摘要
目的评价质子泵抑制剂（PPI）和左氧氟沙星为基础的三联疗法作为一线方案根除幽门螺杆菌的疗效与安全性。方法在Medline、Embase、OVID、Cochrane Library、Clinical evidence online、Socolar检索平台和CNKI中国期刊全文数据库（1994至2008年）中检索2008年5月17日之前已发表的关于PPI和左氧氟沙星为基础的三联疗法作为一线方案根除幽门螺杆菌的随机对照临床试验。应用Jadad评分对纳入的研究进行质量评价。利用Stata9．0软件进行数据分析，根据异质性检验结果，选择相应的效应模型进行荟萃分析。并通过Egger回归和剪切-添补的方法评定是否存在发表偏倚，利用剪切-添补的方法对未发表的研究结果进行估计。结果按入选标准，共纳入11个随机对照临床试验，共1926例幽门螺菌感染者纳入荟萃分析。荟萃分析表明：作为一线方案，PPI和左氧氟沙星为基础的三联疗法与标准三联疗法比较，其根除率高，比值比（OR）值为1．56[95％可信区间（cI）为1．25～1．94，P=0．000]，不良反应发生低，OR值为0．57（95％CI为0．44～0．74，P=0．000），依从性差异无统计学意义，OR值为0．72（95％CI为0．34～1．49，P=0．374）。结论PPI和左氧氟沙星为基础的三联疗法可以有效地根除幽门螺杆菌，可以作为根除幽门螺杆菌的一线方案。
Objective To evaluate the effectiveness and safety of the proton pump inhibitor and levofloxacin based first-line triple therapy in the eradication of Helicobacter pylori （Hp）. Methods Correlated randomized controlled clinical trials （ RCTs ） evaluating the effectiveness and safety of proton pump inhibitor and levofloxaein based first-line triple therapy to eradicate Hp were searched in Medline, Embase, OVID, Coehrane Library, Clinical evidence online, Socolar searching platform, and National Knowledge Infrastructure （1994 -2008 ） . The final searching date was 17 May 2008. The quality of trials was assessed according to the Jadad standard. Effective model for calculation was selected according to statistical heterogeneity between the trials evaluated by Stata 9.0. Egger regression model and trim-and-fill method were utilized to evaluate publication bias, and trim and fill method was employed to estimate the outcomes of the articles unpublished. Results Eleven RCTs including 1926 cases were selected for analysis in accordance with the enrollment criteria. As the first line treatment, proton pump inhibitor and levofloxaein based triple therapy was more effective than standard triple therapy （ total OR = 1.56, 95% CI = 1.25 - 1.94, P=0.000）, had lower side effect rate than standard triple therapy （total OR =0.57, 95% CI = 0.44 - 0.74, P = 0.000） , and there was no significant difference in the compliance with the two therapies （total OR = 0. 72, 95% CI = 0.34 - 1.49, P = 0. 374）. Conclusion Proton pump inhibitor and levofloxacin based triple therapy is effective in the eradication of Hp, and should be advocated to be the first-line regime in the treatment of Hp.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2008年第38期2722-2725,共4页
National Medical Journal of China
