泮托拉唑对比奥美拉唑治疗胃溃疡的Meta-分析
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摘要
目的系统评价泮托拉唑对比奥美拉唑治疗胃溃疡的疗效和安全性。方法计算机检索PubMed、EmBase、Cochrane Library、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、维普中文期刊全文数据库(VIP)和万方数据库,从建库至2018年7月公开发表的泮托拉唑和奥美拉唑治疗胃溃疡的随机临床对照试验(RCT),由两位研究者独立筛选评价文献并提取资料,采用RevMan 5.3软件行系统评价。结果共纳入15项RCTs,合计1 482例患者。Meta-分析结果显示:泮托拉唑组相对于奥美拉唑组在溃疡治愈率[RR=1.12,95%CI(1.02,1.24),P=0.02]和幽门螺杆菌根除率[RR=1.40,95%CI(1.22,1.61),P<0.000 01]方面的差异均有统计学意义;两组总有效率[RR=1.03,95%CI(1.00,1.07),P=0.09]以及不良反应发生率[RR=1.34,95%CI(0.89,2.04),P=0.16]比较无显著性差异。结论泮托拉唑的胃溃疡治愈率和幽门螺杆菌根除率优于奥美拉唑,两者总有效率和不良反应发生率相当,安全性、耐受性均较好。
Objective To systematically review the efficacy and safety of pantoprazole versus omeprazole in treatment of gastric ulcer(GU).Method Retrieving published randomized controlled clinical trials about pantoprazole versus omeprazole in treatment of gastric ulcer in PubMed,EmBase,Cochrane Library,CNKI,CBM,VIP and Wanfang from the foundation of database to July2018,then making the Meta-analysis by RevMan 5.3.Results A total of 15 RCTs involving 1 482 patients were included.The Metaanalysis results showed that compared with omeprazole,there was a significant difference(P<0.05) in treatment group with regard to GU cure rate [RR=1.12,95%CI(1.02,1.24),P=0.02] and Helicobacter pylori eradication rate [RR=1.40,95%CI(1.22,1.61),P<0.000 01].There were no significant differences(P>0.05) among the total effective rate [RR=1.03,95%CI(1.00,1.07),P=0.09]and adverse reaction(ADR) incidence [RR=1.34,95%CI(0.89,2.04),P=0.16] in 2 groups.Conclusion The cure rate and H.pylori eradication rate of pantoprazole are better than omeprazole.Pantoprazole and omeprazole have similar total effective rate and ADR incidence in the treatment of GU.The safety and tolerance are all acceptable.
Objective To systematically review the efficacy and safety of pantoprazole versus omeprazole in treatment of gastric ulcer(GU).Method Retrieving published randomized controlled clinical trials about pantoprazole versus omeprazole in treatment of gastric ulcer in PubMed,EmBase,Cochrane Library,CNKI,CBM,VIP and Wanfang from the foundation of database to July2018,then making the Meta-analysis by RevMan 5.3.Results A total of 15 RCTs involving 1 482 patients were included.The Metaanalysis results showed that compared with omeprazole,there was a significant difference(P<0.05) in treatment group with regard to GU cure rate [RR=1.12,95%CI(1.02,1.24),P=0.02] and Helicobacter pylori eradication rate [RR=1.40,95%CI(1.22,1.61),P<0.000 01].There were no significant differences(P>0.05) among the total effective rate [RR=1.03,95%CI(1.00,1.07),P=0.09]and adverse reaction(ADR) incidence [RR=1.34,95%CI(0.89,2.04),P=0.16] in 2 groups.Conclusion The cure rate and H.pylori eradication rate of pantoprazole are better than omeprazole.Pantoprazole and omeprazole have similar total effective rate and ADR incidence in the treatment of GU.The safety and tolerance are all acceptable.
引文
[1]刘宇宏,王世鑫.近年来质子泵抑制剂的研究进展[J].中国新药杂志,2001,10(3):161-164.
