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2009香港-北京-杭州内科论坛暨2009年浙江省内科学学术年会

作者： Department of Infection and Liver Diseases,The First Affiliated Hospital of Wenzhou Medical College,Wenzhou,China Ming-Hua Zheng Dian-Na Gu Lei Zhang Yong-Ping Chen Base for Drug Clinical Trial / GCP Center,West China Hospital, Sichuan University,Chengdu,China Mao-Bin meng Yong-Ping Chen Department of Clinical Pharmacy,West China School of Pharmacy, Sichuan University,Chengdu,China Qian Jiang Yong-Ping Chen

Objective:To compare rifaximin with non-absorbable disaccharides in treating patients with hepatic encephalopathy(HE). Methods:We performed a meta-analysis using Cochrane Collaboration guidelines of comparative random... 详细信息

关键词： rifaximin non-absorbable disaccharides hepatic encephalopathy meta-analysis

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Rifaximin vs conventional oral therapy for hepatic encephalopathy:A meta-analysis

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World Journal of Gastroenterology 2012年第8期18卷 767-777页

作者： Karim M Eltawil Marie Laryea Kevork Peltekian Michele Molinari Department of Surgery and Transplantation Queen Elizabeth Ⅱ Health Sciences Center Dalhousie University Department of Medicine Hepatology and Transplantation Queen Elizabeth Ⅱ Health Sciences Center Dalhousie University

AIM: To characterize the efficacy of rifaximin in the management of hepatic encephalopathy (HE) as several randomized controlled studies have shown contradictory results on its effectiveness in comparison to other oral agents. METHODS: We performed a systematic review and random effects meta-analysis of all eligible trials identifi ed through electronic and manual searches. Twelve randomized controlled trials met the inclusion criteria with a total of 565 patients. RESULTS: The clinical effectiveness of rifaximin was equivalent to disaccharides or other oral antibiotics[odds ratio (OR) 0.96; 95% CI: 0.94-4.08] but with a better safety profi le (OR 0.27; 95% CI: 0.12-0.59). At the completion of treatment protocols, patients receiving rifaximin showed lower serum ammonia levels [weighted mean difference (WMD) = -10.65; 95% CI: -23.4-2.1; P = 0.10], better mental status (WMD = -0.24; 95% CI: -0.57-0.08; P = 0.15) and less asterixis (WMD -0.1; 95% CI -0.26-0.07; P = 0.25) without reaching statistical signifi cance. On the other hand, other psychometric outcomes such as electroencephalographic response and grades of portosystemic encephalopathy were superior in patients treated with rifaximin in comparison to the control group (WMD = 0.21, 95% CI: -0.33-0.09, P = 0.0004; and WMD = -2.33, 95% CI: -2.68-1.98, P = 0.00001, respectively). Subgroup and sensitivity analysis did not show any signifi cant difference in the above fi ndings. CONCLUSION: Rifaximin appears to be at least as effective as other conventional oral agents for the treatment of HE with a better safety profi le.

关键词： Hepatic encephalopathy Lactulose Neo-mycin non-absorbable disaccharides Rifaximin

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