雷尼替丁枸櫞酸鉍根除幽門螺桿菌的系統評價_《中國循證醫學雜志》

作者：

王一平 , 王瓊 , 田玲

四川大學華西醫院消化科,成都,610041;

關鍵詞：

雷尼替丁枸櫞酸鉍幽門螺桿菌系統評價隨機對照試驗

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　評價雷尼替丁枸櫞酸鉍(Ranitidine bismuth citrate,RBC)根除幽門螺桿菌(Helicobacter Pylori,H.pylori)治療的療效.
方法　應用國際Cochrane協作網系統評價方法對雷尼替丁枸櫞酸鉍(RBC)根除幽門螺桿菌治療的隨機對照試驗(RCT)進行系統評價.
資料來源 　檢索Cochrane圖書館、Cochrane協作網上消化道專業試驗數據庫、MEDLINE、中國生物醫學文獻數據庫(CBM)、手工檢索發表與未發表的中文文獻.
納入標準 　收集比較RBC或以RBC為主的二聯、三聯、四聯方案與質子泵抑制劑(PPI)、H2受體拮抗劑(H2RA)、其他鉍劑或安慰劑治療根除H.pylori的隨機對照試驗.試驗無論是否使用盲法或發表語種均不受納入限制.
資料提取與統計方法 　兩名評價人員獨立提取資料.數據采用Cochrane協作網專用軟件RevMan4.1版進行統計分析.
結果　 15篇RCT共治療3 638例患者滿足納入標準.其中高質量的試驗有八篇,雙盲試驗有五篇,單盲試驗有三篇.Meta-分析的結果,RBC和對照組比較,OR值為3.06(95%的可信區間[2.62,3.58],P＜0.00001.但具有顯著異質性(P＜0.00001),故采用隨機效應模型,OR值為2.05(95%的可信區間[1.29,3.25],P=0.002).敏感性分析提示文章的質量及研究樣本的大小并不影響分析的結果.試驗未發現嚴重的副作用.
結論　RBC根除H.pylori療效優于對照組,是一個值得選用的治療方法.

