幽门螺杆菌根除治疗对幽门螺杆菌阳性的功能性消化不良患者疗效的Meta分析

目的系统评价幽门螺杆菌根除治疗对幽门螺杆菌阳性患者功能性消化不良的疗效．方法计算机检索PubMeb、Ovid、EMbase和TheCochraneLibrary（2012年第1期）、CBM、CNKI、WanFangData，查找国内外采用幽门螺杆菌根除治疗方案和一般治疗方案比较治疗幽门螺杆菌阳性患者的功能性消化不良的随机对照试验（RCT），检索时限截至2012年4月。由2位研究者根据纳入与排除标准独立筛选文献、提取资料和评价质量后，采用RevMan5．1软件进行Meta分析。结果最终纳入14个RCT，共计2665例患者，其中治疗组1339例，对照组1326例。Meta分析结果显示：根除幽门螺杆菌治疗在治疗幽门螺杆菌阳性的功能性消化不良的临床疗效、症状积分及改善上腹疼痛症状方面均优于对照组，其差异均有统计学意义临床疗效：RR=3．90，95％CI（3．08，4．94），P〈0．0000l；症状积分：WMD=-1．68，95％CI（-1．88，-1．47），P〈0．00001；上腹疼痛症状改善情况：RR=2．84，95％CI（2．02，3．99），P〈0．00001]。结论幽门螺杆菌根除治疗的临床疗效明显，可使幽门螺杆菌阳性的功能性消化不良患者的消化不良症状积分降低，尤其是上腹疼痛症状得到显著改善。受纳入研究质量和数量所限，上述结论尚需进一步开展严格设计的随机双盲对照试验加以验证。

Clinical Effectiveness of Helicobacter Pylori Eradication in Treating Functional Dyspepsia Patients with Helicobacter Pylori Infection: A Meta-Analysis

Objective To evaluate the clinical effectiveness of helicobacter pylori （HP） eradication in treating functional dyspepsia （FD） patients with HP infection. Methods The randomized controlled trials （RCTs） about HP eradication vs. general treatment for FD patients published by April, 2012 were searched in the following databases： CBM, CNKI, WanFang Data, PubMed, Ovid, EMbase and The Cochrane Library （Issue l, 2012）. According to the inclusion and exclusion criteria, two reviewers independently screened studies, extracted data, and evaluated the methodological quality. Then the meta-analysis was conducted using RevMan 5.1 software. Results The total 14 RCTs were included. Among all 2 665 patients involved in, 1 339 were in the treatment group, while the other 1 326 were in the control group. The results of meta-analysis showed that HP eradication was superior to general treatment for FD patients in clinical effects （RR=3.90, 95%CI 3.08 to 4.94, P〈0.000 01）, symptomatic score （WMD=-1.68, 95%CI -1.88 to -1.47, P〈0.000 01）, and improvement of upper abdominal pain （RR=2.84, 95%CI 2.02 to 3.99, P〈0.000 01）. Conclusion With obviously clinical effects, HP eradication can decrease the symptomatic score of dyspepsia, and especially improve upper abdominal pain. For the qual- ity and quantity limitations of the included studies, more well-designed and double blind RCTs are required to further prove this conclusion.