呋喃唑酮初治方案治療幽門螺桿菌感染效果的Meta分析_《中國循證醫學雜志》

作者：

黃宣 ,  呂賓 , 孟立娜

浙江中醫藥大學附屬第一醫院消化內科（杭州 310006）;

關鍵詞：

呋喃唑酮幽門螺桿菌 Meta分析

DOI：

10.7507/1672-2531.20100543

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目的　評價以呋喃唑酮為基礎的方案在幽門螺桿菌初次治療中的療效與安全性。
方法　電子檢索Cochrane圖書館（2009年第1期）、PubMed（1992～2009.1）、OVID數據庫（1994～2009.1）、萬方數據庫（1994～2009.1）、中國期刊網（1994～2009.1）、維普中文科技期刊全文數據庫（1994～2009.1），收集以呋喃酮唑為基礎的方案初次治療幽門螺桿菌感染的隨機對照試驗（RCT），評價納入研究質量，用RevMan 5.0軟件進行統計分析。
結果　共納入5個RCT，合計499例患者。其方法學質量等級為B的4個，為C的1個。呋喃唑酮組與對照組幽門螺桿菌根除率的ITT分析分別為78.3%與66.8%，PP分析分別為83.1%與70.9%，其RR（95%CI）分別為1.18（0.86，1.62）、1.17（0.88，1.57）；呋喃唑酮與對照組輕度不良反應發生率分別為40.8%與39.4%，重度不良反應發生率為7.8%與3.7%，其RR（95%CI）分別為1.03（0.79，1.36）、1.86（0.84，4.09）。
結論　以呋喃唑酮為基礎的方案在幽門螺桿菌初次治療療效與對照組相似，輕中度及重度不良反應發生率無明顯升高，可考慮作為幽門螺桿菌一線治療方案。受納入研究數量及質量限制，上述結論尚需大樣本、高質量的RCT進一步證實。

引用本文： 黃宣,呂賓,孟立娜. 呋喃唑酮初治方案治療幽門螺桿菌感染效果的Meta分析. 中國循證醫學雜志, 2010, 10(9): 1048-1052. doi: 10.7507/1672-2531.20100543 復制

1.	孟靈梅, 周麗雅, 林三仁, 等. 幽門螺桿菌與消化性潰瘍關系的10年隨訪研究. 中華消化雜志, 2009, 29(6): 361-364.
2.	周麗雅, 林三仁, 丁士剛, 等. 根除幽門螺桿菌對胃癌患病率及胃黏膜組織學變化的八年隨訪研究. 中華消化雜志, 2005, 25(6): 324-327.
3.	中華醫學會消化病學分會幽門螺桿菌學組. 中國幽門螺桿菌耐藥狀況以及耐藥對治療的影響. 胃腸病學, 2007, 12(9): 525-530.
4.	Khatibian M, Ajvadi Y, Nasseri-Moghaddam S, et al. Furazolidone-based, metronidazole-based, or a combination regimen for eradication of Helicobacter pylori in peptic ulcer disease. Arch Iran Med, 2007, 10(2): 161-167.
5.	Cheng H, Hu FL. Furazolidone, amoxicillin, bismuth and rabeprazole quadruple rescue therapy for the eradication of Helicobacter pylori. World J Gastroenterol, 2009, 15(7): 860-864.
6.	Malfertheiner P, Megraud F, O’Morain C, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut, 2007, 56(6): 772-781.
7.	Alderson P, Green S, Higgins JPT. Cochrane Reviewers’Handbook 4.2.2[updated March 2004]. In: The Cochrane Library, Issue 1, 2004.
8.	Liu WZ, Xiao SD, Shi Y, et al. Furazolidone-containing short-term triple therapies are effective in the treatment of Helicobacter pylori infection. Aliment Pharmacol Ther, 1999, 13(3): 317-322.
9.	Fakheri H, Malekzadeh R, Merat S, et al. Clarithromycin vs. furazolidone in quadruple therapy regimens for the treatment of Helicobacter pylori in a population with a high metronidazole resistance rate. Aliment Pharmacol Ther, 2001, 15(3): 411-416.
10.	Ecclissato C, Marchioretto MA, Mendonca S, et al. Increased primary resistance to recommended antibiotics negatively affects Helicobacter pylori eradication. Helicobacter, 2002, 7(1): 53-59.
11.	楊伏. 奧美拉唑、阿莫西林、呋喃唑酮三聯根除幽門螺桿菌感染的療效觀察. 現代醫藥衛生, 2004, 20(15): 1469-1470.
12.	Frota LC, da CMP, Luz CR, et al. Helicobacter pylori eradication using tetracycline and furazolidone versus amoxicillin and azithromycin in lansoprazole based triple therapy: an open randomized clinical trial. Arq Gastroenterol, 2005, 42(2): 111-115.
13.	European Helicobacter Pylori Study Group.Current European concepts in the management of Helicobacter pylori infection. The Maastricht Consensus Report. Gut, 1997, 41(1): 8-13.
14.	Paoluzi P, Iacopini F, Crispino P, et al. 2-week triple therapy for Helicobacter pylori infection is better than 1-week in clinical practice: a large prospective single-center randomized study. Helicobacter, 2006, 11(6): 562-568.
15.	Calvet X, Ducons J, Bujanda L, et al. Seven versus ten days of rabeprazole triple therapy for Helicobacter pylori eradication: a multicenter randomized trial. Am J Gastroenterol, 2005, 100(8): 1696-1701.
16.	Rokkas T, Sechopoulos P, Robotis I, et al. Cumulative H. pylori eradication rates in clinical practice by adopting first and second-line regimens proposed by the Maastricht III consensus and a third-line empirical regimen. Am J Gastroenterol, 2009, 104(1): 21-25.
17.	Kwon DH, Lee M, Kim JJ, et al. Furazolidone- and nitrofurantoin-resistant Helicobacter pylori: prevalence and role of genes involved in metronidazole resistance. Antimicrob Agents Chemother, 2001, 45(1): 306-308.
18.	Treiber G, Wittig J, Ammon S, et al. Clinical outcome and influencing factors of a new short-term quadruple therapy for Helicobacter pylori eradication: a randomized controlled trial (MACLOR study). Arch Intern Med, 2002, 162(2): 153-160.

