| Objective:To compare the efficacy and safety of rabeprazole-based triple therapy for Helicobacter pylori with other proton pump inhibitors(PPIs) by performing a Meta-analysis.Methods:1.Inclusion and exclusion criterion:randomized controlled trials comparing the efficacy of triple seven-day therapy for Helicobacter pylori with rabeprazole and other PPI,providing the eradication rate,and the patients should be adults with chronic gastritis or non-ulcer dyspepsia or gastric ulcer or duodenal ulcer, receiving eradication therapy for the first time.2.Search strategy:database:MEDLINE(1998-current),EMBASE(1998-current),CBMDISC(2001-2009);search type:keyword:rabeprazole and(Helicobacter pylori or h pylori or hp).3.Quality assessment:use the quality assessment criteria of Cochrane Reviewer Handbook 4.2.3 for RCTs.4.Data extraction and analysis:use Cochrane RevMan4.2.8 to analysis.Results:1.Search results:740 papers were searched out,and 29 papers were included,15 in Chinese and 14 in English.2.Characteristic of included studies:29 studies provided eradication rates,16 studies provided peptic ulcer healing rates,8 studies provided symptom remission rates,20 studies provided side-effect rates,3 studies provided eradication rates when clarithromycin resistance was considered,3 studies provided eradication rates when CYP2C19 genotype was considered,2 studies provided eradication rates when basic disease was considered.3.Quality assessment:11 grade as A,10 grade as B,8 grade as C.4.Analysis results: (1).Helicobacter pylori eradication rate:intention-to-treat eradication rate was higher for rabeprazole group than other proton pump inhibitor group(85.5%vs.78.1%; OR1.49,95%CI1.27,1.74;P＜0.00001);per protocol eradication rate(88.4%vs. 84.1%;OR1.33,95%CI1.08,1.64;P=0.007);no significant difference was found between low-dose and high-dose rabeprazole group(84.1%vs.86.9%); rabeprazole group was higher than omeprazole group(85.1%vs.78.0%;OR1.60, 95%CI 1.32,1.94;p＜0.00001);rabeprazole group was higher than lansoprazole group(84.3%vs.79.8%;OR1.34,95%CI 1.02,1.77;p=0.004);no significant difference was found between rabeprazole and esomeprazole(82.1%vs.81.5%; OR1.02,95%CI0.68,1.51;P=0.94);no significant difference was found between rabeprazole and pantoprazole(74.0%vs.67.5%;OR1.71,95%CI0.54,5.46; P=0.36).(2).Peptic ulcer healing rate:intention-to-treat healing rate was higher in rabeprazole group than omeprazole group;per protocol(91.9%vs.86.8%;OR1.93,95%CI 1.10,3.38;P=0.02).(3).Symptom remission rate:rabeprazole group was higher than omeprazole in day 1(70.0%vs.45.5%;OR2.96,95%CI 2.21,3.97;P＜0.00001);day 3(87.8%vs. 65.8%;OR3.80,95%CI2.59,5.57;P＜0.00001);day 5(94.3%vs.89.4%;OR2.01, 95%CI1.21,3.35;P＜0.007).(4).Side-effect rate:no significant difference was found between rabeprazole group and other proton pump inhibitor group(20.7%vs.24.1%;OR1.04,95%CI0.84, 1.28;P=0.72).Conclusion:1.Rabeprazole group had a higher Helicobacter pylori eradication rate than omeprazole and lansoprazole.2.Rabeprazole group had a higher peptic ulcer healing rate and symptom remission rate compared with omeprazole group.3.There was no significant difference in side-effect rate between rabeprazole group and other proton pump inhibitor group.
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