本文選題：序貫療法 + 三聯(lián)療法��； 參考：《福建醫(yī)科大學(xué)》2014年碩士論文

【摘要】：背景： 三聯(lián)療法(Triple Therapy, TT)的根除率逐年下降，，當(dāng)前國內(nèi)外有較多關(guān)于序貫療法(Sequential Therapy, ST)根除幽門螺旋桿菌(Helicobacter pylori,Hp)感染的報道，應(yīng)用循證醫(yī)學(xué)的方法對ST與TT根除Hp感染的療效進(jìn)行比較具有一定的臨床意義。 目的： 運用Meta分析法評價ST與TT根除Hp感染的療效差異。方法： 選用Cochrane系統(tǒng)綜述方法，確定恰當(dāng)?shù)臋z索詞、檢索年限及檢索的數(shù)據(jù)庫。納入ST與TT根除Hp感染療效比較的隨機(jī)對照試驗(RCTs)，對納入文獻(xiàn)進(jìn)行資料提取及質(zhì)量評價，對研究結(jié)果進(jìn)行異質(zhì)性檢驗，根據(jù)異質(zhì)性分析結(jié)果選擇適當(dāng)?shù)男?yīng)模型及決定是否采用Meta分析，同時進(jìn)行亞組分析、敏感性分析、安全性評價及發(fā)表偏倚評價。 結(jié)果： 共11篇RCTs研究文獻(xiàn)符合納入標(biāo)準(zhǔn)， Cochrane風(fēng)險偏倚評估提示低風(fēng)險偏倚見于選擇偏倚、隨訪偏倚及報告偏倚，高風(fēng)險偏倚見于實施偏倚、測量偏倚及其他偏倚，Jadad量表結(jié)果提示高質(zhì)量文獻(xiàn)、較高質(zhì)量文獻(xiàn)、低質(zhì)量文獻(xiàn)分別為2篇、5篇、4篇。Meta分析結(jié)果顯示，意向性治療(ITT)分析ST組與TT組根除率的OR為3.39，95%可信區(qū)間(CI)為2.66～4.33，ST組與TT組根除率比較有統(tǒng)計學(xué)差異(Z=9.87, p0.00001)。符合方案集(PP)分析ST組與TT組根除率的OR為4.76，95%可信區(qū)間(CI)為3.53～6.40，ST組與TT組根除率比較有統(tǒng)計學(xué)差異(Z=10.29, p0.00001)。亞組分析成人、兒童及中國的ST與TT療法，結(jié)果均支持ST根除Hp感染療效優(yōu)于TT。而ST與TT不良反應(yīng)無差異。 結(jié)論： ST根除Hp感染療效優(yōu)于TT。因納入研究的文獻(xiàn)數(shù)量較少，質(zhì)量良莠不齊，今后仍需進(jìn)行多中心、大樣本RCTs分析以證實ST根除Hp感染的優(yōu)越性。
[Abstract]:Background: The eradication rate of Triple Therapy (TT) has been decreasing year by year. There are many reports about Sequential Therapy (ST) for the eradication of Helicobacter pylori (Helicobacter pylori) infection at home and abroad. Evidence-based medicine was used to compare the efficacy of St and TT in the eradication of HP infection. Objective: Meta analysis was used to evaluate the efficacy of St and TT in the eradication of HP infection. Methods: Cochrane system review method is used to determine the appropriate search term, retrieval time and retrieval database. A randomized controlled trial to compare the efficacy of St and TT in the eradication of HP infection was used to extract the data and evaluate the quality of the literature, and to test the heterogeneity of the results. According to the results of heterogeneity analysis, appropriate effect models were selected and Meta analysis was used to determine whether to use Meta analysis, while subgroup analysis, sensitivity analysis, safety evaluation and publication bias evaluation were carried out. Results: A total of 11 RCTs studies met the inclusion criteria. The Cochrane risk bias assessment showed that low risk bias was found in selective bias, follow-up bias and reporting bias, and high risk bias in implementation bias. The results of Jadad scale for measuring bias and other biases suggested that there were 2 articles with high quality, 5 articles with high quality and 4 articles with low quality. The results of meta-analysis showed that: 1. The OR of the eradication rate of St group and TT group was 3.39 鹵95% CI). The eradication rate of St group and TT group was 2.664.33 St group and TT group. There was significant difference in eradication rate between St group and TT group (P 0.00001). The OR of eradication rate of St group and TT group was 4.76% 95% CI). The eradication rate of St group and TT group was 3.53 ~ 6.40%. There was significant difference in eradication rate between St group and TT group (P = 10.29, p 0.00001). The subgroup analysis of St and TT therapy in adults, children and China showed that the efficacy of St to eradicate HP infection was better than that of TTT. There was no difference in adverse reactions between St and TT. Conclusion: The efficacy of St in eradicating HP infection was better than that of TT. Due to the small number of literatures and the uneven quality, there are still many centers to be carried out in the future. Large sample RCTs analysis is needed to confirm the superiority of St in eradicating HP infection.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R57

【參考文獻(xiàn)】

相關(guān)期刊論文 前9條

1 馬春曦;彭國林;趙勇凱;張曉云;詹麗英;;序貫療法與標(biāo)準(zhǔn)三聯(lián)療法治療幽門螺桿菌陽性功能性消化不良患者的療效比較[J];第二軍醫(yī)大學(xué)學(xué)報;2008年08期

2 王瑜;劉改芳;;幽門螺桿菌耐藥及對策[J];臨床薈萃;2009年14期

3 胡伏蓮;胡伏蓮;胡品津;劉文忠;王繼德;呂農(nóng)華;蕭樹東;張萬岱;成虹;謝勇;;第三次全國幽門螺桿菌感染若干問題共識報告[J];臨床藥物治療雜志;2008年03期

4 成虹;李江;胡伏蓮;;枸櫞酸鉍鉀對幽門螺桿菌耐藥菌株體外抗菌活性研究[J];胃腸病學(xué)和肝病學(xué)雜志;2008年07期

5 成虹;胡伏蓮;謝勇;胡品津;王吉耀;呂農(nóng)華;張建中;張桂英;周曾芬;吳克利;張玲霞;彭孝偉;戴寧;唐國都;姜葵;李巖;侯曉華;白文元;王明春;葉紅軍;劉玉蘭;許樂;;中國幽門螺桿菌耐藥狀況以及耐藥對治療的影響—全國多中心臨床研究[J];胃腸病學(xué);2007年09期

6 張萬岱;胡伏蓮;蕭樹東;徐智民;;中國自然人群幽門螺桿菌感染的流行病學(xué)調(diào)查[J];現(xiàn)代消化及介入診療;2010年05期

7 Yuksel Gumurdulu;Ender Serin;Birol 銉zer;Fazilet Kayaselcuk;Kursat Ozsahin;Arif Mansur Cosar;Murat Gursoy;Gurden Gur ;Ugur Yilmaz;Sedat Boyacioglu;;Low eradication rate of Helicobacterpyloriwith triple 7-14 days and quadriple therapy in Turkey[J];World Journal of Gastroenterology;2004年05期

8 ;Resistance of Helicobacter pylori to antibiotics from 2000 to 2009 in Shanghai[J];World Journal of Gastroenterology;2010年40期

9 劉文忠;謝勇;成虹;呂農(nóng)華;胡伏蓮;張萬岱;周麗雅;陳燁;曾志榮;王崇文;蕭樹東;潘國宗;胡品津;;第四次全國幽門螺桿菌感染處理共識報告[J];胃腸病學(xué);2012年10期

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