1. 孟靈梅, 周麗雅, 林三仁, 等. 幽門螺桿菌與消化性潰瘍關系的10年隨訪研究. 中華消化雜志, 2009, 29(6): 361-364.
2. 周麗雅, 林三仁, 丁士剛, 等. 根除幽門螺桿菌對胃癌患病率及胃黏膜組織學變化的八年隨訪研究. 中華消化雜志, 2005, 25(6): 324-327.
3. 中華醫學會消化病學分會幽門螺桿菌學組. 中國幽門螺桿菌耐藥狀況以及耐藥對治療的影響. 胃腸病學, 2007, 12(9): 525-530.
4. Khatibian M, Ajvadi Y, Nasseri-Moghaddam S, et al. Furazolidone-based, metronidazole-based, or a combination regimen for eradication of Helicobacter pylori in peptic ulcer disease. Arch Iran Med, 2007, 10(2): 161-167.
5. Cheng H, Hu FL. Furazolidone, amoxicillin, bismuth and rabeprazole quadruple rescue therapy for the eradication of Helicobacter pylori. World J Gastroenterol, 2009, 15(7): 860-864.
6. Malfertheiner P, Megraud F, O’Morain C, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut, 2007, 56(6): 772-781.
7. Alderson P, Green S, Higgins JPT. Cochrane Reviewers’Handbook 4.2.2[updated March 2004]. In: The Cochrane Library, Issue 1, 2004.
8. Liu WZ, Xiao SD, Shi Y, et al. Furazolidone-containing short-term triple therapies are effective in the treatment of Helicobacter pylori infection. Aliment Pharmacol Ther, 1999, 13(3): 317-322.
9. Fakheri H, Malekzadeh R, Merat S, et al. Clarithromycin vs. furazolidone in quadruple therapy regimens for the treatment of Helicobacter pylori in a population with a high metronidazole resistance rate. Aliment Pharmacol Ther, 2001, 15(3): 411-416.
10. Ecclissato C, Marchioretto MA, Mendonca S, et al. Increased primary resistance to recommended antibiotics negatively affects Helicobacter pylori eradication. Helicobacter, 2002, 7(1): 53-59.
11. 楊伏. 奧美拉唑、阿莫西林、呋喃唑酮三聯根除幽門螺桿菌感染的療效觀察. 現代醫藥衛生, 2004, 20(15): 1469-1470.
12. Frota LC, da CMP, Luz CR, et al. Helicobacter pylori eradication using tetracycline and furazolidone versus amoxicillin and azithromycin in lansoprazole based triple therapy: an open randomized clinical trial. Arq Gastroenterol, 2005, 42(2): 111-115.
13. European Helicobacter Pylori Study Group.Current European concepts in the management of Helicobacter pylori infection. The Maastricht Consensus Report. Gut, 1997, 41(1): 8-13.
14. Paoluzi P, Iacopini F, Crispino P, et al. 2-week triple therapy for Helicobacter pylori infection is better than 1-week in clinical practice: a large prospective single-center randomized study. Helicobacter, 2006, 11(6): 562-568.
15. Calvet X, Ducons J, Bujanda L, et al. Seven versus ten days of rabeprazole triple therapy for Helicobacter pylori eradication: a multicenter randomized trial. Am J Gastroenterol, 2005, 100(8): 1696-1701.
16. Rokkas T, Sechopoulos P, Robotis I, et al. Cumulative H. pylori eradication rates in clinical practice by adopting first and second-line regimens proposed by the Maastricht III consensus and a third-line empirical regimen. Am J Gastroenterol, 2009, 104(1): 21-25.
17. Kwon DH, Lee M, Kim JJ, et al. Furazolidone- and nitrofurantoin-resistant Helicobacter pylori: prevalence and role of genes involved in metronidazole resistance. Antimicrob Agents Chemother, 2001, 45(1): 306-308.
18. Treiber G, Wittig J, Ammon S, et al. Clinical outcome and influencing factors of a new short-term quadruple therapy for Helicobacter pylori eradication: a randomized controlled trial (MACLOR study). Arch Intern Med, 2002, 162(2): 153-160.

《中國循證醫學雜志》

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《中國循證醫學雜志》

呋喃唑酮初治方案治療幽門螺桿菌感染效果的Meta分析

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