艾普拉唑与奥美拉唑治疗消化性溃疡的疗效及安全性的Meta分析

Meta-analysis of the efficacy and safety of ilaprazole and omeprazole in the treatment of peptic ulcer

目的:通过对艾普拉唑和奥美拉唑治疗消化性溃疡的疗效及安全性进行系统评价,为临床合理用药提供循证依据。方法:计算机检索PubMed、Cochrane Library、Web of Science、Embase、中国知网、中国生物医学文献服务系统、维普、万方数据库,检索时间限定为建库至2021年6月20日。纳入以艾普拉唑对比奥美拉唑治疗消化性溃疡的随机对照试验(Randomized Controlled Trial,RCT),提取数据,使用RevMan 5.3进行Meta分析。结果:共纳入10篇RCT,1 971名患者进行Meta分析。结果显示艾普拉唑治疗消化性溃疡的内镜下黏膜愈合率高于奥美拉唑(OR=1.40,95%CI:1.13~1.73,P=0.002)、Hp清除率高于奥美拉唑(RR=1.06,95%CI:1.01~1.11,P=0.01)、不良反应发生率低于奥美拉唑(RR=0.80,95%CI:0.66~0.98,P=0.03),对患者的恶心呕吐、反酸嗳气以及疼痛等症状的缓解强度与奥美拉唑相当,差异无统计学意义(P>0.05)。结论:艾普拉唑在消化性溃疡治疗中的疗效与安全性均优于奥美拉唑。

OBJECTIVE To systematically review the efficacy and safety of ilaprazole and omeprazole in the treatment of peptic ulcer,so as to provide evidence-based basis for clinical rational drug use.METHODS PubMed,Cochrane Library,Web of Science,Embase,CNKI,CBM,Weipu,Wanfang and other databases were searched by computer,and the retrieval time was limited to the establishment of the database to 2021-6-20.A randomized controlled trial(Randomized Controlled Trial,RCT)of ilaprazole versus omeprazole in the treatment of peptic ulcer was included,and the required data were extracted and analyzed using RevMan 5.3.RESULTS A total of 10 RCTs were included and 1 971 patients were included for Meta-analysis.The results showed that the ulcer healing rate of ilaprazole in the treatment of peptic ulcer was better than that of omeprazole(OR=1.40,95%CI:1.13-1.73,P=0.002),Ilaprazole has better Hp clearance than omeprazole(RR=1.06,95%CI:1.01-1.11,P=0.01).However,there was no significant difference between ilaprazole and omeprazole in the relief intensity of nausea,vomiting,acid reflux,belching and pain in patients(P>0.05).In addition,the incidence of adverse reactions in the ilaprazole group was slightly lower than that of omeprazole(RR=0.80,95%CI:0.66-0.98,P=0.03).CONCLUSION The efficacy and safety of ilaprazole in the treatment of peptic ulcer was better than that of omeprazole.