根除幽门螺杆菌对治疗胆汁反流性胃炎患者有效性的Meta分析

Efficacy of Helicobacter pylori eradication in the treatment of bile reflux gastritis patients:a Meta-analysis

目的系统评价根除幽门螺杆菌(Helicobacter pylori,H.pylori)对治疗H.pylori(+)的胆汁反流性胃炎患者的影响。方法检索中国知网、维普中文期刊数据库、万方数字化期刊全文数据库、PubMed、Web of Science、Cochrane Library数据库,收集进行H.pylori根除治疗的胆汁反流性胃炎的随机对照试验,检索时限为建库至2023年8月。共纳入6篇文献,并对其进行数据提取和改良Jadad量表质量评价。采用RevMan 5.4.1软件对纳入文献的总有效率、H.pylori根除率、症状评分进行Meta系统评价。结果纳入的6篇文献均为高质量文献。H.pylori根除组在总有效率(MD=1.49,95%CI:1.30~1.72,Z=5.53,P<0.00001)和H.pylori根除率方面(MD=3.83,95%CI:2.33~6.29,Z=5.31,P<0.00001)均优于未根除H.pylori组,腹痛评分(MD=-0.64,95%CI:-1.30~0.02,Z=1.91,P=0.06)和腹胀评分(MD=-0.11,95%CI:-0.45~0.23,Z=0.63,P=0.53)方面差异均无统计学意义。结论对于H.pylori(+)的胆汁反流性胃炎患者的治疗,根除H.pylori治疗可以提高其治疗总有效率、H.pylori根除率,但在缓解腹痛、腹胀症状上无显著意义。

Objective To systematically review the effect of Helicobacter pylori(H.pylori)eradication on the treatment of bile reflux gastritis patients infected with H.pylori.Methods Databases including PubMed,Web of Science,Cochrane Library,WanFang Data,CNKI and VIP were searched to collect RCTs about H.pylori eradication treatment for bile reflux gastritis.The search period was from the self-established database to Aug.2023.A total of 6 literatures were included,and the data were extracted and the quality of the improved Jadad scale was evaluated.RevMan 5.4.1 software was used to evaluate the total effective rate,H.pylori eradication rate and symptom evaluation of the included literatures.Results A total of 6 RCTs studies were included,all of which were of high quality.The total effective rate(MD=1.49,95%CI:1.30-1.72,Z=5.53,P<0.00001)and the eradication rate(MD=3.83,95%CI:2.33-6.29,Z=5.31,P<0.00001)in the H.pylori eradication group were superior to those in the non-eradication group.There was no significant difference in abdominal pain score(MD=-0.64,95%CI:-1.30-0.02,Z=1.91,P=0.06)and abdominal distension score(MD=-0.11,95%CI:-0.45-0.23,Z=0.63,P=0.53).Conclusion To treat bile reflux gastritis with H.pylori infection,eradicating H.pylori can improve the total effective rate and eradication rate of H.pylori.Still,it has no significant effect on relieving abdominal pain and bloating.