Department of Gastroenterology, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China.
Intern Med J. 2009 Feb;39(2):103-9. doi: 10.1111/j.1445-5994.2008.01791.x.
Lactobacilli are used in an attempt to maintain remission for Crohn disease. The aim of this study was to evaluate the efficacy and adverse events of Lactobacilli compared with placebo in maintenance therapy for Crohn disease.
We searched MEDLINE, EMBASE, the Cochrane Controlled Trials Register, OVID and BIOSIS. All randomized trials comparing Lactobacilli with placebo in maintenance therapy for Crohn disease were included.
Six randomized controlled trials with a total of 359 participants met the inclusion criteria. From the meta-analyses, the relative risk (RR) of clinical relapse rate was 1.15 (95% confidence interval (CI) 0.90-1.48) comparing Lactobacilli with placebo and RR of endoscopic relapse rate was 1.31 (95%CI 0.57-3.00). Subgroup analyses showed RR for clinical relapse rates of Lactobacilli versus placebo was 0.99 (95%CI 0.76-1.29) in adults, 1.85 (95%CI 1.00-3.41) in children, 1.68 (95%CI 1.07-2.64) in Lactobacillus rhamnosus strain GG and 0.91 (95%CI 0.68-1.23) in Lactobacillus johnsonii respectively. The pooled RR of adverse events was 0.83 (95%CI 0.61-1.12).
Our meta-analysis suggests that compared with placebo, administration of L. rhamnosus strain GG as maintenance therapy may increase the relapse rates of Crohn disease. L. johnsonii is inefficacious in reducing the incidence of relapse.
乳杆菌被用于尝试维持克罗恩病的缓解。本研究的目的是评估乳杆菌与安慰剂在克罗恩病维持治疗中的疗效和不良反应。
我们检索了 MEDLINE、EMBASE、Cochrane 对照试验登记处、OVID 和 BIOSIS。所有比较乳杆菌与安慰剂在克罗恩病维持治疗中的随机对照试验均被纳入。
共有 6 项随机对照试验，共计 359 名参与者符合纳入标准。从荟萃分析来看，与安慰剂相比，乳杆菌的临床复发率相对风险（RR）为 1.15（95%置信区间（CI）0.90-1.48），内镜复发率 RR 为 1.31（95%CI 0.57-3.00）。亚组分析显示，成人组乳杆菌与安慰剂相比，临床复发率 RR 为 0.99（95%CI 0.76-1.29），儿童组 RR 为 1.85（95%CI 1.00-3.41），鼠李糖乳杆菌 GG 组 RR 为 1.68（95%CI 1.07-2.64），而约翰逊乳杆菌组 RR 为 0.91（95%CI 0.68-1.23）。不良反应的汇总 RR 为 0.83（95%CI 0.61-1.12）。
我们的荟萃分析表明，与安慰剂相比，给予鼠李糖乳杆菌 GG 作为维持治疗可能会增加克罗恩病的复发率。约翰逊乳杆菌在降低复发率方面无效。
