Jinghua weikang plus proton pump inhibitor-based triple regimen in the treatment of helicobacter pylori associated chronic gastritis or peptic ulcer: A meta-analysis

Objective To systematically evaluate the efficacy and safety of Jinghua Weikang (JHWK) capsules plus proton pump inhibitor (PPI)-based triple regimen in the treatment of Helicobacter pylori (Hp) associated chronic gastritis or peptic ulcer. Methods We searched CNKI, VIP, WanFang Data, CBM, PubMed, EMbase, The Cochrane Library (Issue 6,2016) from inception to July 2016, to collect randomized controlled trials (RCTs) about JHWK capsules plus PPI-based triple regimen (JPTR) for the treatment of Hp associated chronic gastritis or peptic ulcer. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. Results Twenty RCTs were finally included, involving 2 301 patients. The results of meta-analyses showed: ① JPTR vs. PPI-based triple regimen: the JPTR group had higher eradication rate of Hp (RR=1.21, 95%CI 1.12 to 1.31, P<0.001), remission of gastrointestinal symptom (RR=1.07, 95%CI 1.03 to 1.11, P=0.001) and the healing of peptic ulcer (RR=1.18, 95%CI 1.07 to 1.30, P=0.000 9), and lower adverse reactions rate (RR=0.52, 95%CI 0.36 to 0.75, P<0.001) than that of the control group. ② JPTR vs. bismuth-containing quadruple therapy: No significant differences between both groups in Hp eradication rate and the remission of gastrointestinal symptom (RR=0.96, 95%CI 0.86 to 1.07, P=0.47; RR=1.09, 95%CI 0.93 to 1.28, P=0.30), but the JPTR group had lower adverse reactions rate than that of the bismuth-containing quadruple therapy group (RR=0.32, 95%CI 0.15 to 0.72, P=0.005). Conclusion Current evidence shows that JPTR is superior to PPI-based triple regimen in Hp eradication rate, the remission of gastrointestinal symptom, the healing of peptic ulcer, and safety. However, JPTR is not superior to the bismuth-containing quadruple therapy in eradication rate of Hp, which may be related to the insufficient sample size. Because of the limitation of methodological quality of the included studies and sample size, multicenter, high-quality RCTs with large sample are required to prove the above conclusion.