序列与标准三重疗法对第一线杆菌根除:一个更新
Olga P Nyssen1, Belén Martínez1, Francis Mégraud2
1Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28006 Madrid, Spain.
在2010年之前,非比斯穆特序列疗法 (SEQ) 显示出比标准三重疗法 (STT) 对H. pylori根除更高的疗效. 两种疗法都不是最佳的第一线治疗.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 作为H. pylori. 标准三重疗法 (STT) 的替代方案,提出了非比斯穆特序列疗法 (SEQ).
- 评估SEQ和STT疗效对于优化H. pylori根除策略至关重要.
研究的目的:
- 为了比较10天SEQ与STT (≥7天) 作为一线H. pylori治疗的疗效.
- 通过系统性审查和元分析分析根除率和风险差异.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析,截至2021年7月.
- 包括以前没有接受过治疗的成人和儿科患者.
- 计算的治疗意图 (ITT) 根除率和风险差异 (RD).
主要成果:
- 69个涉及19657名患者的RCT与SEQ和STT进行了比较.
- 总体来说,SEQ的疗效显著提高 (82%对75%;RD 0.08;p < 0.001).
- 观察到高异质性 (I2 = 68%);子组分析表明SEQ在克拉里胺耐药病例和特定地区的好处.
结论:
- 在2010年之前,SEQ比STT更有效,特别是7天STT.
- 治疗方法之间的差异减少的趋势,在较长的STT持续时间 (10天) 和2010年后发现.
- 两种疗法都没有达到最佳的疗效,排除了作为一线H. pylori治疗的推.
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