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目的评价以奥美拉唑为质子泵抑制剂(proton pump inhibitor,PPI),含有左氧氟沙星的三联疗法与标准三联疗法治疗消化性溃疡(peptic ulcer,Pu)的临床疗效及根除幽门螺杆菌(helicobacter pylori,Hp)的有效性,为选择Pu治疗的临床用药提供依据。方法在中国知网CNKI知识资源总库、维普数据库、万方数据库、Pubmed数据库、Cochrane图书馆和EMBASE数据库进行文献检索,搜索与Pu及Hp阳性治疗方法有关的文献。依Cochrane评价手册Handbook4.2.6对文献进行质量评价,应用Revman 5.0软件对最终纳入的文献进行Meta分析。结果最终共纳入9篇文献,实验组(含左氧氟沙星)570人,对照组562人。两组治疗Pu有效率的比较,实验组明显高于对照组,合并OR值为3.16(95%CI:2.16~4.62);Hp根除率比较,实验组明显高于对照组,合并OR值为2.99(95%CI:2.18~4.11);两组之间不良反应发生率未见明显差异。进一步分析显示,实验组的治疗Pu有效率、Hp根除率分别显著高于对照组应用克拉霉素或甲硝唑。结论含左氧氟沙星的三联疗法更能有效地促进Pu的愈合,且Hp根除率更高,临床应用价值高。
Objective To evaluate the clinical efficacy of omeprazole as a proton pump inhibitor (PPI), triple therapy with levofloxacin and standard triple therapy in the treatment of peptic ulcer (Pu) and to eradicate helicobacter pylori , Hp) for the selection of the clinical treatment of Pu provide the basis. Methods The CNKI knowledge database, VIP database, Wanfang database, Pubmed database, Cochrane library and EMBASE database were searched for literature search, and the literature about the positive treatment of Pu and Hp was searched. The quality of the literature was evaluated according to the Handbook 4.2.6 of the Cochrane Review Manual and Meta-analysis of the finally incorporated literature using Revman 5.0 software. Results A total of 9 articles were included in the study, 570 in the experimental group (including levofloxacin) and 562 in the control group. Compared with the control group, the OR of the two groups was significantly higher than that of the control group (OR = 3.16, 95% CI: 2.16-4.62). The Hp eradication rate was significantly higher in the experimental group than in the control group with a combined OR of 2.99 (95% CI: 2.18 ~ 4.11). There was no significant difference in the incidence of adverse reactions between the two groups. Further analysis showed that the treatment group Pu efficiency, Hp eradication rates were significantly higher than the control group using clarithromycin or metronidazole. Conclusion The triple therapy with levofloxacin is more effective in promoting the healing of Pu, and has a higher Hp eradication rate and higher clinical value.