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[目的]评价序贯疗法与传统标准三联疗法治疗幽门螺杆菌(Hp)感染的疗效及两者之间发生不良反应的异同。[方法]检索国内常用的电子数据库,纳入比较标准三联疗法与序贯疗法对Hp根除率的随机对照试验,提取选择患者的基本资料、试验研究的质量、Hp根除率以及不良反应发生率等。荟萃综合分析各项研究对该2种疗法的相对危险度(relative risk,RR)及95%可信区间(95%CI)。利用Cochrane协作网风险偏倚评价标准制作漏斗图评价出版偏倚。[结果]8项随机对照临床试验(RCT),共计890例患者符合纳入标准。Meta分析结果显示,序贯疗法较比传统标准三联疗法具有更高的Hp根除率,即具有更高优越性,其中RR=1.23,95%CI:1.16~1.32。2种疗法的不良反应发生率之间差异无统计学意义(P>0.05)。[结论]序贯疗法比传统标准三联疗法具有更高的Hp根除率,其不良反应发生率亦较传统标准三联疗法偏低,但由于纳入文献质量不高,故仍需要多中心,大样本的高质量的随机对照临床研究,以期做出更为严谨的系统评价。
[Objective] To evaluate the efficacy of sequential therapy and traditional standard triple therapy in the treatment of Helicobacter pylori (Hp) infection and the similarities and differences between the two. [Methods] We searched the commonly used electronic databases in our country and included the randomized controlled trials comparing the standard triple therapy and sequential therapy to the Hp eradication rate. We extracted the basic data of selected patients, the quality of the experimental study, the eradication rate of Hp and the incidence of adverse reactions. A meta-analysis comprehensively analyzed the relative risk (RR) and 95% confidence interval (95% CI) of the two treatments for each of the two therapies. Using the Cochrane Collaboration Network Risk Bias Evaluation Criteria to Make Funnels to Assess Publication Bias. [Results] Eight randomized controlled clinical trials (RCTs), a total of 890 patients met the inclusion criteria. Meta-analysis showed that sequential therapy had higher Hp eradication rate than traditional standard triple therapy, which had superiority, of which RR = 1.23, 95% CI: 1.16-1.32 The incidence of adverse reactions The difference was not statistically significant (P> 0.05). [Conclusion] Sequential therapy has a higher Hp eradication rate than the traditional standard triple therapy and its incidence of adverse reactions is also lower than that of the traditional standard triple therapy. However, due to the low quality of the included literature, multiple-center, large sample High-quality randomized controlled clinical study with a view to making a more rigorous systematic review.