摘要
目的 基于卫生技术评估(HTA)方法,综合评价复方嗜酸乳杆菌在幽门螺杆菌(Helicobacter pylori,HP)根除治疗中的价值,为临床合理应用益生菌制剂及决策部门药物遴选提供证据支持。方法 系统检索PubMed、Embase和the Cochrane library英文数据库,CNKI、万方、SinoMed中文数据库,同时检索国内外卫生技术评估机构官方网站、Clinical Trials及相关数据库,根据纳排标准筛选所有包含复方嗜酸乳杆菌联合标准四联疗法根除HP的HTA报告、随机对照临床试验(RCT)和药物经济学研究,并对纳入研究进行Meta分析或描述性分析。结果 共纳入15篇RCTs,纳入文献总体质量一般。与标准四联疗法比较,添加复方嗜酸乳杆菌治疗14 d后,可明显促进消化性胃溃疡患者的溃疡创面愈合(OR=4.62,95%CI:2.46-8.66,P<0.01)、缓解HP感染患者消化道不适症状(OR=2.05,95%CI:1.24-3.40,P<0.01)、提高HP根除率(OR=2.54,95%CI:1.92-3.35,P<0.01)及降低HP根除治疗过程中不良反应发生率。结论 复方嗜酸乳杆菌在辅助根除HP感染方面具有一定的价值,且安全性良好。
Objective To comprehensively evaluate the value of compound Lactobacillus acidophilus in the treatment of patients with Helicobacter pylori infection,the Health Technology Assessment(HTA)method was employed to provide evidence-based support for the clinical rational use of probiotics. Methods The HTA reports,randomized controlled trials(RCT)and pharmacoeconomic researches,which related to compound Lactobacillus acidophilus combined with standard quadruple therapy for the eradication of HP,were retrieved from PubMed,Embase,the Cochrane Library,CNKI,CBM and Wanfang databases,as well as the official website of HTA organization and Clinical trials from inception to July 31,2021. A Meta-analysis or descriptive analysis for included results were performed. Results Totally 15 RCTs were included in this study. The quality of included studies were mediocre. Compared to standard quadruple therapy group,the addition of compound Lactobacillus acidophilus significantly promoted the ulcer wound healing in patients with peptic ulcer after 14 days treatment(OR = 4. 62,95% CI:2. 46-8. 66,P<0. 01),and significantly relieved the discomfort symptoms of HP infected(OR = 2. 05,95% CI:1. 24-3. 40,P<0. 01),and significantly improved the eradication rate of HP(OR = 2. 54,95% CI:1. 92-3. 35,P < 0. 01)and decreased the incidence of adverse reactions. Conclusion The present study showed that addition of compound Lactobacillus acidophilus might be benefit for eradication of HP infection and with good safety.
作者
李慧博
邢亚兵
李代晓
赵荣生
LI Hui-bo;XING Ya-bing;LI Dai-xiao;ZHAO Rong-sheng(Department of Pharmacy,Peking University Third Hospital,Beijing 100191,China;Institute for Drug Evaluation,Peking University Health Science Center,Beijing 100191,China;Department of Pharmacy,Children's Hospital Affiliated to Zhengzhou Universityt Zhengzhou 450018,China;Department of Pharmacy,Affiliated hospital of Chengde medical college,Hebei Chengde 067000,China)
出处
《临床药物治疗杂志》
2022年第4期43-49,共7页
Clinical Medication Journal
关键词
复方嗜酸乳杆菌
幽门螺杆菌
循证评价
治疗效果
不良反应
compound Lactobacillus acidophilus
Helicobacter pylori
evidence-based evaluation
therapeutic effect
adverse reaction
作者简介
通信作者:赵荣生,博士研究生,教授、主任药师,研究方向:临床药学、循证药学、临床药物治疗评价等。E-mail:zhaomngsheng@bjmu.edu.cn。
