Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan ; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
J Clin Biochem Nutr. 2015 Mar;56(2):85-90. doi: 10.3164/jcbn.14-101. Epub 2014 Dec 27.
Mucosal protective agents may improve healing of patients with endoscopic submucosal dissection-induced ulcers. The present study systematically evaluated published clinical trials to determine whether combined therapeutic use of mucosal protective agents and proton pump inhibitors can improve the outcome of patients with endoscopic submucosal dissection-induced ulcers compared to treatment with proton pump inhibitors alone. PubMed, the Cochrane Library, and the Igaku-Chuo-Zasshi database were searched to identify eligible randomized trials for systematic review. We identified 11 randomized trials for inclusion in our study (1,160 patients). Pooled endoscopic submucosal dissection-induced ulcer healing rates were 45.8% and 34.4% for patients with or without mucosal protective agents, respectively. The odds ratio was 2.28 (95% confidence interval, 1.57-3.31) with no significant study heterogeneity. In conclusion, the systematic review and meta-analysis showed that the combined therapeutic use of proton pump inhibitors and mucosal protective agents improved healing rates of endoscopic submucosal dissection-induced ulcers compared to treatment with proton pump inhibitor monotherapy.
黏膜保护剂可能有助于改善内镜黏膜下剥离术所致溃疡患者的愈合。本研究系统评估了已发表的临床试验，以确定与单独使用质子泵抑制剂相比，黏膜保护剂联合质子泵抑制剂的联合治疗是否能改善内镜黏膜下剥离术所致溃疡患者的结局。通过检索 PubMed、Cochrane 图书馆和 Igaku-Chuo-Zasshi 数据库，以确定系统评价的合格随机试验。我们共纳入了 11 项随机试验（共 1160 例患者）。有或没有黏膜保护剂的患者内镜黏膜下剥离术后溃疡愈合率分别为 45.8%和 34.4%。优势比为 2.28（95%置信区间，1.57-3.31），且无显著的研究异质性。总之，系统评价和荟萃分析表明，与单独使用质子泵抑制剂相比，质子泵抑制剂联合黏膜保护剂的联合治疗可提高内镜黏膜下剥离术所致溃疡的愈合率。
