Boyle Robert John, Bath-Hextall Fiona J, Leonardi-Bee Jo, Murrell Dedee F, Tang Mimi Lk
Allergy and Clinical Immunology, Royal Children's Hospital, Flemington Road, Parkville, Victoria, Australia, 3052.
Cochrane Database Syst Rev. 2008 Oct 8(4):CD006135. doi: 10.1002/14651858.CD006135.pub2.
Probiotics have been proposed as an effective treatment for eczema, and recently a number of clinical trials have been undertaken.
To assess the effects of probiotics for the treatment of eczema
We searched the Cochrane Skin Group Specialised Register (to April 2008), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2,2008) MEDLINE (from 2003 to April 2008), EMBASE (from 2005 to April 2008), PsycINFO, AMED and LILACS (from inception to April 2008) and ISI Web of Science (to December 2006) and reference lists of articles. We also searched registries of ongoing clinical trials, conference proceedings and searched for adverse events.
Randomised controlled trials of live orally ingested microorganisms for the treatment of eczema.
Two authors independently applied eligibility criteria, assessed the quality of trials and extracted data. We contacted study authors for more information where necessary. We recorded adverse events from the included studies, and from the separate adverse events search.
Twelve randomised controlled trials involving 781 participants met the inclusion criteria. All trial participants were children. There was no significant difference in participant or parent-rated symptom scores in favour of probiotic treatment (5 trials, 313 participants). Symptom severity on a scale from 0 to 20 was 0.90 points lower after probiotic treatment than after placebo (95%CI -1.04, 2.84; p = 0.36).There was also no significant difference in participant or parent-rated overall eczema severity in favour of probiotic treatment (3 trials, 150 participants). There was no significant difference in investigator rated eczema severity between probiotic and placebo treatments (7 trials, 588 participants). On a scale from 0 to 102 investigator rated eczema severity was 2.46 points lower after probiotic treatment than after placebo treatment (95%CI -2.53, 7.45 p = 0.33). Significant heterogeneity was noted between the results of individual studies, which may be explained by the use of different probiotic strains. Subgroup analysis by age of participant, severity of eczema, presence of atopy or presence of food allergy did not identify a population with different treatment outcomes to the population as a whole. The adverse events search identified some case reports of infections and bowel ischaemia caused by probiotics.
AUTHORS' CONCLUSIONS: The evidence suggests that probiotics are not an effective treatment for eczema, and probiotic treatment carries a small risk of adverse events.
益生菌已被提议作为湿疹的一种有效治疗方法，最近已开展了多项临床试验。
评估益生菌治疗湿疹的效果。
我们检索了Cochrane皮肤小组专业注册库（至2008年4月）、Cochrane对照试验中心注册库（《Cochrane图书馆》2008年第2期）、MEDLINE（2003年至2008年4月）、EMBASE（2005年至2008年4月）、PsycINFO、AMED和LILACS（自创刊至2008年4月）以及ISI科学网（至2006年12月）和文章的参考文献列表。我们还检索了正在进行的临床试验注册库、会议论文集并搜索了不良事件。
口服活微生物治疗湿疹的随机对照试验。
两位作者独立应用入选标准、评估试验质量并提取数据。必要时我们与研究作者联系以获取更多信息。我们记录了纳入研究中的不良事件以及单独的不良事件搜索结果。
12项涉及781名参与者的随机对照试验符合纳入标准。所有试验参与者均为儿童。在参与者或家长评定的症状评分方面，益生菌治疗无显著优势（5项试验，313名参与者）。益生菌治疗后症状严重程度（0至20分制）比安慰剂治疗后低0.90分（95%CI -1.04, 2.84；p = 0.36）。在参与者或家长评定的总体湿疹严重程度方面，益生菌治疗也无显著优势（3项试验，150名参与者）。在研究者评定的湿疹严重程度方面，益生菌治疗与安慰剂治疗之间无显著差异（7项试验，588名参与者）。在0至102分制中，益生菌治疗后研究者评定的湿疹严重程度比安慰剂治疗后低2.46分（95%CI -2.53, 7.45；p = 0.33）。各研究结果之间存在显著异质性，这可能是由于使用了不同的益生菌菌株所致。按参与者年龄、湿疹严重程度、特应性的存在或食物过敏的存在进行亚组分析，未发现与总体人群治疗结果不同的亚人群。不良事件搜索发现了一些益生菌引起感染和肠道缺血的病例报告。
证据表明益生菌不是治疗湿疹的有效方法，且益生菌治疗存在小的不良事件风险。
