The Influence Of Pretreatment With Ppi On Helicobacter Pylori Eradication:a Meta Analysis

Objective:To systematically investigate the pretreatment impact of proton pump inhibitor (PPI) on Helicobacter pylori (Hp) eradication rate.Methods:PubMed, EMBASE, Cochrane database, Web of Science, Clinical trial.gov, SinoMed, China National Knowledge Internet, WANFANG Data, VIP database and Google Scholar were utilized to search for randomized controlled trials (RCT), per-protocol analysis (PP) was used to calculate Hp eradication rate, RevMan 5.2 was applied to analyze data.Results:There were 10 articles included (982 cases),43 cases didn’t meet the program have been removed, a total of 939 cases included. The result showed that there was no significant difference between the pretreatment of PPI group and the control group, RR=0.99 (95%CI: 0.95-1.05, P=0.75). Conducted a subgroup analysis according to eradication regimen, regimen combining a PPI, amoxicillin and clarithromycin and regimen combining a PPI, clarithromycin and metronidazole the pooled risk ratio were 1.02 (95%CI:0.90-1.14, P=0.79) and 1.02 (95%CI:0.92-1.12, P=0.74) respectively, there were no significant difference as well.Conclusions:The pretreatment with PPI does not affect Hp eradication rates of triple or quadruple therapies for Hp eradication. We can eradicate Hp directly for the patients who have used PPI but were diagnosed to be positive to Hp.