中国药房2026，Vol.37Issue(8)：1074-1079,6.DOI:10.6039/j.issn.1001-0408.2026.08.18
阿莫西林二联方案根除幽门螺杆菌疗效与安全性的网状Meta分析
Network meta-analysis of the efficacy and safety of dual amoxicillin-based regimens for Helicobacter pylori eradication
摘要
Abstract
OBJECTIVE To evaluate the efficacy and safety of amoxicillin combined with proton pump inhibitor(PPI)or potassium-competitive acid blocker(P-CAB)for Helicobacter pylori(Hp)eradication.METHODS Randomized controlled trial(RCTs)on amoxicillin combined with PPI or P-CAB for Hp eradication were retrieved from PubMed,Embase,the Cochrane Library,Web of Science,CNKI,Wanfang,and VIP data.The search time frame was from database inception to September 5,2025.After literature screening,data extraction,and quality assessment,a network meta-analysis was performed using Stata 17.0 software.RESULTS A total of 12 RCTs involving 5 515 patients were included,encompassing 8 therapeutic regimens:PPI combined with high-dose amoxicillin for 14 days(TR1),PPI combined with low-dose amoxicillin for 14 days(TR2),P-CAB combined with high-dose amoxicillin for 7 days(TR3),P-CAB combined with high-dose amoxicillin for 14 days(TR4),P-CAB combined with high-dose amoxicillin for 10 days(TR5),P-CAB combined with low-dose amoxicillin for 7 days(TR6),P-CAB combined with low-dose amoxicillin for 14 days(TR7),and P-CAB combined with low-dose amoxicillin for 10 days(TR8).The network meta-analysis results showed that,in terms of intention-to-treat Hp eradication rates,the eradication rates of TR5 and TR4 were significantly higher than those of TR3,TR8,TR6 and TR1(P＜0.05).The surface under the cumulative ranking curve(SUCRA)values from highest to lowest were:TR4(89.7%)＞TR5(82.3%)＞TR7(71.5%)＞TR2(48.6%)＞TR1(43.9%)＞TR8(28.7%)＞TR3(22.7%)＞TR6(12.6%).Regarding safety,the incidence of adverse reactions in TR3 and TR5 was significantly lower than that in TR1(P＜0.05).The SUCRA values from highest to lowest were:TR1(91.3%)＞TR4(79.8%)＞TR5(55.0%)＞TR7(50.9%)＞TR8(41.3%)＞TR2(36.4%)＞TR3(27.6%)＞TR6(17.7%).CONCLUSIONS Although the regimen of P-CAB combined with high-dose amoxicillin for 14 days demonstrates the best efficacy,the combination of P-CAB with high-dose amoxicillin for 10 days exhibits a better balanced profile in terms of both efficacy and safety.关键词
阿莫西林/幽门螺杆菌/二联方案/质子泵抑制剂/钾离子竞争性酸阻滞剂/网状Meta分析/疗效/安全性Key words
amoxicillin/Helicobacter pylori/dual therapy/proton pump inhibitor/potassium-competitive acid blocker/network meta-analysis/efficacy/safety分类
医药卫生引用本文复制引用
宋子文,段飞,原鑫淼,罗俐媛,何雨芳,杨玲淑,黄译续,佘建朋,魏培涵,郭思涵..阿莫西林二联方案根除幽门螺杆菌疗效与安全性的网状Meta分析[J].中国药房,2026,37(8):1074-1079,6.基金项目
河南省科技发展计划项目(No.232102310410,No.231111312400) （No.232102310410,No.231111312400）
河南省卫生健康委国家中医临床研究基地科研专项(No.2022JDZX092) （No.2022JDZX092）
