caused by chemotherapy,and it was safe.