补硒干预对慢性萎缩性胃炎治疗疗效循证研究.docVIP

补硒干预对慢性萎缩性胃炎治疗疗效循证研究 　　摘 要 目的：评价补硒干预对慢性萎缩性胃炎治疗的疗效与安全性。方法：对补硒干预治疗慢性萎缩性胃炎的临床随机、对照试验进行质量评价和数据分析，采用RevMan 5.0软件进行meta分析，评价患者的血硒水平和治疗有效率。共纳入1 077例慢性萎缩性胃炎患者，其中补硒干预组541例患者接受抗幽门螺杆菌（Helicobacter pylori， Hp）治疗联合补硒干预，对照组536例患者仅接受抗Hp治疗。结果：补硒干预组患者的临床症状（胃痛、痞满、纳差和嗳气）改善率显著高于对照组[比值比（odds ratio， OR）=2.41， 95% CI： 1.80， 3.22； P0.01]，黏膜内镜检查（腺体萎缩、肠化生和异型增生）评分改善率也显著高于对照组（OR=2.32， 95% CI： 1.68， 3.22； P0.01），同时血硒水平更高（标准化均数差=3.60， 95% CI： 1.07， 6.13； P0.05）。结论：补硒干预能显著提高慢性萎缩性胃炎治疗的疗效。 　　关键词 硒 慢性萎缩性胃炎 氧化应激 　　中图分类号：R573.32 文献标识码：A 文章编号：1006-1533（2017）21-0009-03 　　Evidence-based study on the effect of selenium supplementation in the treatment of chronic atrophic gastritis* 　　YIN Li1**， LIU Xia2*** 　　（1. Department of Gastroenterology， Shanghai 6th People’s Hospital， Shanghai Jiao Tong University， Shanghai 200233， China； 2. Pharmacological Evaluation Center， Chinese Pharmaceutical Industry Research Institute， Shanghai 201210， China） 　　ABSTRACT Objective： To evaluate the efficacy and safety of selenium supplementation in the treatment of chronic atrophic gastritis. Methods： The quality evaluation and data analysis of randomized controlled trials for chronic atrophic gastritis treated with selenium supplementation were carried out. The blood selenium levels， effective rate and adverse events were evaluated by RevMan 5.0 analysis. A total of 1 077 cases of patients with chronic atrophic gastritis were involved， in which 541 cases in a convention group were treated with anti-Helicobacter pylori （Hp） therapy combined with selenium supplementation while 536 cases in a control group only with anti-Hp therapy. Results： The improvement rates in clinical symptoms such as pain， fullness， anorexia， belching， the endoscopic scores including glandular atrophy， intestinal metaplasia and dysplasia and the blood selenium levels were all significantly higher in the convention group than in the control group. Conclusion： Selenium supplementation can significantly improve the clinical efficacy of chronic atro