摘要
According to a meta-analysis, H pylori and non-steroidal anti-inflammatory drugs （NSAID） independently and significantly increase the risk of gastroduodenal ulcer and ulcer bleeding. Their coincidence is frequent, demonstration of a possible relationship and consequent attitude is of important implications. But unfortunately, no consensus has been approved in the past years and their interactions are still controversial. H pylori and NSAID are known to share a number of pathogenic mechanisms, but there is no evidence for the significant synergic action between these two risk factors. Their relationship is independent, additive, synergistic or antagonistic without considering the influence of other factors because studies on this subject are different in almost all aspects of their methodology, including the definition of a NSAID user as well as the types, doses, duration and their indications for NSAID use, as well as their end-points, definition of dyspepsia and regimes used for eradication of H pylori. These might contribute to the conflicting results and opinions. H pylori infection in humans does not act synergistically with NSAID on ulcer healing, and there is no need to eradicate it. This notion is supported by the finding that the eradication of H pylori does not affect NSAID induced gastropathy treated with omeprazole and that H pylori infection induces a strong cyclooxygenase-2 （COX-2） expression resulting in excessive biosynthesis of gastroprotective prostaglandin which in turn counteracts NSAID-induced gastropathy and heals the existing ulcer. Other investigators claimed that H pylori infection acts synergistically with NSAID on ulcer development, and H pylori should be eradicated, particularly at the start of long-term NSAID therapy. Eradication of H pylori prior to NSAID treatment does not appear to accelerate ulcer healing or to prevent recurrent ulcers in NSAID users. However, some recommendations can be drawn from the results of clinical trails.
根据元分析， H pylori 和 non-steroidal，反煽动性的药(NSAID ) 独立地并且显著地增加胃与十二指肠的溃疡并且溃疡流血的风险。他们的巧合是经常的，一种可能的关系的示范和作为结果的态度具有重要含意。但是不幸地，没有一致在过去的年里被同意了，他们的相互作用仍然是争论的。H pylori 和 NSAID 被知道分享很多病原的机制，但是为在这二个风险因素之间的重要协作行动没有证据。他们的关系没有因为这个题目上的研究在他们的方法论的几乎所有方面是不同的，考虑另外的因素的影响独立、添加剂、协同的或对抗，包括象为 NSAID 使用的类型，剂量，持续时间和他们的指示一样的一个 NSAID 用户的定义，象他们的端点一样，消化不良和政体的定义为 H pylori 的根除使用了。这些可能贡献冲突结果和意见。在人的 H pylori 感染不对溃疡愈合与 NSAID synergistically 起作用，并且没有需要根除它。这个观点被发现 H pylori 的根除不影响导致 NSAID 的胃病，这与 omeprazole 对待支持，那 H pylori 感染导致强壮的 cyclooxygenase-2 (COX-2 ) 表示导致接着抵抗导致 NSAID 的胃病并且愈合的胃的保护的前列腺素的过多的生合成存在溃疡。另外的调查者宣称感染在溃疡开发与 NSAID synergistically 扮演的那 H pylori，并且 H pylori 应该特别地在长期的 NSAID 治疗的开始被根除。在 NSAID 处理以前的 H pylori 的根除不看起来加速溃疡愈合或在 NSAID 用户阻止周期性的溃疡。然而，一些建议能从临床的小道的结果被拉。
