伏诺拉生联合阿莫西林双联方案根除幽门螺杆菌疗效及安全性的Meta分析OA北大核心CSTPCD

Objective:To compare the efcacy and safety of Vonoprazan-Amoxicillin(VA)dual therapy versus proton pump in-hibitor(PPI)-based bismuth-containing quadruple therapy(BCQ)in the eradication of Helicobacter(H.)pylori.Methods:We per-formed a systematic search in PubMed,Embase,Cochrane Library,CNKI,and Wanfang databases for relevant clinic trials up to September 2019.The related literatures were analyzed by RevMan 5.4 software.Results:Eleven studies with 3 033 patients were evaluated in this meta-analysis.The H.pylori radication rate of VA dual Therapy was compared with PPI-based quadruple therapy(P＞0.05)by intention-to-treat(ITT)analysis and per-protocol(PP)analysis.The incidence of adverse events in VA dual thera-py was lower than that in PPI-based quadruple therapy[pooled incidence,11.5%vs.25.3%,RR:0.46,95%CI:0.39～0.54,P＜0.001].Subgroup analysis showed that vonoprazan and high-dose amoxicillin(VHA)dual therapy had a higher eradication rate than BCQ(ITT pooledincidence,91.8%vs.82.6%,RR=1.09,95%CI:1.03～1.17,P＜0.05;PP pooled incidence,95.6%vs.86.7%,RR=1.08,95%CI:1.02～1.14,P＜0.05).Conclusions:VA dual therapy can be recommended for H.pylori eradication therapy.