高剂量双联疗法与铋剂四联疗法治疗幽门螺杆菌感染的系统评价与 Meta 分析。
High-Dose Dual Therapy Versus Bismuth-Containing Quadruple Therapy for the Treatment of Helicobacter pylori Infection: A Systematic Review with Meta-Analysis.
机构信息
Fujian Medical University The Third Clinical Medical College, Fuzhou, Fujian, China; Department of Gastroenterology, The First Affiliated Hospital of Xiamen University Faculty of Medicine, Xiamen, China.
Department of Gastroenterology, The First Affiliated Hospital of Xiamen University Faculty of Medicine, Xiamen, China.
出版信息
Turk J Gastroenterol. 2022 Jun;33(6):454-462. doi: 10.5152/tjg.2022.21579.
BACKGROUND
This study aimed to evaluate the efficacy and safety of high-dose dual therapy for Helicobacter pylori (H. pylori) eradication compared to bismuth-containing quadruple therapy.
METHODS
The electronic database of PubMed, Embase, and Cochrane Library were searched from inception to March 18, 2021. Randomized, controlled trials that evaluated high-dose dual therapy versus bismuth-containing quadruple therapy for H. pylori infection were included.
RESULTS
We included 6 studies containing 1677 patients with H. pylori infection. This meta-analysis demonstrated that high-dose dual therapy achieved similar eradication rate compared with bismuth-containing quadruple therapy (intention-to-treat: 84.6% vs 83.7%, relative risk (RR) = 1.01, 95% CI: 0.97-1.06, P = .49; per-protocol = 88.4% vs 89.0%, RR = 1.00, 95% CI: 0.97-1.04, P = .99). However, highdose dual therapy showed fewer side effects (13.1% vs 32.0%, RR = 0.51, 95% CI: 0.34-0.78, P = .002) and better compliance (96.1% vs 93.3%, RR = 1.03, 95% CI: 1.00-1.05, P = .03) compared to bismuth-containing quadruple therapy.
CONCLUSION
This meta-analysis demonstrated that high-dose dual therapy is equally effective with bismuth-containing quadruple therapy in eradicating H. pylori, with fewer side effects and better compliance.
背景
本研究旨在评估高剂量双联疗法与含铋四联疗法治疗幽门螺杆菌（H. pylori）感染的疗效和安全性。
方法
检索 PubMed、Embase 和 Cochrane Library 电子数据库，检索时间从建库至 2021 年 3 月 18 日。纳入评估高剂量双联疗法与含铋四联疗法治疗 H. pylori 感染的随机对照试验。
结果
纳入 6 项研究，共包含 1677 例 H. pylori 感染患者。Meta 分析结果显示，高剂量双联疗法与含铋四联疗法的根除率相似（意向治疗分析：84.6% vs 83.7%，相对风险（RR）=1.01，95%CI：0.97-1.06，P=0.49；按方案分析：88.4% vs 89.0%，RR=1.00，95%CI：0.97-1.04，P=0.99）。然而，高剂量双联疗法的不良反应发生率较低（13.1% vs 32.0%，RR=0.51，95%CI：0.34-0.78，P=0.002），且依从性更好（96.1% vs 93.3%，RR=1.03，95%CI：1.00-1.05，P=0.03）。
结论
与含铋四联疗法相比，高剂量双联疗法在根除 H. pylori 方面同样有效，且不良反应更少，依从性更好。
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