Szajewska H, Horvath A, Kołodziej M
Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland.
Aliment Pharmacol Ther. 2015 Jun;41(12):1237-45. doi: 10.1111/apt.13214. Epub 2015 Apr 21.
Unsatisfactory Helicobacter pylori eradication rates and therapy-associated side effects remain a problem.
To update our 2010 meta-analysis on the effects of Saccharomyces boulardii as supplementation to a standard eradication regimen on H. pylori eradication rates and therapy-associated side effects.
The Cochrane Library, MEDLINE and EMBASE databases were searched from July 2010 (end date of last search) to February 2015, with no language restrictions, for randomised controlled trials (RCTs); additional references were obtained from reviewed articles. Quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines.
Eleven RCTs (2200 participants, among them 330 children) met the inclusion criteria. Of the 853 patients in the S. boulardii group, 679 (80%, 95% CI 77-82) experienced eradication compared with 608 of the 855 patients (71%, 95% CI 68-74) in the control group [relative risk (RR) 1.11, 95% confidence interval (CI) 1.06-1.17; moderate quality evidence]. S. boulardii compared with control reduced the risk of overall H. pylori therapy-related adverse effects (RR 0.44, 95% CI 0.31-0.64; moderate quality evidence), particularly of diarrhoea (RR 0.51, 95% CI 0.42-0.62; high quality evidence) and nausea [RR 0.6, 95% CI 0.44-0.83 (moderate quality of evidence)].
In the populations studied, the effectiveness of standard triple therapy was unsatisfactory. The addition of S. boulardii significantly increased the eradication rate, but it was still below the desired level of success. Saccharomyces boulardii significantly decreased some therapy-related side effects.
幽门螺杆菌根除率不尽人意以及治疗相关副作用仍是一个问题。
更新我们2010年关于布拉酵母菌作为标准根除方案补充剂对幽门螺杆菌根除率及治疗相关副作用影响的荟萃分析。
检索Cochrane图书馆、MEDLINE和EMBASE数据库，检索时间为2010年7月（上次检索截止日期）至2015年2月，无语言限制，检索随机对照试验（RCT）；从综述文章中获取其他参考文献。使用推荐分级、评估、制定和评价（GRADE）指南评估证据质量。
11项RCT（2200名参与者，其中330名儿童）符合纳入标准。布拉酵母菌组的853例患者中，679例（80%，95%可信区间77 - 82）实现根除，而对照组855例患者中有608例（71%，95%可信区间68 - 74）实现根除[相对危险度（RR）1.11，95%置信区间（CI）1.06 - 1.17；中等质量证据]。与对照组相比，布拉酵母菌降低了幽门螺杆菌总体治疗相关不良反应的风险（RR 0.44，95% CI 0.31 - 0.64；中等质量证据），尤其是腹泻（RR 0.51，95% CI 0.42 - 0.62；高质量证据）和恶心[RR 0.6，95% CI 0.44 - 0.83（中等质量证据）]。
在所研究的人群中，标准三联疗法的有效性不尽人意。添加布拉酵母菌显著提高了根除率，但仍低于期望的成功水平。布拉酵母菌显著降低了一些治疗相关的副作用。
