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(yīng)用國際Cochrane協(xié)作網(wǎng)系統(tǒng)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(tǒng)評價.
資料來源 檢索Cochrane圖書館、Cochrane協(xié)作網(wǎng)上消化道專業(yè)試驗數(shù)據(jù)庫、MEDLINE、中國生物醫(yī)學文獻數(shù)據(jù)庫(CBM)、手工檢索發(fā)表與未發(fā)表的中文文獻.
納入標準 收集比較RBC或以RBC為主的二聯(lián)、三聯(lián)、四聯(lián)方案與質(zhì)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(fā)表語種均不受納入限制.
資料提取與統(tǒng)計方法 兩名評價人員獨立提取資料.數(shù)據(jù)采用Cochrane協(xié)作網(wǎng)專用軟件RevMan4.1版進行統(tǒng)計分析.
結(jié)果 15篇RCT共治療3 638例患者滿足納入標準.其中高質(zhì)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(jié)果,RBC和對照組比較,OR值為3.06(95%的可信區(qū)間[2.62,3.58],P＜0.00001.但具有顯著異質(zhì)性(P＜0.00001),故采用隨機效應(yīng)模型,OR值為2.05(95%的可信區(qū)間[1.29,3.25],P=0.002).敏感性分析提示文章的質(zhì)量及研究樣本的大小并不影響分析的結(jié)果.試驗未發(fā)現(xiàn)嚴重的副作用.
結(jié)論 RBC根除H.pylori療效優(yōu)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(tǒng)評價. 中國循證醫(yī)學雜志, 2003, 03(2): 98-107. doi: 復(fù)制
| 1. | ［1］中華醫(yī)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(xié)作組.枸櫞酸鉍雷尼替丁為主三聯(lián)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(chǎn)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(lián)治療H.pvlori相關(guān)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(yī)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(xié)作組.枸櫞酸鉍雷尼替丁為主三聯(lián)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(chǎn)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(lián)治療H.pvlori相關(guān)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.