Abstract
The increase in drug-resistant strains poses a severe challenge for Helicobacter pylori (Hp) treatment, and the failure of traditional triple or bismuth quadruple therapy makes it difficult to eradicate Hp. Tailored therapies should be expanded, and traditional Chinese medicine (TCM) may provide the potential regimen. The aim of the present study is to systematically compare TCM-based therapy (TCM combined with Western medicine) and Western medicine as a rescue therapy for Hp re-eradication. Studies through June 12, 2021, with keywords “Helicobacter pylori,” “medicine, Chinese traditional,” or “rescue treatment” and their related expressions were retrieved from PubMed, SinoMed, China National Knowledge Infrastructure, and Wanfang databases. Randomized clinical trials based on PICOS (population, intervention, comparators, outcomes, and study design) eligibility criteria that evaluated the efficacy and safety of integrated therapy on Hp re-eradication were included. The extracted contents included the demographic data of the participants, specific treatment measures, and the results of outcome indicators and safety indicators. Review Manager 5.3 software was used to perform this meta-analysis. Outcome measures including the HP re-eradication rate, symptom remission rate, and adverse effects were seriously analyzed. Under the guide of PRISMA, 18 studies were finally included. Pooled results showed significant differences in eradication rate between integrated and Western medicine therapy in intention-to-treat (ITT) analysis (OR = 2.21, 95% CI: (1.74, 2.81), P < 0.01). Symptom remission is higher in the administration of integrated therapy than in the administration of Western medicine therapy (OR = 2.45, 95% CI: (1.78, 3.37), P < 0.01). It is also indicated that integrated therapy showed significantly less adverse effects (OR = 0.60, 95% CI: (0.42, 0.84), P < 0.01. In conclusion, compared with Western medicine therapy, integrated therapy yields a higher eradication rate and acceptable safety profiles.
Highlights
Helicobacter pylori (Hp) is a flagellated Gram-negative and spiral-shaped bacterium that is colonized in the stomach, which is one of the most common chronic bacterial infections in humans, affecting approximately 4.4 billion individuals worldwide [1, 2]
On the contrary, classified as a Group 1 carcinogen by the International Agency for Research on Cancer, it is indicated that 1%–3% of the Hp-infected patients may develop gastric cancer [5]. erefore, eradicating Hp may relieve Hp-related gastrointestinal diseases and reduce the risk of gastric cancer
Compared with Western medicine therapy, integrated therapy showed favored eradication rate with odds ratios in improving the Hp clearance rate of 2.21 (95% confidence intervals (CI) (1.74, 2.81); P < 0.01) (Figure 4(a))
Summary
Helicobacter pylori (Hp) is a flagellated Gram-negative and spiral-shaped bacterium that is colonized in the stomach, which is one of the most common chronic bacterial infections in humans, affecting approximately 4.4 billion individuals worldwide [1, 2]. Erefore, eradicating Hp may relieve Hp-related gastrointestinal diseases and reduce the risk of gastric cancer. It is rarely hard for the spontaneous clearance of Hp once it colonizes in the stomach, so antibiotic therapy is recommended for the treatment of Hp. Triple therapy including clarithromycin, amoxicillin, and a proton pump inhibitor (PPI) is the standard worldwide [6]. The resistance rate of metronidazole and tetracycline has exceeded 15% globally [9] Other regimens such as adding probiotic supplementation as an emerging therapy may improve the eradication rate and alleviate side effects [10], but there is not enough evidence and consensus
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Evidence-Based Complementary and Alternative Medicine
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
