Andreev D N, Kucheryavyy Y A, Maev I V
Yevdokimov Moscow State University of Medicine and Dentistry.
Ter Arkh. 2021 Feb 15;93(2):158-163. doi: 10.26442/00403660.2021.02.200608.
Systematization of data on the efficacy and safety of butyric acid inclusion in eradication therapy (ET) regimens for Helicobacter pylori infection.
Research searches were carried out in the electronic databases MEDLINE/PubMed, EMBASE, Cochrane, Google Scholar, the Russian Science Citation Index (RSCI) until November 2020. All controlled studies comparing the efficacy and/or safety of including butyric acid in ET regimens for H. pylori infection were included in the final analysis.
The meta-analysis included 6 controlled studies (1 Italy, 5 Russia) involving 736 patients (381 in the ET groups with butyric acid; 355 in the comparison groups). The pooled eradication efficiency in the butyric acid groups was 90.23% (95% confidence interval CI 86.73493.069), while in the comparison groups it was 65.69% (95% CI 60.44170.669). Meta-analysis showed that the addition of butyric acid to ET regimens significantly increased the eradication efficiency (odds ratio OR 5.355, 95% CI 3.5048.184; p0.001). There was no significant heterogeneity between results (p=0.1408; I2=42.1%). The addition of butyric acid to ET regimens significantly reduces the risk of diarrhea (OR 0.225, 95% CI 0.09230.549; p=0.001; I2=34.21%) and abdominal distention (OR 0.357, 95% CI 0.1550.818; p=0.015; I2=80.13%) by the end of the 1st week of treatment.
The present meta-analysis demonstrated that the inclusion of butyric acid in ET regimens for H. pylori infection significantly increases the effectiveness of treatment and reduce the incidence of side effects. Apparently, the increase in the effectiveness of eradication is due to an increase in patient compliance with treatment due to an improvement in the safety profile of therapy.
系统整理关于丁酸纳入幽门螺杆菌感染根除治疗(ET)方案的疗效和安全性的数据。
截至2020年11月,在电子数据库MEDLINE/PubMed、EMBASE、Cochrane、谷歌学术、俄罗斯科学引文索引(RSCI)中进行检索。所有比较丁酸纳入幽门螺杆菌感染ET方案的疗效和/或安全性的对照研究均纳入最终分析。
荟萃分析纳入了6项对照研究(1项来自意大利,5项来自俄罗斯),涉及736例患者(丁酸ET组381例;对照组355例)。丁酸组的综合根除效率为90.23%(95%置信区间CI 86.73493.069),而对照组为65.69%(95%CI 60.44170.669)。荟萃分析表明,在ET方案中添加丁酸显著提高了根除效率(优势比OR 5.355,95%CI 3.5048.184;p<0.001)。结果之间无显著异质性(p = 0.1408;I2 = 42.1%)。在治疗第1周结束时,在ET方案中添加丁酸显著降低了腹泻风险(OR 0.225,95%CI 0.09230.549;p = 0.001;I2 = 34.21%)和腹胀风险(OR 0.357,95%CI 0.1550.818;p = 0.015;I2 = 80.13%)。
本荟萃分析表明,在幽门螺杆菌感染的ET方案中纳入丁酸可显著提高治疗效果并降低副作用发生率。显然,根除效果提高是由于治疗安全性改善导致患者治疗依从性提高。