a Department of Applied Health Sciences, Azienda di Servizi alla Persona (ASP) di Pavia , University of Pavia , Pavia , Italy.
b Department of Gastroenterology , Policlinico di Monza , Monza , Italy and Centro Diagnostico Italiano , Milan , Italy.
Gut Microbes. 2017 Nov 2;8(6):521-543. doi: 10.1080/19490976.2017.1345414. Epub 2017 Jul 21.
The scientific literature has demonstrated that probiotics have a broad spectrum of activity, although often the results are contradictory. This study provides a critical overview of the current meta-analyses that have evaluated the efficacy of probiotics in physiologic and pathological conditions, such as metabolic disease, antibiotic-associated and Clostridium difficile-associated diarrhea, IBS, constipation, IBD, chemotherapy-associated diarrhea, respiratory tract infection, ventilator-associated pneumonia, NAFLD, liver encephalopathy, periodontitis, depression, vaginosis, urinary tract infections, pancreatitis, incidence of ventilator-associated pneumonia, hospital infection and stay in ICU, mortality of post-trauma patients, necrotising enterocolitis in premature infants. Only for antibiotic- and Clostridium difficile-associated diarrhea, and respiratory tract infections the effects of probiotics are considered "evidence-based." Concerning other fields, meta-analyses lacks to define type and biologic effect of probiotic strains, as well as the outcome in a disease state. Therefore, the results presented should be a stimulus for further studies which will provide clinical recommendations.
科学文献已经证明，益生菌具有广泛的活性，尽管结果常常相互矛盾。本研究对目前评估益生菌在生理和病理情况下（如代谢疾病、抗生素相关性和艰难梭菌相关性腹泻、IBS、便秘、IBD、化疗相关性腹泻、呼吸道感染、呼吸机相关性肺炎、NAFLD、肝性脑病、牙周炎、抑郁症、阴道炎、尿路感染、胰腺炎、呼吸机相关性肺炎发生率、医院感染和 ICU 住院时间、创伤后患者死亡率、早产儿坏死性小肠结肠炎）疗效的荟萃分析进行了批判性评价。只有在抗生素相关性和艰难梭菌相关性腹泻以及呼吸道感染方面，益生菌的作用被认为是“基于证据的”。关于其他领域，荟萃分析缺乏对益生菌菌株的类型和生物学效应以及疾病状态下的结果进行定义。因此，本研究结果应能进一步刺激开展研究，为临床提供建议。
