Abstract:
Background: Helicobacter pylori (H. pylori) infection is one of the most common chronic bacterial infections worldwide. The resistance of H. pylori to antibiotics may increase the risk of treatment failure. Complementary and alternative regimens are still needed. This study aimed to critically assess the efficacy and safety of Jinghua Weikang capsule (JWC) for H. pylori eradication. Materials and methods: PubMed, Embase, Web of Science, Cochrane library, China National Knowledge Infrastructure, Wanfang Digital Periodicals, and Chinese Science and Technology Periodicals database were searched from inception to April 2022. Randomized controlled trials (RCTs) comparing a combination of JWC and conventional treatments with conventional treatments alone or combined with a placebo for H. pylori eradication were considered for inclusion. The primary outcome was H. pylori eradication rate. The meta-analysis and trial sequential analysis (TSA) were conducted where possible. Results: A total of 34 studies were included in the statistical analysis. A pooled result showed that JWC with the duration of 2 weeks combined with the triple/quadruple therapy could significantly increase the H. pylori eradication rate compared with the triple/quadruple therapy alone (RR: 1.13, 95% CI: 1.05 to 1.21, p = 0.0008). However, the evidence of benefit was not confirmed by TSA. Another pooled result showed that JWC with the duration of 4 weeks combined with the triple/quadruple therapy could significantly increase the H. pylori eradication rate compared with the triple/quadruple therapy alone (RR: 1.21, 95% CI: 1.15 to 1.27, p < 0.00001). The evidence of benefit was confirmed by TSA. There were no statistically significant differences in the incidence of adverse reactions between the two groups. Conclusion: The present study suggests that JWC with the duration of 4 weeks can significantly improve the H. pylori eradication rate and should be considered as a complementary treatment to conventional regimens for H. pylori eradication. However, more high-quality RCTs are still needed to confirm these findings.
摘要:
背景:幽门螺杆菌(H.pylori)感染是全球最常见的慢性细菌感染之一。幽门螺杆菌对抗生素的耐药性可能会增加治疗失败的风险。仍然需要补充和替代方案。本研究旨在严格评估京花胃康胶囊(JWC)根除幽门螺杆菌的疗效和安全性。材料和方法:PubMed,Embase,WebofScience,科克伦图书馆,中国国家知识基础设施,万方数字期刊,和中国科技期刊数据库从成立到2022年4月进行了检索。考虑纳入比较JWC和常规治疗组合与常规治疗单独或与安慰剂联合根除幽门螺杆菌的随机对照试验(RCT)。主要结果是幽门螺杆菌根除率。在可能的情况下进行荟萃分析和试验序贯分析(TSA)。结果:共有34项研究纳入统计分析。合并结果显示,与单独使用三联/四联疗法相比,持续2周的JWC可以显着提高幽门螺杆菌的根除率(RR:1.13,95%CI:1.05至1.21,p=0.0008)。然而,TSA未确认获益证据.另一个汇总结果表明,与单独的三联/四联疗法相比,持续4周的JWC联合三联/四联疗法可以显着提高幽门螺杆菌的根除率(RR:1.21,95%CI:1.15至1.27,p<0.00001)。TSA证实了获益的证据。两组不良反应发生率差异无统计学意义。结论:本研究表明,持续4周的JWC可以显着提高H.pylori的根除率,应被视为常规根除H.pylori方案的补充治疗。然而,仍需要更多高质量的RCT来证实这些发现.