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目的系统评价含左氧氟沙星的三联方案补救根除幽门螺杆菌的疗效和耐受性。方法检索Medline、Embase、Cinahl,检索词为(Helicobacter pylori或H.pylori)和(levofloxaxin或fluoru- quinolones或quinolones),检索中国生物医学文献数据库(CBM-disc),检索词为“幽门螺杆菌和左氧氟沙星”或“幽门螺杆菌和喹诺酮”。筛选比较含左氧氟沙星的三联方案和含铋剂的四联方案的根除幽门螺杆菌补救治疗随机对照试验,进行荟萃分析,进而评价研究质量,提取数据计算根除率和不良反应率。结果共有7项随机对照试验符合入选标准,含左氧氟沙星的10d三联方案Hp根除率高于含铋剂的7d四联方案(86.9%比61.8%,P<0.01),不良反应率或严重不良反应率低于后者(16.8%比37.1%,P<0.01;0.41%比12.1%,P<0.01),耐受性较好。含左氧氟沙星的7d三联方案疗效与含铋剂的7d四联方案相当(71.4%比78.6%,P=0.2d)。结论含左氧氟沙星的10d三联方案补救根除的疗效和耐受性均优于含铋剂的7d四联方案。
Objective To systematically evaluate the efficacy and tolerability of levofloxacin triple therapy in the eradication of Helicobacter pylori. METHODS: Medline, Embase and Cinahl were searched for the terms Helicobacter pylori or H.pylori and (levofloxaxin or fluoru-quinolones or quinolones). The Chinese biomedical literature database (CBM-disc) was searched with the search term “Helicobacter pylori And levofloxacin ”or“ Helicobacter pylori and quinolone ”. Screening and comparing levofloxacin triple programs and bismuth-containing quadruple programs in the eradication of Helicobacter pylori remedial treatment randomized controlled trials, meta-analysis, and then evaluate the quality of research, data extraction and calculation of eradication rates and adverse reaction rates. Results A total of 7 randomized controlled trials met the inclusion criteria. The Hp eradication rate of levofloxacin-containing 10-day triple regimen was higher than that of bismuth-containing regimen for 7 days (86.9% vs 61.8%, P <0.01), and adverse reactions or serious adverse reactions Lower than the latter (16.8% vs. 37.1%, P <0.01; 0.41% vs. 12.1%, P <0.01). The efficacy of the 7d triple regimen with levofloxacin was comparable to the 7d quadruplex containing bismuth (71.4% vs 78.6%, P = 0.2d). Conclusion The efficacy and tolerability of levofloxacin-based 10-day triple regimen in the eradication of eradication are better than that of bismuth-containing 7-day combined regimen.