呋喃唑酮初治方案治疗幽门螺杆菌感染效果的Meta分析

目的评价以呋喃唑酮为基础的方案在幽门螺杆菌初次治疗中的疗效与安全性。方法电子检索Cochrane图书馆（2009年第1期）、PubMed（1992～2009.1）、OVID数据库（1994～2009.1）、万方数据库（1994～2009.1）、中国期刊网（1994～2009.1）、维普中文科技期刊全文数据库（1994～2009.1）,收集以呋喃酮唑为基础的方案初次治疗幽门螺杆菌感染的随机对照试验（RCT）,评价纳入研究质量,用RevMan5.0软件进行统计分析。结果共纳入5个RCT,合计499例患者。其方法学质量等级为B的4个,为C的1个。呋喃唑酮组与对照组幽门螺杆菌根除率的ITT分析分别为78.3%与66.8%,PP分析分别为83.1%与70.9%,其RR（95%CI）分别为1.18（0.86,1.62）、1.17（0.88,1.57）;呋喃唑酮与对照组轻度不良反应发生率分别为40.8%与39.4%,重度不良反应发生率为7.8%与3.7%,其RR（95%CI）分别为1.03（0.79,1.36）、1.86（0.84,4.09）。结论以呋喃唑酮为基础的方案在幽门螺杆菌初次治疗疗效与对照组相似,轻中度及重度不良反应发生率无明显升高,可考虑作为幽门螺杆菌一线治疗方案。受纳入研究数量及质量限制,上述结论尚需大样本、高质量的RCT进一步证实。

The Furazolidone-based First-line Therapy for Helicobacter Pylori Infection: A Meta-analysis

Objective To evaluate the efficacy and safety of furazolidone-based first-line therapy for Helicobacter pylori infection.Methods The randomized controlled trials （RCTs） of furazolidone-based first-line therapy for Helicobacter pylori infection were identified from Cochrane Library （Issue 1,2009）,PubMed （1992 to January 2009）,OVID （1994 to January 2009）,Wanfang Data （1994 to January 2009）,CNKI （1994 to January 2009）,and VIP Data （1994 to January 2009）.The quality of included RCTs was assessed,and the meta-analysis was conducted with RevMan5.0 software.Results Among five included RCTs involving 499 patients,four were graded as B in methodology quality and the left one was graded as C.As to the intention-to-treat （ITT） analysis,the Helicobacter pylori eradication rate was 78.3% in furazolidone group and 66.8% in control group （RR=1.18,95%CI 0.86 to 1.62）,while the Per Protocol （PP） analysis,the eradication rate of furazolidone group and control group was 83.1% and 70.9% respectively （RR=1.17,95%CI 0.88 to 1.57）.The incidence rate of mild side-effects was 40.8% in furazolidone group and 39.4% in control group （RR=1.03,95%CI 0.79 to 1.36）,and while that of severe side-effects in furazolidone group and control group was 7.8% and 3.7% respectively （RR=1.86,95%CI 0.84 to 4.09）.Conclusions With similar efficacy and safety as control group has,the furazolidone-based therapy could be recommended as a first-line therapy for Helicobacter pylori infection.The high-quality RCTs with large sample are required to prove the above conclusion for the limitation of quantity and quality of included studies.