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目的系统评价泮托拉唑与雷尼替丁治疗胃食管反流病(GERD)的有效性和安全性。方法计算机检索Pub Med、Medline、EMbase、The Cochrane Library、中国知网、重庆维普和万方数据库,查找口服用泮托拉唑与雷尼替丁治疗GERD的随机对照试验(RCT),检索时间从建库至2014年9月。由2位评价员根据纳入与排除标准独立进行文献筛选、资料提取和质量评价,采用Rev Man5.2软件进行Meta分析。结果共纳入RCT 8个,患者1 590例。Meta分析结果显示:对于Ⅰ~Ⅲ级GERD,泮托拉唑的内镜治愈率、主要症状缓解率均高于雷尼替丁,且差异有统计学意义;而不良反应发生率,两者差异无统计学意义[Ⅰ级,RR=1.17,95%CI(0.80,1.70),P=0.43;Ⅱ或Ⅲ级,RR=0.76,95%CI(0.43,1.36),P=0.36]。结论现有临床证据表明,泮托拉唑治疗Ⅰ~Ⅲ级GERD的有效性优于雷尼替丁,但两者的安全性和耐受性相当。
Objective To evaluate the efficacy and safety of pantoprazole and ranitidine in the treatment of gastroesophageal reflux disease (GERD). Methods Randomized controlled trials (RCTs) were conducted in PubMed, Medline, EMbase, The Cochrane Library, CNKI, Chongqing Weipu and Wanfang databases to find the oral gavage of pantoprazole and ranitidine. The retrieval time was Construction of the library until September 2014. Two reviewers independently screened, extracted and evaluated the literature based on the inclusion and exclusion criteria, and Meta-analysis was performed using Rev Man 5.2 software. Results A total of 8 RCTs were included and 1 590 patients were included. The results of Meta analysis showed that for the grade Ⅰ ~ Ⅲ GERD, the endoscopic cure rate and the main symptom relief rate of pantoprazole were higher than ranitidine, and the difference was statistically significant; but the incidence of adverse reactions, the difference between the two No statistically significant [grade I, RR = 1.17, 95% CI (0.80,1.70), P = 0.43; II or III, RR = 0.76, 95% CI (0.43, 1.36), P = 0.36]. Conclusion The available clinical evidence shows that pantoprazole is superior to ranitidine in the treatment of Grade Ⅰ ~ Ⅲ GERD, but the safety and tolerability of the two are comparable.