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[益生菌治疗肠易激综合征的荟萃分析]

[A meta-analysis of probiotics for the treatment of irritable bowel syndrome].

作者信息

Hu Yue, Tao Liyuan, Lyu Bin

机构信息

Department of Gastroenterology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China.

Department of Gastroenterology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China; Email:

出版信息

Zhonghua Nei Ke Za Zhi. 2015 May;54(5):445-51.

Abstract

OBJECTIVE

To evaluate the efficacy of probiotics to treat irritable bowel syndrome (IBS).

METHODS

Publications from database including PubMed, the Cochrane Library, Embase, CNKI, CBM and WanFang Data were searched up to August 31, 2014. The randomized controlled trials (RCTs) on probiotics to treat IBS were eligible. The related articles were extracted and cross-checked independently by two reviewers. Methodological quality of trials was evaluated according to Cochrane Handbook 5.1.0 criteria. Meta-analysis was conducted using RevMan 5.2 software.

RESULTS

A total of 17 RCTs involving 1 700 patients were included. Results of meta-analyses showed that compared with the placebo, probiotics was statistically better in improving the overall symptoms integral (SMD = -0.20, 95% CI -0.33--0.07, P = 0.002), alleviating abdominal pain/discomfort (SMD = -0.19, 95% CI -0.29--0.09, P<0.001), relieving abdominal distention (SMD = -0.16, 95% CI -0.28--0.03, P = 0.020), and defecation discomfort (SMD = -0.22, 95% CI -0.42--0.02, P = 0.030). There was no statistical significance in the overall quality of life (SMD = -0.08, 95% CI -0.07-0.23, P = 0.290) and adverse effect ratio (RR = 1.08, 95% CI 0.79-1.49, P = 0.630).

CONCLUSION

Probiotics have beneficial effects on IBS, which can improve the patients' symptoms and with less adverse reaction. Due to the bias, further large-scale, multicenter and high-quality RCTs are required to unify outcome indicators, further define sensitive strain, and standardize its usage, dosage and course of treatment.

摘要

目的

评估益生菌治疗肠易激综合征(IBS)的疗效。

方法

检索截至2014年8月31日包括PubMed、Cochrane图书馆、Embase、中国知网、中国生物医学文献数据库和万方数据在内的数据库中的出版物。纳入关于益生菌治疗IBS的随机对照试验(RCT)。相关文章由两名研究者独立提取并交叉核对。根据Cochrane手册5.1.0标准评估试验的方法学质量。使用RevMan 5.2软件进行荟萃分析。

结果

共纳入17项RCT,涉及1700例患者。荟萃分析结果显示,与安慰剂相比,益生菌在改善总体症状积分(标准化均数差[SMD]= -0.20,95%可信区间[CI] -0.33至-0.07,P = 0.002)、缓解腹痛/不适(SMD = -0.19,95% CI -0.29至-0.09,P<0.001)、减轻腹胀(SMD = -0.16,95% CI -0.28至-0.03,P = 0.020)和排便不适(SMD = -0.22,95% CI -0.42至-0.02,P = 0.030)方面有统计学意义。在总体生活质量(SMD = -0.08,95% CI -0.07至0.23,P = 0.290)和不良反应发生率(相对危险度[RR]= 1.08,95% CI 0.79至1.49,P = 0.630)方面无统计学意义。

结论

益生菌对IBS有有益作用,可改善患者症状且不良反应较少。由于存在偏倚,需要进一步开展大规模、多中心和高质量的RCT以统一结局指标,进一步明确敏感菌株,并规范其用法、用量和疗程。

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