大蒜素治疗幽门螺杆菌阳性十二指肠溃疡的Meta分析

目的 探讨大蒜素对幽门螺杆菌阳性十二指肠溃疡的治疗作用.方法 计算机检索PubMed、CENTRAL、Embase、VIP、CNKI、CBM和WanFang Data,查找所有探讨大蒜素对幽门螺杆菌阳性十二指肠溃疡的随机对照试验,检索时限均为建库至2016年8月15日.同时手检纳入文献的参考文献.按纳入排除标准由3名研究者独立进行RCT的筛选、资料提取和质量评价后,采用RevMan 5.2软件进行Meta分析.结果 共纳入8个研究、961例患者.Meta分析结果显示:①在有效性方面:大蒜素治疗幽门螺杆菌阳性十二指肠溃疡的溃疡愈合总体有效率[OR=3.33,95％CI(1.82,6.06),P<0.01]高于对照组;对溃疡愈合情况进行亚组分析痊愈率高于对照组[OR=1.92,95％CI(1.29,2.87),P<0.01],无效率低于对照组[OR=0.35,95％CI(0.16,0.75),P<0.01];幽门螺杆菌根除率[OR=2.88,95％CI(1.77,4.67),P<0.01]高于对照组;②在安全性方面:腹痛消失时间较早[SMD=-1.06,95％CI(-1.91,-0.22),P=0.01].通过Jadad法进行文献质量评价,所有研究均为5分,文献质量较高.结论 大蒜素对幽门螺杆菌阳性十二指肠溃疡患者有明显疗效;但因纳入研究较少、质量参差不齐、样本含量小、各研究方法变异性大,建议临床上慎重选择使用,需要更多高质量、大样本、多中心的随机对照试验进一步论证.

Meta-analysis for the effects of allicin on the treatment of duodenal peptic ulcer with Helicobacter pylori positive

Objective To explore the effect of allicin on the treatment of duodenal peptic ulcer with Helico-bacter pylori positive. Methods The randomized controlled trials (RCTs) of allicin against Helicobacter pylori-positive duodenal ulcer were searched in PubMed, CENTRAL, Embase, VIP, CNKI, CBM and WanFang Data (The search time-line ranged from the construction of the library to August 15, 2016), and the references of those RCTs were also searched by hand. According to inclusion criteria, screening, data extraction and quality evaluation of RCTs were conducted inde-pendently by three researchers. Meta-analysis was performed by the RevMan 5.2 software. Results A total of 8 studies involving 961 patients met the including criteria. The results of Meta-analysis showed that:(1) Efficacy:the overall effec-tive rate of allicin for duodenal peptic ulcer with Helicobacter pylori positive (OR=3.33, 95％ CI [1.82, 1.82], P<0.01) was higher than that in the control group;the healing rate of subgroup analysis of the peptic ulcer was higher than that in the control group (OR=1.92, 95％ CI [1.29, 1.29], P<0.01); the non-effective rate was lower that in the control group (OR=0.35, 95％CI [0.16, 0.16], P<0.01);the eradication rate of Helicobacter pylori (OR=2.88, 95％CI [1.77,1.77], P<0.01) was higher than that in the control group. (2) Safety:Abdominal pain disappeared earlier (SMD=-1.06, 95％ CI [-1.91,-0.22], P=0.01). The qualities of papers were assessed by using the Jadad score, all trials had a score of 5 and the quality of the literature was higher. Conclusion Allicin has a significant effect on duodenal peptic ulcer with Helico-bacter pylori positive. But because of uneven quality, small sample size and great variability of each research method, it is suggested to choose it carefully in clinical practice. It requires more high-quality, large sample, multi-center random-ized controlled trials to further demonstrate the efficacy of allicin.