摘要
目的系统评价酪酸梭菌辅助根除幽门螺杆菌(Helicobacter pylori,H.pylori)感染的疗效和安全性。方法计算机检索PubMed、CENTRAL(2016年7期)、CBM、CNKI、万方数据库、维普数据库,同时追溯纳入文献和相关综述的参考文献,收集关于酪酸梭菌辅助根除H.pylori感染的随机对照试验(RCT),检索时间均从建库至2016年7月30日。由两名评价员根据纳入排除标准筛选文献、提取资料、评价纳入研究的偏倚风险,采取RevMan 5.3进行Meta分析。结果最终纳入13个RCT,共1 372例患者(其中试验组742例,对照组630例)。Meta分析结果显示:与标准根除方案相比,酪酸梭菌辅助治疗组有利于提高H.pylori的根除率(RR=1.26,95%CI:1.18~1.34,P<0.00001),并且降低总不良反应(RR=0.41,95%CI:0.32~0.52,P<0.00001)、腹泻(RR=0.31,95%CI:0.16~0.58,P=0.0003)、味觉紊乱的发生率(RR=0.35,95%CI:0.17~0.73,P=0.005);然而,在腹胀、恶心的发生率上,酪酸梭菌辅助治疗组虽低于标准方案组,但差异无统计学意义。结论当前证据显示酪酸梭菌联合标准方案不仅可提高H.pylori的根除率,还能降低总不良反应、腹泻及味觉紊乱的发生。受纳入研究的质量和数量的限制,上述结论有待更多高质量的研究予以验证。
Objective To systematically evaluate the efficacy and safety of Clostridium butyricum as the ad- junctive therapy for Helicobacterpylori （H. pylori） infection. Methods PubMed, CENTRAL （Issue 7, 2016）, CBM, CNKI, Wanfang database and VIP database were searched for the relevant references and re- views about the randomised controlled trials （RCTs） on Clostridium butyricum as adjunctive therapy for e- radication of H. pylori from inception to July 2016, with no language restrictions. Two investigators inde- pendently screened the literatures, extracted data and assessed the risk of bias of the included studies. The Meta-analysis was performed by RevMan 5.3. Results A total of 13 RCTs containing 1,372 patients （742 in Probiotic group, 630 patients in Control group） were included. The results of meta-analysis showed that compared with the standard regimen, Clostridium butyricum as adjunctive therapy for eradication of H. py- [ori could increase the eradication rate （RR= 1.26, 95-CI： 1.18 - 1.34, P〈.0. 00001）, and reduce the in- cidences of total adverse effects （RR=O. 41, 95-CI： O. 32 - 0.52, P%0. 00001）, diarrhea （RR=0.31, 95-CI： 0.16 - 0.58, P=0. 0003） and taste disorders （RR=O. 35, 95%CI： O. 17 - O. 73, P=0. 005） . However, there was no significant difference between the two groups in the incidence of abdominal disten- sion and nausea. Conclusion The current evidences show that Clostridium butyricum combined with stand-ard regimen can not only increase the eradication rate of H. pylori, but also reduce the incidence of total ad- verse effects, diarrhea and taste disorders. Due to the limited quality and quantity of included studies, the a- bove Conclusion need to be verified by more high-quality studies.
出处
《中国微生态学杂志》
CAS
CSCD
2017年第4期406-412,共7页
Chinese Journal of Microecology
关键词
酪酸梭菌
幽门螺杆菌
META分析
Clostridium butyricum
Helicobacter pylori
Meta-analysis
