He Ji-dong, Liu Li, Zhu Yu-jiang
Department of Gastroenterology, Second Municipal People's Hospital, Ya'an 625000, China. Email:
Department of Gastroenterology, Second Municipal People's Hospital, Ya'an 625000, China.
Zhonghua Yi Xue Za Zhi. 2013 Nov 26;93(44):3500-5.
To assess the efficacy and safety of 10-day sequential therapy for Helicobacter pylori (H.pylori) eradication in children.
The databases of Cochrane Central Register of Controlled Trials (CENTRAL, 2013,N01), Medline, Embase, OVID, Chinese Biological Medicine database (CBMDisc), CNKI, Chinese VIP and WANFANG (all from 2000-2013) were searched. And manual searches were performed for the relevant journals and conference proceedings. Prospective, randomized controlled trials of 10-day sequential therapy for H.pylori eradication in children were selected. The systematic review was conducted with the method recommended by The Cochrane Collaboration.
Fifteen trials with a total of 1348 patients were included for analysis. The meta-analysis showed: (1) H.pylori eradication rates: 10-day sequential therapy were superior to triple therapy (80.78% (521/645) vs 69.84% (491/703), OR 2.13, 95%CI: 1.62-2.80, P < 0.01). It was also superior to 7-day and 10-day standard triple therapy (86.03% (271/315) vs 73.77% (225/305), 79.04% (181/229) vs 65.19% (176/270); OR 2.23, 2.11; 95%CI:1.47-3.36, 1.37-3.24;both P < 0.01) . There were non-superior to 14-day standard triple therapy (73.97% (108/146) vs 70.31% (90/128), OR 1.87, 95%CI: 0.46-7.69, P = 0.38). (2) Adverse effect rate: adverse events were similar between sequential and standard triple therapies (P = 0.58).
The 10-day sequential therapy may be a new effective and safe option in treatment of H.pylori infections in children.
评估10天序贯疗法根除儿童幽门螺杆菌（H.pylori）的疗效和安全性。
检索Cochrane对照试验中心注册库（CENTRAL，2013年，第1期）、Medline、Embase、OVID、中国生物医学数据库（CBMDisc）、中国知网、维普中文科技期刊数据库和万方数据库（均为2000 - 2013年）。并对相关期刊和会议论文进行手工检索。纳入关于儿童幽门螺杆菌根除的10天序贯疗法的前瞻性随机对照试验。按照Cochrane协作网推荐的方法进行系统评价。
纳入15项试验，共1348例患者进行分析。荟萃分析显示：（1）幽门螺杆菌根除率：10天序贯疗法优于三联疗法（80.78%（521/645）对69.84%（491/703），OR 2.13，95%CI：1.62 - 2.80，P < 0.01）。也优于7天和10天标准三联疗法（86.03%（271/315）对73.77%（225/305），79.04%（181/229）对65.19%（176/270）；OR 2.23，2.11；95%CI：1.47 - 3.36，1.37 - 3.24；P均< 0.01）。但不优于14天标准三联疗法（73.97%（108/146）对70.31%（90/128），OR 1.87，95%CI：0.46 - 7.69，P = 0.38）。（2）不良反应率：序贯疗法和标准三联疗法的不良事件相似（P = 0.58）。
10天序贯疗法可能是治疗儿童幽门螺杆菌感染的一种新的有效且安全的选择。
