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埃索美拉唑钠作为幽门螺杆菌根除辅助治疗的疗效和安全性:系统评价与荟萃分析。

Efficacy and safety of ecabet sodium as an adjuvant therapy for Helicobacter pylori eradication: a systematic review and meta-analysis.

作者信息

Wang Youhua, Wang Ben, Lv Zhi Fa, Yang Yang, Wang Fucai, Wang Hui, Chen Shuping, Xie Yong, Zhou Xiaojiang

机构信息

Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.

出版信息

Helicobacter. 2014 Oct;19(5):372-81. doi: 10.1111/hel.12136. Epub 2014 May 14.

Abstract

BACKGROUND

Several studies have reported that the application of ecabet sodium during the eradication of Helicobacter pylori can improve the eradication rate and reduce therapy-associated side effects. However, the efficacy and safety of this therapy are controversial.

OBJECTIVES

To determine whether ecabet sodium improves the eradication rate of H. pylori and examine treatment safety by conducting a meta-analysis based on randomized controlled trials (RCTs).

METHODS

Literature searches were conducted in the following databases: PubMed, Embase, the Cochrane Library, the Science Citation Index, the China National Knowledge Infrastructure Database, and the Wanfang Database. A meta-analysis of all RCTs comparing ecabet sodium supplementation with nonecabet sodium-containing therapy was performed.

RESULTS

Thirteen RCTs that included a total of 1808 patients were assessed. The meta-analysis showed that the eradication rate in the ecabet sodium-containing quadruple therapy group was higher than that in the standard triple therapy group (84.5% vs 74.55%, OR 1.757 (95%CI: 1.307 to 2.362), p < .001). The analysis also showed that the eradication rate in the ecabet sodium-containing triple therapy group was significantly higher than that in the PPI plus amoxicillin or clarithromycin therapy group (74.6% vs 43.9%,OR 3.727 (95%CI: 2.320 to 5.988), p < .001)(ITT), (74.6% vs 43.9%,OR 3.863 (95%CI: 2.369 to 6.298), p < .001) (PP). Furthermore, our meta-analysis suggested that the occurrence of side effects did not significantly differ between patients receiving ecabet sodium-containing therapy and patients receiving nonecabet sodium-containing therapy (14.0% vs 13.3%, OR 1.055 (95%CI: 0.632 to 1.759), p = .839).

CONCLUSION

Supplementation with ecabet sodium during H. pylori eradication therapy improves the eradication rate. The use of ecabet sodium does not increase the side effects based on our meta-analysis.

摘要

背景

多项研究报告称,在根除幽门螺杆菌过程中应用伊索佳硫酸氨基葡萄糖可提高根除率并减少治疗相关副作用。然而,该疗法的疗效和安全性存在争议。

目的

通过基于随机对照试验(RCT)进行荟萃分析,确定伊索佳硫酸氨基葡萄糖是否能提高幽门螺杆菌的根除率并检验治疗安全性。

方法

在以下数据库进行文献检索:PubMed、Embase、Cochrane图书馆、科学引文索引、中国知网数据库和万方数据库。对所有比较补充伊索佳硫酸氨基葡萄糖与不含伊索佳硫酸氨基葡萄糖治疗的RCT进行荟萃分析。

结果

评估了13项RCT,共纳入1808例患者。荟萃分析表明,含伊索佳硫酸氨基葡萄糖的四联疗法组的根除率高于标准三联疗法组(84.5%对74.55%,OR 1.757(95%CI:1.307至2.362),p <.001)。分析还表明,含伊索佳硫酸氨基葡萄糖的三联疗法组的根除率显著高于PPI加阿莫西林或克拉霉素疗法组(74.6%对43.9%,OR 3.727(95%CI:2.320至5.988),p <.001)(ITT),(74.6%对43.9%,OR 3.863(95%CI:2.369至6.298),p <.001)(PP)。此外,我们的荟萃分析表明,接受含伊索佳硫酸氨基葡萄糖治疗的患者与接受不含伊索佳硫酸氨基葡萄糖治疗的患者之间副作用的发生率没有显著差异(14.0%对13.3%,OR 1.055(95%CI:0.632至1.759),p =.839)。

结论

在幽门螺杆菌根除治疗期间补充伊索佳硫酸氨基葡萄糖可提高根除率。根据我们的荟萃分析,使用伊索佳硫酸氨基葡萄糖不会增加副作用。

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