聚普瑞锌颗粒联合三联疗法根除幽门螺杆菌疗效的Meta分析

Polaprezinc Combined with Triple Regimen in Eradication of Helicobacter pylori: A Meta-Analysis

摘要: 目的：系统评价聚普瑞锌颗粒联合三联方案根除幽门螺杆菌(H. pylori、Hp)的疗效与安全性。方法：计算机检索CNKI、Wanfang、VIP、CBM、ChiCTR数据库、PubMed、theCochranelibrary，搜集国内外公开发表的关于聚普瑞锌颗粒根除Hp的随机对照试验(RCT)，检索时间均从建库至2021年11月。采用RevMan 5.4软件进行Meta分析。结果：共纳入7个RCT，包含990例Hp阳性的患者。Meta分析结果显示：① 聚普瑞锌颗粒联合三联方案在Hp的根除率(RR = 1.24, 95% CI 1.15~1.34, P < 0.00001)、临床有效率(RR = 1.19, 95% CI 1.08~1.31, P = 0.0004)均优于单纯三联方案；聚普瑞锌颗粒联合三联方案的不良反应发生率(RR = 0.82, 95% CI 0.52~1.29, P = 0.4)并不高于单纯三联方案。② 与铋剂四联方案相比，聚普瑞锌颗粒联合三联方案在Hp根除率(RR = 1.08, 95% CI 0.99~1.18, P = 0.1)、临床有效率(RR = 1.09, 95% CI 0.99~1.19, P = 0.07)、不良反应发生率(RR = 0.73, 95% CI 0.31~1.71, P = 0.47)方面，差异无统计学意义。结论：聚普瑞锌颗粒联合三联方案能够提高Hp的根除率、临床有效率，并且不良反应的发生率更低；与铋剂四联方案相比，聚普瑞锌颗粒联合三联方案在Hp根除率、临床有效率方面效果相当，不良反应发生率方面并不高于剂四联方案。

Abstract: Objective: To systematically evaluate the efficacy and safety of Polaprezinc combined with triple therapy (TR) in eradication of Hp. Methods: We electronically searched PubMed, theCochranelibrary, CNKI, Wanfang, VIP database, CBM, ChiCTR database from inception to November 2021, to collect randomized controlled trials (RCT) of Polaprezinc in combination with TR for eradication of Hp. Revman 5.3 software was utilized to perform the Meta-analysis. Results: A total of 7 RCT containing 990 patients (479 cases in the experimental group and 511 cases in the control group) were included. The results of meta-analysis showed that: 1) Compared with the TR, the eradication rate (RR = 1.24, 95% CI 1.15~1.34, P < 0.00001) and clinical effective rate (RR = 1.19, 95% CI 1.08~1.31, P = 0.0004) of Hp were superior to those of the TR alone, with statistically significant differences; there were no significant differences between both group in incidence of adverse reactions (RR = 0.82, 95% CI 0.52~1.29, P = 0.4). 2) There were no significant differences in Hp eradication rate (RR = 1.08, 95% CI 0.99~1.18, P = 0.1), clinical effective rate (RR = 1.09, 95% CI 0.99~1.19, P = 0.07), and incidence of adverse reactions (RR = 0.73, 95% CI 0.31~1.71, P = 0.47) between Polaprezinc combined with TR and bismuth-based quadruple therapy. Conclusion: The existing clinical evidence shows that compared with the TR, the combination of Polaprezinc and TR improves the Hp eradication rate, the clinical effective rate and reduces the occurrence of adverse reactions. However, Polaprezinc combined with TR is not superior to bismuth-based quadruple therapy in the Hp eradication rate, the clinical effective rate and the occurrence of adverse reactions.