Effect of Helicobacter pylori treatment on gastroesophageal reflux disease (GERD): meta-analysis of randomized controlled trials
Effect of Helicobacter pylori treatment on gastroesophageal reflux disease (GERD): meta-analysis of randomized controlled trials
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DOI：
10.3109/00365521.2011.648955
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发表时间：
2012-02-01
影响因子：
1.9
通讯作者：
Bechtold, Matthew L.
中科院分区：
文献类型：
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作者：
Saad, Abdo M.;Choudhary, Abhishek;Bechtold, Matthew L.
Objective.胃食管反流病（GERD）是一种多因素疾病，其特征是酸性胃内容物反流到食管中，导致组织损伤和症状。H的作用。pylori在GERD发病机制中的作用存在争议。因此，我们对H.幽门螺杆菌治疗对胃食管反流病相关症状以及内镜变化的影响。材料和方法。检索了多个医学数据库（4/2011）。比较H. pylori治疗和未治疗的有症状的GERD成人患者。H.通过计算GERD或内镜反流性食管炎新发或症状变化的汇总估计值，分析幽门螺杆菌根除情况。通过固定和随机效应模型，使用比值比（OR）或加权平均差（WMD）对每个结局进行单独分析。通过漏斗图评估发表偏倚。通过计算I-2不一致性指标来评估研究之间的异质性。结果10项试验符合纳入标准。两组之间的症状性GERD（OR 0.81，95% CI 0.56-1.17，p = 0.27）或反流性食管炎的内镜证据（OR 1.13; 95% CI：0.72-1.78，p = 0.59）无统计学显著影响。根除数据的亚组分析显示，与未根除组（24.9%）相比，根除组（13.8%）的GERD症状发生率在统计学上显著较低（OR 0.55; 95% CI：0.35-0.87，p = 0.01）。漏斗图显示无发表偏倚。结论. H.幽门螺杆菌似乎不会增加GERD症状或反流性食管炎。然而，有记录的H. pylori似乎显著改善GERD症状。
Objective. Gastroesophageal reflux disease (GERD) is a multifactorial disorder characterized by reflux of acidic gastric contents into the esophagus leading to tissue damage and symptoms. The role of H. pylori in the pathogenesis of GERD is controversial. Therefore, we performed a meta-analysis on the effect of H. pylori treatment on symptomatic as well as endoscopic changes associated with GERD. Material and methods. Multiple medical databases were searched (4/2011). Randomized controlled trials (RCTs) comparing H. pylori treatment with no treatment on symptomatic adults with GERD were included. The effects of H. pylori eradication were analyzed by calculating pooled estimates for new onset or changes in the symptoms of GERD or endoscopic reflux esophagitis. Separate analyses were performed for each outcome by using odds ratio (OR) or weighted mean difference (WMD) by fixed and random effects models. Publication bias was assessed by funnel plots. Heterogeneity among studies was assessed by calculating I-2 measure of inconsistency. Results. Ten trials met the inclusion criteria. No statistically significant effect was found for symptomatic GERD (OR 0.81, 95% CI 0.56-1.17, p = 0.27) or endoscopic evidence of reflux esophagitis (OR 1.13; 95% CI: 0.72-1.78, p = 0.59) between the two groups. A subgroup analysis of eradication data revealed a statistically significant lower incidence of GERD symptoms in the eradicated group (13.8%) compared with the non-eradicated group (24.9%) (OR 0.55; 95% CI: 0.35-0.87, p = 0.01). Funnel plot revealed no publication bias. Conclusions. Treatment of H. pylori does not seem to increase GERD symptoms or reflux esophagitis. However, documented eradication of H. pylori appears to significantly improve GERD symptoms.