Hoveyda Nourieh, Heneghan Carl, Mahtani Kamal R, Perera Rafael, Roberts Nia, Glasziou Paul
Department of Primary Health Care, Centre for Evidence Based Medicine, University of Oxford, Rosemary Rue Building, Old Road Campus, Headington, Oxford, UK.
BMC Gastroenterol. 2009 Feb 16;9:15. doi: 10.1186/1471-230X-9-15.
Irritable Bowel Syndrome (IBS) is a common chronic gastrointestinal disorder and the evidence for efficacy of most drug therapies in the treatment of IBS is weak. A popular alternative is probiotics, which have been used in several conditions. including IBS. Probiotics are live microbial food supplements.The aim of this systematic review and meta-analysis of randomized trials study was to evaluate the efficacy of probiotics in alleviating symptoms in patients with irritable bowel syndrome. We searched Ovid versions of MEDLINE (1950-2007), EMBASE (1980-2007), CINAHL (1982-2007), AMED (1985-2007), the Cochrane library and hand searched retrieved papers.
We identified 14 randomized placebo controlled trials. Combined data suggested a modest improvement in overall symptoms after several weeks of treatment: for dichotomous data from seven trials the overall Odds Ratio (OR) was 1.6 (95% CI, 1.2 to 2.2); for continuous data from six trials the standardised mean difference (SMD) was 0.23 (95% CI, 0.07 to 0.38).For individual symptoms the results differed between the pooled dichotomous and pooled continuous data. Trials varied in relation to the length of treatment (4-26 weeks), dose, organisms and strengths of probiotics used.
Probiotics may have a role in alleviating some of the symptoms of IBS, a condition for which currently evidence of efficacy of drug therapies is weak. However, as IBS is a condition that is chronic and usually intermittent longer term trials are recommended. Such research should focus on the type, optimal dose of probiotics and the subgroups of patients who are likely to benefit the most.
肠易激综合征（IBS）是一种常见的慢性胃肠疾病，大多数药物疗法治疗IBS的疗效证据不足。一种流行的替代方法是益生菌，已用于多种病症，包括IBS。益生菌是活的微生物食品补充剂。本随机试验的系统评价和荟萃分析旨在评估益生菌缓解肠易激综合征患者症状的疗效。我们检索了Ovid版的MEDLINE（1950 - 2007年）、EMBASE（1980 - 2007年）、CINAHL（1982 - 2007年）、AMED（1985 - 2007年）、Cochrane图书馆，并对手检获得的论文进行了检索。
我们确定了14项随机安慰剂对照试验。综合数据表明，治疗数周后总体症状有适度改善：来自7项试验的二分数据的总体优势比（OR）为1.6（95%可信区间，1.2至2.2）；来自6项试验的连续数据的标准化平均差（SMD）为0.23（95%可信区间，0.07至0.38）。对于个体症状，汇总的二分数据和汇总的连续数据结果有所不同。试验在治疗时长（4 - 26周）、剂量、使用的益生菌种类和强度方面存在差异。
益生菌可能在缓解IBS的某些症状方面发挥作用，目前药物疗法治疗IBS的疗效证据不足。然而，由于IBS是一种慢性且通常为间歇性的病症，建议进行长期试验。此类研究应关注益生菌的类型、最佳剂量以及最可能受益的患者亚组。
