Sazawal Sunil, Hiremath Girish, Dhingra Usha, Malik Pooja, Deb Saikat, Black Robert E
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Lancet Infect Dis. 2006 Jun;6(6):374-82. doi: 10.1016/S1473-3099(06)70495-9.
To evaluate the evidence for the use of probiotics in the prevention of acute diarrhoea, we did a meta-analysis of the available data from 34 masked, randomised, placebo-controlled trials. Only one trial was community based and carried out in a developing country. Most of the remaining 33 studies were carried out in a developed country in a health-care setting. Evaluating the evidence by types of acute diarrhoea suggests that probiotics significantly reduced antibiotic-associated diarrhoea by 52% (95% CI 35-65%), reduced the risk of travellers' diarrhoea by 8% (-6 to 21%), and that of acute diarrhoea of diverse causes by 34% (8-53%). Probiotics reduced the associated risk of acute diarrhoea among children by 57% (35-71%), and by 26% (7-49%) among adults. The protective effect did not vary significantly among the probiotic strains Saccharomyces boulardii, Lactobacillus rhamnosus GG, Lactobacillus acidophilus, Lactobacillus bulgaricus, and other strains used alone or in combinations of two or more strains. Although there is some suggestion that probiotics may be efficacious in preventing acute diarrhoea, there is a lack of data from community-based trials and from developing countries evaluating the effect on acute diarrhoea unrelated to antibiotic usage. The effect on acute diarrhoea is dependent on the age of the host and genera of strain used.
为评估使用益生菌预防急性腹泻的证据，我们对34项采用盲法、随机、安慰剂对照试验的现有数据进行了荟萃分析。仅1项试验是在发展中国家的社区开展的。其余33项研究大多在发达国家的医疗环境中进行。按急性腹泻类型评估证据表明，益生菌可使抗生素相关性腹泻显著减少52%（95%可信区间35 - 65%），使旅行者腹泻风险降低8%（-6至21%），使多种原因引起的急性腹泻风险降低34%（8 - 53%）。益生菌使儿童急性腹泻相关风险降低57%（35 - 71%），使成人降低26%（7 - 49%）。在单独使用或两种或更多菌株联合使用的布拉酵母菌、鼠李糖乳杆菌GG、嗜酸乳杆菌、保加利亚乳杆菌及其他菌株之间，保护作用无显著差异。尽管有一些迹象表明益生菌可能对预防急性腹泻有效，但缺乏来自社区试验和发展中国家的关于评估其对非抗生素相关性急性腹泻影响的数据。对急性腹泻的影响取决于宿主年龄和所用菌株种类。
