| objective: proton pump inhibitors(proton pump,inhibitors,PPIs)is the Primary choicefor the treatment of acid related diseases,but with the widespread PPIs long-term global using,the adverse reactions(Adverse Drug,Reaction,ADR)have been reported more and more.In order to ensure the safety of medication,reduce the medical risk,we explore the characteristics of ADR and ADR related factors.At present,there is no systematic evaluation of the rational useing of PPIs all over the world.On the basis of the relevant literature?guideline all over the world,under the evidence-based medicine we evaluate these common PPIs and ADR,in order to provide evidences and suggestions for clinical rational useing of drugs.Methods : through computer retrieval MEDLINE(Pub Med platform),Embase,Cochran(Library Cochrane system evaluation database CDSR,DARE effect abstract database and the Cochrane controlled trials register database,EBSCO,CENTRAL)OVID,SCI,CNKI(China,WANFANG(Journal Full-text Database)Wanfang digital periodical full-text database(CBM),China biomedical literature database),Chongqing VIP(Chinese journal database)related literature about adverse reaction of PPIs in the database;manual retrieval has been incorporated into the relevant research references.Key words:Chinese and English including proton pump inhibitors,omeprazole,esomeprazole,pantoprazole,lansoprazole,and ray Bella with Ilaprazole,adverse reactions and adverse events,safety,randomized controlled trials,cohort study,case-control study,etc.,and the retrieval time published up to January 2017.According to the inclusion and exclusion criteria,two researchers independently screened the literatures,extracted the data and evaluated the quality,and analyzed by Rev Man5.3 software.Results: a total of 75 articles were included in this study,and the overall risk of bias was lower in the randomized controlled trials.This study collected from domestic and foreign literature with the incidence of the adverse reaction of omeprazole,there are major adverse reaction : acute myocardial infarction / unstable angina(7.3%),leukopenia(5.9%),headache(5%);esomeprazole.The main adverse reactions have occurred: respiratory tract infection(7.1%),diarrhea(5%),headache(4%);the adverse reactions of lansoprazole occurred mainly include diarrhea(5.8%),nausea(2.8%),headache(2.1%);the adverse reactions of pantoprazole mainly are: head pain(4.8%),diarrhea(4.7%),nausea(4.3%)adverse reactions;ray Bella with mainly include: headache(2.7%),diarrhea(1.7%).Different types of PPIs were compared with each other,no significant adverse reactions occurred in most of these PPIs,which is a major concer for the using of omeprazole.The incidence of diarrhea,nausea and vomiting occurred in omeprazole were less than in lansoprazole;the incidence of spirit,nervous system(headache)occurred in omeprazole were less in esomeprazole;the overall incidence rate of ADR in omeprazole is higher than that of anti-rheumatic drugs,while less than placebo or blank control;the overall incidence of ADR of esomeprazole was less than or placebo and the blank control.Conclusion: there is no significant difference in the incidence of adverse reactions between the PPIs and other similar drugs.The incidence of adverse reactions of PPIs is low,but it can not be ignored,and the adverse reactions of digestive system is more difficult to identify with the disease itself.Therefore,the clinical rational useing of PPIs should be strengthend to observe and monitored for adverse reactions,and should analysis of the factors of ADR timely,to improve the safety of clinical medication. |
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