Efficacy of different durations of bismuth-based quadruple therapy for
Helicobacter pylori infection in China: a meta-analysis- Journal of Third Military Medical University Vol. 39, Issue 10, Pages: 1044-1055(2017)
- 作者机构：
1.400038 重庆，第三军医大学西南医院全军消化病研究所
2.400042 重庆，第三军医大学大坪医院野战外科研究所消化内科
- 作者简介：
- 基金信息：
DOI：10.16016/j.1000-5404.201612195
CLC： R516;R573;R975Received：28 December 2016，
Revised：2017-02-15，
Published：30 May 2017
- 稿件说明：
移动端阅览
Jiali Hu, Chunhui Lan, Haoxiang Zhang, et al. Efficacy of different durations of bismuth-based quadruple therapy for
Helicobacter pylori infection in China: a meta-analysis[J]. Journal of Third Military Medical University, 2017, 39(10): 1044-1055.Jiali Hu, Chunhui Lan, Haoxiang Zhang, et al. Efficacy of different durations of bismuth-based quadruple therapy for
Helicobacter pylori infection in China: a meta-analysis[J]. Journal of Third Military Medical University, 2017, 39(10): 1044-1055. DOI： 10.16016/j.1000-5404.201612195.
摘要
目的
2
评价不同疗程(10 d或14 d)铋剂四联疗法在中国幽门螺杆菌感染的根除疗效及安全性。
方法
2
计算机检索2005年1月至2016年11月Pubmed、EMBASE、the Cochrane Central Register of Controlled Trials、中国知网、中国生物医学文献数据库、维普等数据库关于10 d或14 d铋剂四联疗法在中国根除幽门螺杆菌感染的随机对照试验，提取受试者的基本资料、观察指标(根除率及不良反应发生率)、研究质量等相关数据，使用RevMan 5.3软件分析相关指标，计算RR及95%
CI
，使用漏斗图行发表偏倚评价。
结果
2
纳入43篇文献，共7 686例患者。合并结果显示：据意向性分析，10 d或14 d铋剂四联疗法和三联疗法根除率分别是88.96%(95%
CI
:87.73%~90.19%)和74.11%(95%
CI
:72.53%~75.69%)，差异有统计学意义(
RR
=1.20，95%
CI
：1.16%~1.25%)；10 d或14 d铋剂四联疗法和7 d铋剂四联疗法相比，根除率分别是87.34%(95%
CI
：84.87% ~89.80%)、81.65%(95%
CI
:78.76% ~84.54%)(意向性分析)，差异有统计学意义(
RR
=1.07，95%
CI
：1.02%~1.12%)；10 d或14 d铋剂四联联疗法与序贯疗法(
RR
=1.02，95%
CI
：0.97%~1.07%)及与伴随疗法(
RR
=1.01，95%
CI
：0.95%~ 1.07%)差异无统计学意义。
结论
2
10 d或14 d铋剂四联疗法与序贯疗法及伴随疗法疗效相当，三联疗法及7 d铋剂四联疗法不作为首选治疗方案。
Abstract
Objective
2
To assess the efficacy and safety of bismuth quadruple therapy for 10 or 14 days in eradicating
Helicobacter pylori
(
H.pylori
) infections in Chinese patients.
Methods
2
The databases including PubMed
Embase
the Cochrane Central Register of Controlled Trials
China National Knowledge Infrastructure Database
Chinese Biomedical Database and VIP database were searched for randomized controlled trials (RCTs) published from the year 2005 to 2016 describing bismuth-based quadruple therapy for 10 or 14 days in Chinese patients. The trails retrieved were examined for clinical features of patients
quality of study
eradication rate of
H.pylori
and incidence of adverse events. A meta-analysis of the included trials was performed using Revman 5.3 software
and the pooled relative risk (RR) and 95% confidence intervals (CIs) were calculated; the
publication bias was assessed with funnel plot.
Results
2
Forty-three trials involving a total of 7 686 patients were eligible for inclusion in the analysis. Intention-to-treat analysis showed that the eradication rate of
H.pylori
was 88.96% (95%
CI
: 87.73%~90.19%) with bismuth quadruple therapy for 10 or 14 d and 74.11% (95%
CI
: 72.53%~75.69%) with triple therapy
showing a significant difference in the efficacy between the 2 therapies (
RR
=1.20
95%
CI
:1.16%~1.25%). Analysis of 9 trials comparing bismuth quadruple therapy for 10 or 14 d and for 7 d showed that a treatment duration for 10 or 14 d resulted in an significantly higher eradication rate than a treatment duration of 7 days
CI
: 84.87%~89.80%)
vs
81.65% (95%
CI
: 78.76%~84.54%)
RR
=1.07
95%
CI
: 1.02%~1.12%
]
. The eradication rate produced by bismuth quadruple therapy for 10 or 14 d did not differ significantly from that by sequential therapy (
RR
=1.02
95%
CI
: 0.97%~1.07%) or concomitant therapy (
RR
=1.01
95%
CI
: 0.95%~1.07%).
Conclusion
2
Bismuth-based quadruple therapy for 10 or 14 d has a comparable efficacy in eradicating
H.pylori
with sequential therapy and concomitant therapy. Triple therapy and bismuth quadruple therapy for 7 d are not recommended as the primary options for treatment of
H.pylori
infection.
关键词
Keywords
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