引用本文： 王一平,王瓊,田玲. 雷尼替丁枸櫞酸鉍根除幽門螺桿菌的系統評價. 中國循證醫學雜志, 2003, 03(2): 98-107. doi: 復制

1.	［1］中華醫學會消化病學分會.幽門螺桿菌若干問題的共識意見[J]中華消化雜志2000;20(2):117-118.Branch of Gastroenterology , Medicine Association of China. The unanimous opinion about some problem of H. Pylor [J]. Gas-trotroenteric magazine of China. 2002;20(2):117- 118.
2.	［2］urrent concepts in the management of Helicobacter pylori infection The Maastricht 2 - 2000 Consensus Report. Aliment [J]. Pharmacol Ther 2002; 16 (2): 167- 180.
3.	［3］Van Oijen A H, Verbeek A L, Jansen J B, et al. Review article: treatment of heliconbacter pylori infection with Ranitidine bithmuth citrate- or proton pump inhibitor- based triple therapies. Aliment Phamacol Ther 2000; 16 (8): 991 - 999.
4.	［4］Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of Randomized clinical trials: is blinding necessary [J]?Control Clin Trials 1996; 17:1 - 12.
5.	［5］Danese S, Armuz zi A, Romano A, et al. Efficacy and tolerability of antibiotics in patients undergoing H. Pylori eradication [J].Hepatogastroenterology 2001; 48 (38): 465 - 467.
6.	［6］Savarino V, Zentilin P, Pivari M, et al. The impact of antibioticresistanee on the efficacy of three 7 - day regimens against Helicobacter pylor [J]. Aliment Pharmacol Ther 2000; 14 (7): 893- 900.
7.	［7］Pare P, Farley A, Romaozinho JM, et al. Coomparison of Ritidine bismuth citrate plus Crithromycin with Oprazole plus Crithromycin for the eradication of Helicobacter pylor [J ]. Aliment PharmacolTher 1999; 13 (8): 1071 - 1078.
8.	［8］catalano F, Catanzaro R, Bentivegina C, et al. Ritidine bismuth citrate versus Oprazole triple therapy for the eradication of Helicobacter pylori and healing of duodenal ulcer. Aliment [J ]. Pharmacol Ther 1998; 12 (1): 59-62.
9.	［9］上海市瑞倍臨床試驗協作組.枸櫞酸鉍雷尼替丁為主三聯1周方案根除H. pylori方案的研究.中華消化雜志2001:2:124-125Association Groupof clinicalTrials,Rui-Pei,Shang-hai.The Research about eradication .H. Pylori with ranitidine Bismuth Citrate. Gastroenteric magazine of China. 2001 ;2:124 - 125.
10.	［10］Kung NN, Sung JJ, Yuen NW, et al. One week R anitidine bismuth citrate versus colloidal bismuth subcitrate based anti Helicobacter triple therapy: a prospective Randomized controlled trial [J]. Am J Gastroenterol 1999; 94 (3): 721-724.
11.	［11］方秀才陸星華董恩鈺國產枸櫞酸鉍雷尼替丁治療消化性潰瘍的臨床研究中國臨床藥理雜志2001;1:3-6FangXiu cai, lu Xing hua , Dong En- yu. The clinical re-search of Eradicating gastroenteritic ulceration with RBC made inchina. Clinical Pharmacological Magazine of China. 2001; 1:3-6.
12.	［12］沈磊,羅和生,沈志祥等.雷尼替丁枸櫞酸鉍三聯治療H.pvlori相關性消化性潰瘍療效觀察.胃腸病學2001;6:增刊.Shen Lei, Luo He-sheng, Shen Zhi-xiang. The observe of Curative effect of relativity Gastroenteritic ulceration with RBC Gastroenterology. 2001 ;6: supplement.
13.	［13］catalano F, BRciforte G, Catanzaro R, et al. Helicobacter pylori - positive duodenal ulcer: three - day antibiotic eradication regi men [J]. Aliment Pharmacol Ther 2000; 14 (10):1329-1334.
14.	［14］Mao HV, Lack BV, Long T, et al. Oprazole or Ranitidine hismuth citrate triple therapy to treat Helicobacter pylori infection: a Randomized, controlled trial in Vietnamese patients with duo denal ulcer [J]. Aliment Pharmacol Ther 2000; 14 (1): 97-101.
15.	［15］Spadaecini A, De Fanis C, Sciampa G, et al. Triple regimens using Lsoprazole or Ranitidine bismuth citrate for Helicobacter pylori eradication [J]. Aliment Pharmacol Ther 1998; 12 ( 10): 997- 1001.
16.	［16］SungJ.J., LeungW. K, LingT. K. et al. One-week use of Ritidine bismuth citrate, axycillin and Crithromycin for the treat ment of Helicobacter pylori - related duodenal ulcer. Aliment Pharmacol Ther 1998; 12 (8): 725 - 730.
17.	［17］Kolkman J. J, Tan T. G, Oudkerk Pool M, et al. Ritidine bis muth citrate with Crithromycin versus Oprazole with Axycillin in the cure of Helicobacter pylori infection [J ]. Aliment Phamacol Ther1997; 11 (6): 1123-1129.
18.	［18］Peterson W. L, Ciociola A. A, Sykes D. L, et al. Ritidine bis muth citrate plus Crithromycin is effective for healing duodenal ulcers, eradicaTg H. pylori and reducing ulcer recurrence [J]. Aliment Pharrmacol Ther 1996; 11 (2): 251 - 261.
19.	［19］Bardhan K.D, DekkersC. P.M, LarmS. K, etal. GR122311 (Ritidine bismuth citrate), a new drug for the treatment of duo denal ulcer [J]. Aliment Pharmacol Ther 1995; 9 (7): 497-506.
20.	［20］Vondracek TG. Ranitidine bismuth citrate in the treatment of he licobacter pylori infection and duodenal ulcer [J ]. Annals Pharmacol Ther 1998; 32: 672- 679.

