Ortiz-Lucas María, Tobías Aurelio, Saz Pablo, Sebastián Juan José
Rev Esp Enferm Dig. 2013 Jan;105(1):19-36. doi: 10.4321/s1130-01082013000100005.
immune system alteration in irritable bowel syndrome (IBS) patients may be modulated by probiotics. We assessed the efficacy of some probiotic species in alleviating characteristic IBS symptoms.
a meta-analysis of all identified randomized controlled trials comparing probiotics with placebo in treating IBS symptoms was performed with continuous data summarized using standardized mean differences (SMDs) with 95% confidence intervals (95% CIs), where appropriate. The random-effects model was employed in cases of heterogeneity; otherwise, fixed-effects models were used.
meta-analysis was performed with 10 of 24 studies identified as suitable for inclusion. Probiotics improved pain scores if they contained Bifidobacterium breve (SMD, - 0.34; 95% CI, - 0.66; -0.02), Bifidobacterium longum (SMD, -0.48; 95% CI, - 0.91; -0.06), or Lactobacillus acidophilus (SMD, -0.31; 95% CI, -0.61; -0.01) species. Distension scores were improved by probiotics containing B. breve (SMD, -0.45; 95% CI, -0.77; -0.13), Bifidobacterium infantis, Lactobacillus casei, or Lactobacillus plantarum (SMD, -0.53; 95% CI, -1.00; -0.06) species. All probiotic species tested improved flatulence: B. breve (SMD, -0.42; 95% CI, -0.75;- 0.10), B. infantis, L. casei, L. plantarum (SMD, -0.60; 95% CI, -1.07; -0.13), B. longum, L. acidophilus, Lactobacillus bulgaricus, and Streptococcus salivarius ssp. thermophilus (SMD, -0.61; 95% CI, -1.01; -0.21). There was not a clear positive effect of probiotics concerning the quality of life.
some probiotics are an effective therapeutic option for IBS patients, and the effects on each IBS symptom are likely species-specific. Future studies must focus on the role of probiotics in modulating intestinal microbiota and the immune system while considering individual patient symptom profiles.
肠易激综合征（IBS）患者的免疫系统改变可能受到益生菌的调节。我们评估了某些益生菌种类在缓解IBS特征性症状方面的疗效。
对所有已确定的比较益生菌与安慰剂治疗IBS症状的随机对照试验进行荟萃分析，在适当情况下，使用标准化均数差（SMD）及95%置信区间（95%CI）汇总连续数据。在存在异质性的情况下采用随机效应模型；否则，使用固定效应模型。
对24项被确定适合纳入的研究中的10项进行了荟萃分析。如果益生菌含有短双歧杆菌（SMD，-0.34；95%CI，-0.66；-0.02）、长双歧杆菌（SMD，-0.48；95%CI，-0.91；-0.06）或嗜酸乳杆菌（SMD，-0.31；95%CI，-0.61；-0.01），则疼痛评分会改善。含有短双歧杆菌（SMD，-0.45；95%CI，-0.77；-0.13）、婴儿双歧杆菌、干酪乳杆菌或植物乳杆菌（SMD，-0.53；95%CI，-1.00；-0.06）的益生菌可改善腹胀评分。所有测试的益生菌种类均能改善肠胃胀气：短双歧杆菌（SMD，-0.42；95%CI，-0.75；-0.10）、婴儿双歧杆菌、干酪乳杆菌、植物乳杆菌（SMD，-0.60；95%CI，-1.07；-0.13）、长双歧杆菌、嗜酸乳杆菌、保加利亚乳杆菌和嗜热唾液链球菌（SMD，-0.61；95%CI，-1.01；-0.21）。益生菌对生活质量没有明显的积极影响。
某些益生菌是IBS患者的有效治疗选择，对每种IBS症状的影响可能具有菌种特异性。未来的研究必须关注益生菌在调节肠道微生物群和免疫系统方面的作用，同时考虑个体患者的症状特征。
