Wang Chih-Hung, Fang Cheng-Chung, Chen Nai-Chuan, Liu Sot Shih-Hung, Yu Ping-Hsun, Wu Tao-Yu, Chen Wei-Ting, Lee Chien-Chang, Chen Shyr-Chyr
Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Arch Intern Med. 2012 Jul 9;172(13):988-96. doi: 10.1001/archinternmed.2012.3004.
Urinary tract infection (UTI) is one of the most commonly acquired bacterial infections. Cranberry-containing products have long been used as a folk remedy to prevent UTIs. The aims of this study were to evaluate cranberry-containing products for the prevention of UTI and to examine the factors influencing their effectiveness.
MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were systemically searched from inception to November 2011 for randomized controlled trials that compared prevention of UTIs in users of cranberry-containing products vs placebo or nonplacebo controls. There were no restrictions for language, population, or publication year.
Thirteen trials, including 1616 subjects, were identified for qualitative synthesis from 414 potentially relevant references; 10 of these trials, including a total of 1494 subjects, were further analyzed in quantitative synthesis. The random-effects pooled risk ratio (RR) for cranberry users vs nonusers was 0.62 (95% CI, 0.49-0.80), with a moderate degree of heterogeneity (I(2) = 43%) after the exclusion of 1 outlier study. On subgroup analysis, cranberry-containing products seemed to be more effective in several subgroups, including women with recurrent UTIs (RR, 0.53; 95% CI, 0.33-0.83) (I(2) = 0%), female populations (RR, 0.49; 95% CI, 0.34-0.73) (I(2) = 34%), children (RR, 0.33; 95% CI, 0.16-0.69) (I(2) = 0%), cranberry juice drinkers (RR, 0.47; 95% CI, 0.30-0.72) (I(2) = 2%), and subjects using cranberry-containing products more than twice daily (RR, 0.58; 95% CI, 0.40-0.84) (I(2) = 18%).
Our findings indicate that cranberry-containing products are associated with protective effect against UTIs. However, this result should be interpreted in the context of substantial heterogeneity across trials.
尿路感染（UTI）是最常见的获得性细菌感染之一。含蔓越莓的产品长期以来一直被用作预防尿路感染的民间疗法。本研究的目的是评估含蔓越莓的产品对尿路感染的预防作用，并研究影响其有效性的因素。
对MEDLINE、EMBASE和Cochrane对照试验中央注册库进行系统检索，从建库至2011年11月，查找比较含蔓越莓产品使用者与安慰剂或非安慰剂对照者尿路感染预防情况的随机对照试验。对语言、人群或发表年份没有限制。
从414篇潜在相关参考文献中确定了13项试验（包括1616名受试者）进行定性综合分析；其中10项试验（共1494名受试者）进一步进行定量综合分析。排除1项离群研究后，蔓越莓使用者与非使用者的随机效应合并风险比（RR）为0.62（95%CI，0.49 - 0.80），异质性程度中等（I² = 43%）。亚组分析显示，含蔓越莓的产品在几个亚组中似乎更有效，包括复发性尿路感染女性（RR，0.53；95%CI，0.33 - 0.83）（I² = 0%）、女性人群（RR，0.49；95%CI，0.34 - 0.73）（I² = 34%）、儿童（RR，0.33；95%CI，0.16 - 0.69）（I² = 0%）、饮用蔓越莓汁者（RR，0.47；95%CI，0.30 - 0.72）（I² = 2%）以及每天使用含蔓越莓产品超过两次的受试者（RR，0.58；95%CI，0.40 - 0.84）（I² = 18%）。
我们的研究结果表明，含蔓越莓的产品对尿路感染有保护作用。然而，这一结果应在各试验存在大量异质性的背景下进行解释。