1. ［1］中華醫學會消化病學分會.幽門螺桿菌若干問題的共識意見[J]中華消化雜志2000;20(2):117-118.Branch of Gastroenterology , Medicine Association of China. The unanimous opinion about some problem of H. Pylor [J]. Gas-trotroenteric magazine of China. 2002;20(2):117- 118.
2. ［2］urrent concepts in the management of Helicobacter pylori infection The Maastricht 2 - 2000 Consensus Report. Aliment [J]. Pharmacol Ther 2002; 16 (2): 167- 180.
3. ［3］Van Oijen A H, Verbeek A L, Jansen J B, et al. Review article: treatment of heliconbacter pylori infection with Ranitidine bithmuth citrate- or proton pump inhibitor- based triple therapies. Aliment Phamacol Ther 2000; 16 (8): 991 - 999.
4. ［4］Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of Randomized clinical trials: is blinding necessary [J]?Control Clin Trials 1996; 17:1 - 12.
5. ［5］Danese S, Armuz zi A, Romano A, et al. Efficacy and tolerability of antibiotics in patients undergoing H. Pylori eradication [J].Hepatogastroenterology 2001; 48 (38): 465 - 467.
6. ［6］Savarino V, Zentilin P, Pivari M, et al. The impact of antibioticresistanee on the efficacy of three 7 - day regimens against Helicobacter pylor [J]. Aliment Pharmacol Ther 2000; 14 (7): 893- 900.
7. ［7］Pare P, Farley A, Romaozinho JM, et al. Coomparison of Ritidine bismuth citrate plus Crithromycin with Oprazole plus Crithromycin for the eradication of Helicobacter pylor [J ]. Aliment PharmacolTher 1999; 13 (8): 1071 - 1078.
8. ［8］catalano F, Catanzaro R, Bentivegina C, et al. Ritidine bismuth citrate versus Oprazole triple therapy for the eradication of Helicobacter pylori and healing of duodenal ulcer. Aliment [J ]. Pharmacol Ther 1998; 12 (1): 59-62.
9. ［9］上海市瑞倍臨床試驗協作組.枸櫞酸鉍雷尼替丁為主三聯1周方案根除H. pylori方案的研究.中華消化雜志2001:2:124-125Association Groupof clinicalTrials,Rui-Pei,Shang-hai.The Research about eradication .H. Pylori with ranitidine Bismuth Citrate. Gastroenteric magazine of China. 2001 ;2:124 - 125.
10. ［10］Kung NN, Sung JJ, Yuen NW, et al. One week R anitidine bismuth citrate versus colloidal bismuth subcitrate based anti Helicobacter triple therapy: a prospective Randomized controlled trial [J]. Am J Gastroenterol 1999; 94 (3): 721-724.
11. ［11］方秀才陸星華董恩鈺國產枸櫞酸鉍雷尼替丁治療消化性潰瘍的臨床研究中國臨床藥理雜志2001;1:3-6FangXiu cai, lu Xing hua , Dong En- yu. The clinical re-search of Eradicating gastroenteritic ulceration with RBC made inchina. Clinical Pharmacological Magazine of China. 2001; 1:3-6.
12. ［12］沈磊,羅和生,沈志祥等.雷尼替丁枸櫞酸鉍三聯治療H.pvlori相關性消化性潰瘍療效觀察.胃腸病學2001;6:增刊.Shen Lei, Luo He-sheng, Shen Zhi-xiang. The observe of Curative effect of relativity Gastroenteritic ulceration with RBC Gastroenterology. 2001 ;6: supplement.
13. ［13］catalano F, BRciforte G, Catanzaro R, et al. Helicobacter pylori - positive duodenal ulcer: three - day antibiotic eradication regi men [J]. Aliment Pharmacol Ther 2000; 14 (10):1329-1334.
14. ［14］Mao HV, Lack BV, Long T, et al. Oprazole or Ranitidine hismuth citrate triple therapy to treat Helicobacter pylori infection: a Randomized, controlled trial in Vietnamese patients with duo denal ulcer [J]. Aliment Pharmacol Ther 2000; 14 (1): 97-101.
15. ［15］Spadaecini A, De Fanis C, Sciampa G, et al. Triple regimens using Lsoprazole or Ranitidine bismuth citrate for Helicobacter pylori eradication [J]. Aliment Pharmacol Ther 1998; 12 ( 10): 997- 1001.
16. ［16］SungJ.J., LeungW. K, LingT. K. et al. One-week use of Ritidine bismuth citrate, axycillin and Crithromycin for the treat ment of Helicobacter pylori - related duodenal ulcer. Aliment Pharmacol Ther 1998; 12 (8): 725 - 730.
17. ［17］Kolkman J. J, Tan T. G, Oudkerk Pool M, et al. Ritidine bis muth citrate with Crithromycin versus Oprazole with Axycillin in the cure of Helicobacter pylori infection [J ]. Aliment Phamacol Ther1997; 11 (6): 1123-1129.
18. ［18］Peterson W. L, Ciociola A. A, Sykes D. L, et al. Ritidine bis muth citrate plus Crithromycin is effective for healing duodenal ulcers, eradicaTg H. pylori and reducing ulcer recurrence [J]. Aliment Pharrmacol Ther 1996; 11 (2): 251 - 261.
19. ［19］Bardhan K.D, DekkersC. P.M, LarmS. K, etal. GR122311 (Ritidine bismuth citrate), a new drug for the treatment of duo denal ulcer [J]. Aliment Pharmacol Ther 1995; 9 (7): 497-506.
20. ［20］Vondracek TG. Ranitidine bismuth citrate in the treatment of he licobacter pylori infection and duodenal ulcer [J ]. Annals Pharmacol Ther 1998; 32: 672- 679.

《中國循證醫學雜志》

雷尼替丁枸櫞酸鉍根除幽門螺桿菌的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

《中國循證醫學雜志》

雷尼替丁枸櫞酸鉍根除幽門螺桿菌的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料