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[6]李丽.探讨泮托拉唑和奥美拉唑治疗胃溃疡的效果和安全性[J].临床医药文献电子杂志,2017,4(80):15793.
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[8]孙向南.胃溃疡疾病采用泮托拉唑与奥美拉唑治疗的效果分析[J].世界最新医学信息文摘,2017,17(53):106-107.
[9]黄魁.比较泮托拉唑和奥美拉唑治疗胃溃疡的效果和安全性[J].智慧健康,2017,21(44):106-107,110.
[10]梁君铭,骆雪梅.泮托拉唑和奥美拉唑治疗胃溃疡的疗效对比分析[J].现代诊断与治疗,2015,26(7):1502-1503.
[11]吴利华.泮托拉唑和奥美拉唑治疗胃溃疡的疗效对比观察[J].中国农村卫生,2016,3(5):60-61.
[12]刘中宏,王秀江,马香华.泮托拉唑与奥美拉唑治疗胃溃疡的疗效观察[J].中国基层医药,2002,9(2):111-112.
[13]栗红梅.泮托拉唑和奥美拉唑治疗胃溃疡的疗效对比[J].大家健康:学术版,2016,10(2):131-132.
[14]郁心圃.泮托拉唑钠和奥美拉唑治疗胃溃疡的对照研究[J].实用临床医药杂志,2012,16(19):97-98,104.
[15]王慧.泮托拉唑与奥美拉唑治疗胃溃疡的效果对比评估及观察[J].中国现代药物应用,2016,10(5):104-105.
[16]肖胜伦.泮托拉唑与奥美拉唑治疗胃溃疡的效果和安全性比较[J].中华临床医师杂志:电子版,2016,10(11):220-221.
[17]董桂君,巨森,赵平,等.评价泮托拉唑对比奥美拉唑治疗胃溃疡的效果和安全性[J].临床检验杂志:电子版,2017,6(2):240.
[18]胡学琼,习绍彪.泮托拉唑钠肠溶片治疗胃溃疡疗效观察[J].中国基层医药,2002,9(12):1129.
[19]Witzel L,Gütz H,Hüttemann W,et al.Pantoprazole versus omeprazole in the treatment of acute gastric ulcers[J].Aliment Pharmacol Ther,1995,9(1):19-24
[20]住友靖彦.质子泵抑制剂(PPI)的适应证[J].日本医学介绍,2002,23(1):25-26.
[21]Barth J,Hahne W.Review article:rabeprazole-based therapy in Helicobacter pylori eradication[J].Aliment Pharmacol Ther,2002,16(1):31-33.
[22]马丽群.质子泵抑制剂的研究和临床应用进展[J].内科,2012,7(2):160-163.
[23]孙为豪.质子泵抑制剂的胃黏膜保护作用与环氧化酶-2表达[J].中国药理学通报,2002,18(6):661-664.
[24]叶玲梅,蔡咏梅.质子泵抑制剂的不良反应及防治对策[J].中国药房,2011,22(8):760-761.
[25]Salas M,Ward A,Caro J.Are proton pump inhibitors the first choice for acute treatment of gastric ulcers?A meta analysis of randomized clinical trials[J].BMCGastroenterol,2002,2(17):1-8.
[26]张家兴,王中元,谢娟,等.泮托拉唑对比奥美拉唑治疗胃溃疡疗效与安全性的系统评价及药物经济学分析[J].中国药房,2015,26(12):1662-1665.
[27]付振强.系统评价泮托拉唑对比奥美拉唑治疗胃溃疡的效果和安全性[J].中外医学研究,2016,14(5):112-113.
[2]Kusano M,Kuribayashi S,Kawamura O,et al.A review of the management of gastric acid-related diseases:Focus on rabeprazole[J].Clinic Med Insig Gastroenterol,2011,4(3):31-43.
[3]Stedman C A,Barclay M L.Review article:comparison of the pharmacokinetics,acid suppression and efficacy of proton pump inhibitors[J].Aliment Pharmacol Ther,2000,14(8):963-978.
