Wilhelm Sheila M, Brubaker Christine M, Varcak Elizabeth A, Kale-Pradhan Pramodini B
Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Harper University Hospital, Detroit, MI, USA.
Pharmacotherapy. 2008 Apr;28(4):496-505. doi: 10.1592/phco.28.4.496.
Recently, the use of tegaserod and alosetron -- drugs approved for the treatment of irritable bowel syndrome (IBS) -- has been restricted because of adverse events. This has resulted in a need for additional modalities for the treatment of IBS. Our objective was to determine the effectiveness of probiotics in the global relief of symptoms associated with IBS and in the improvement of flatulence, abdominal pain, transit time, and bacterial counts. Using the MEDLINE database from 1966-October 2007 and manually searching article references for relevant articles and abstracts, we identified 14 blinded, placebo-controlled clinical trials of the effectiveness of probiotics in the treatment of IBS. Of 11 studies in which overall symptom relief was assessed, seven indicated a significant improvement with probiotics versus placebo. Five of eight investigations of abdominal pain and distention revealed a benefit with probiotic use. Four studies demonstrated an improvement in symptomatic flatulence in probiotic treatment groups, whereas one study showed no significant benefit. Four of five studies of the effects of probiotics on colonic transit time revealed a benefit compared with placebo. As probiotics have shown benefit and possess a favorable adverse-effect profile, their use may represent an option for symptom relief in patients with IBS. However, additional data are necessary before probiotics can become a standard of care in the treatment of IBS, a complex and chronic condition.
最近，替加色罗和阿洛司琼——两种被批准用于治疗肠易激综合征（IBS）的药物——由于不良事件已被限制使用。这导致需要其他治疗IBS的方法。我们的目的是确定益生菌在全面缓解与IBS相关症状以及改善肠胃胀气、腹痛、转运时间和细菌计数方面的有效性。通过使用1966年至2007年10月的MEDLINE数据库，并手动检索文章参考文献以查找相关文章和摘要，我们确定了14项关于益生菌治疗IBS有效性的双盲、安慰剂对照临床试验。在11项评估总体症状缓解情况的研究中，有7项表明与安慰剂相比，益生菌有显著改善。在8项关于腹痛和腹胀的调查中，有5项显示使用益生菌有益。4项研究表明益生菌治疗组的症状性肠胃胀气有所改善，而1项研究显示无显著益处。在5项关于益生菌对结肠转运时间影响的研究中，有4项显示与安慰剂相比有益。由于益生菌已显示出益处且不良反应情况良好，其使用可能是IBS患者缓解症状的一种选择。然而，在益生菌成为IBS这种复杂慢性病治疗的标准疗法之前，还需要更多数据。
