State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
Arch Oral Biol. 2017 Nov;83:187-192. doi: 10.1016/j.archoralbio.2017.04.030. Epub 2017 Apr 30.
Oral candidiasis is the most common fungal infection and can be attributed in part to dysbiosis, an imbalance in the resident oral microflora. Therefore, probiotics, which counter pathogenic microorganisms through competitive, antagonistic, and immunological effects, have been used by some clinicians. To date, the effect of probiotics in preventing oral candidiasis in the elderly is controversial. A systematic review that summarizes and critically appraises the available clinical trials is therefore necessary.
Electronic searches were performed using the Pubmed, Embase, and Cochrane databases. Only randomized controlled trials were included. The Mantel-Haenszel test was used to appraise the odds ratio for single studies and an overall combined odds ratio for all studies combined.
Three studies matched the inclusion criteria and were homogeneous. The data from one study that estimated candida growth from plaque and saliva were subdivided, thus a total of four studies with 595 people were included. The overall combined odds ratio was 0.54 (95% CI: 0.38-0.77). Three studies provided that active treatment reduced the risk of oral candidiasis more than placebo: Hatakka et al. (OR 0.51, 95% CI 0.26 to 0.97; 192 participants, plaque); Kraft-Bodi et al. (OR 0.46, 95% CI 0.24 to 0.86; 174 participants, palatal); Kraft-Bodi et al. (OR 0.50, 95% CI 0.26 to 0.98; 174 participants, plaque), while one study provided reverse result: Ishikawa et al. (OR 1.24, 95% CI 0.48 to 3.58; 55 participants, saliva).
Probiotics have a preventative effect on oral candidiasis in the elderly.
口腔念珠菌病是最常见的真菌感染，部分原因可归因于微生态失调，即常驻口腔微生物群落失衡。因此，一些临床医生使用了益生菌，通过竞争、拮抗和免疫作用来对抗病原微生物。迄今为止，益生菌预防老年人口腔念珠菌病的效果仍存在争议。因此，有必要进行系统评价，总结和批判性评估现有临床试验。
使用 Pubmed、Embase 和 Cochrane 数据库进行电子检索。仅纳入随机对照试验。采用 Mantel-Haenszel 检验评估单个研究的优势比和所有研究的综合优势比。
有三项研究符合纳入标准且具有同质性。一项研究估计了菌斑和唾液中念珠菌生长情况的数据被细分，因此共有 595 人参与了四项研究。总体合并优势比为 0.54（95%CI：0.38-0.77）。三项研究表明，与安慰剂相比，积极治疗降低了口腔念珠菌病的风险：Hatakka 等人（OR 0.51，95%CI 0.26-0.97；192 名参与者，菌斑）；Kraft-Bodi 等人（OR 0.46，95%CI 0.24-0.86；174 名参与者，腭部）；Kraft-Bodi 等人（OR 0.50，95%CI 0.26-0.98；174 名参与者，菌斑），而一项研究提供了相反的结果：Ishikawa 等人（OR 1.24，95%CI 0.48-3.58；55 名参与者，唾液）。
益生菌对老年人口腔念珠菌病具有预防作用。