[4]Jadad A R,Moore R A,Carroll D,et al.Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J].Control Clin Trials,1996,17(1):1-12.
[5]崔玉霞.泮托拉唑治疗胃溃疡的疗效观察[J].中国中医药咨讯,2011,3(8):168.
[6]李丽.探讨泮托拉唑和奥美拉唑治疗胃溃疡的效果和安全性[J].临床医药文献电子杂志,2017,4(80):15793.
[7]琼吉.奥美拉唑、泮托拉唑、兰索拉唑治疗胃溃疡的临床效果观察[J].养生保健指南:医药研究,2015(16):38-38.
[8]孙向南.胃溃疡疾病采用泮托拉唑与奥美拉唑治疗的效果分析[J].世界最新医学信息文摘,2017,17(53):106-107.
[9]黄魁.比较泮托拉唑和奥美拉唑治疗胃溃疡的效果和安全性[J].智慧健康,2017,21(44):106-107,110.
[10]梁君铭,骆雪梅.泮托拉唑和奥美拉唑治疗胃溃疡的疗效对比分析[J].现代诊断与治疗,2015,26(7):1502-1503.
[11]吴利华.泮托拉唑和奥美拉唑治疗胃溃疡的疗效对比观察[J].中国农村卫生,2016,3(5):60-61.
[12]刘中宏,王秀江,马香华.泮托拉唑与奥美拉唑治疗胃溃疡的疗效观察[J].中国基层医药,2002,9(2):111-112.
[13]栗红梅.泮托拉唑和奥美拉唑治疗胃溃疡的疗效对比[J].大家健康:学术版,2016,10(2):131-132.
[14]郁心圃.泮托拉唑钠和奥美拉唑治疗胃溃疡的对照研究[J].实用临床医药杂志,2012,16(19):97-98,104.
[15]王慧.泮托拉唑与奥美拉唑治疗胃溃疡的效果对比评估及观察[J].中国现代药物应用,2016,10(5):104-105.
[16]肖胜伦.泮托拉唑与奥美拉唑治疗胃溃疡的效果和安全性比较[J].中华临床医师杂志:电子版,2016,10(11):220-221.
[17]董桂君,巨森,赵平,等.评价泮托拉唑对比奥美拉唑治疗胃溃疡的效果和安全性[J].临床检验杂志:电子版,2017,6(2):240.
[18]胡学琼,习绍彪.泮托拉唑钠肠溶片治疗胃溃疡疗效观察[J].中国基层医药,2002,9(12):1129.
[19]Witzel L,Gütz H,Hüttemann W,et al.Pantoprazole versus omeprazole in the treatment of acute gastric ulcers[J].Aliment Pharmacol Ther,1995,9(1):19-24
[20]住友靖彦.质子泵抑制剂(PPI)的适应证[J].日本医学介绍,2002,23(1):25-26.
[21]Barth J,Hahne W.Review article:rabeprazole-based therapy in Helicobacter pylori eradication[J].Aliment Pharmacol Ther,2002,16(1):31-33.
[22]马丽群.质子泵抑制剂的研究和临床应用进展[J].内科,2012,7(2):160-163.
[23]孙为豪.质子泵抑制剂的胃黏膜保护作用与环氧化酶-2表达[J].中国药理学通报,2002,18(6):661-664.
[24]叶玲梅,蔡咏梅.质子泵抑制剂的不良反应及防治对策[J].中国药房,2011,22(8):760-761.
[25]Salas M,Ward A,Caro J.Are proton pump inhibitors the first choice for acute treatment of gastric ulcers?A meta analysis of randomized clinical trials[J].BMCGastroenterol,2002,2(17):1-8.
[26]张家兴,王中元,谢娟,等.泮托拉唑对比奥美拉唑治疗胃溃疡疗效与安全性的系统评价及药物经济学分析[J].中国药房,2015,26(12):1662-1665.
[27]付振强.系统评价泮托拉唑对比奥美拉唑治疗胃溃疡的效果和安全性[J].中外医学研究,2016,14(5):112-113.