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益生菌与氨基水杨酸盐对溃疡性结肠炎维持治疗效果的比较:一项随机对照试验的荟萃分析。

Comparison of maintenance effect of probiotics and aminosalicylates on ulcerative colitis: A meta-analysis of randomized controlled trials.

作者信息

Jiang Yong, Zhang Zhi-Guang, Qi Feng-Xiang, Zhang Ying, Han Tao

机构信息

Department of Gastroenterology, The Second Hospital of Tianjin Medical University, Ping Jiang Road No 23, He Xi District, Tianjin 300170, China.

Department of Hepatology and Gastroenterology, Tianjin Third Central Hospital of Tianjin Medical University, Jin Tang Road No 83, He Dong District, Tianjin 300170, China.

出版信息

Chronic Dis Transl Med. 2016 Aug 9;2(1):34-41. doi: 10.1016/j.cdtm.2016.07.002. eCollection 2016 Mar.

DOI:10.1016/j.cdtm.2016.07.002
PMID:29063023
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5643593/
Abstract

OBJECTIVE

To evaluate the maintenance effect of probiotics versus that of aminosalicylates on ulcerative colitis.

METHODS

MEDLINE, EMBASE, the Cochrane Controlled Trials Register, and the Chinese Biomedical Database were searched in English or Chinese. Data extracted were selected with strict criteria.

RESULTS

In six randomized controlled trials (RCTs), a total of 721 participants were enrolled and the maintenance effect of probiotics ( = 364) versus that of aminosalicylates ( = 357) on ulcerative colitis was investigated. No significant difference was observed between probiotics and aminosalicylate groups (relative risk () = 1.08; 95% confidence interval (): 0.91-1.28;  = 0.40). Three RCTs compared the incidence of adverse events with probiotics versus those with aminosalicylates. No significant difference was observed in the incidence of adverse events between the two groups ( = 1.20; 95% : 0.92-1.56;  = 0.17).

CONCLUSIONS

Probiotics and aminosalicylates both showed a maintenance effect on ulcerative colitis. However, more well-designed RCTs are required.

摘要

目的

评估益生菌与氨基水杨酸盐对溃疡性结肠炎的维持治疗效果。

方法

检索MEDLINE、EMBASE、Cochrane对照试验注册库及中国生物医学数据库,检索语言为英文或中文。严格按照标准选取提取的数据。

结果

在六项随机对照试验(RCT)中,共纳入721名参与者,研究了益生菌(n = 364)与氨基水杨酸盐(n = 357)对溃疡性结肠炎的维持治疗效果。益生菌组与氨基水杨酸盐组之间未观察到显著差异(相对危险度(RR)= 1.08;95%置信区间(CI):0.91 - 1.28;P = 0.40)。三项RCT比较了益生菌与氨基水杨酸盐的不良事件发生率。两组不良事件发生率未观察到显著差异(RR = 1.20;95%CI:0.92 - 1.56;P = 0.17)。

结论

益生菌和氨基水杨酸盐对溃疡性结肠炎均有维持治疗效果。然而,需要更多设计良好的RCT。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c0d/5643593/1467c76e716d/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c0d/5643593/6cb46908bd7f/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c0d/5643593/ae67039ae367/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c0d/5643593/12f4551ceed6/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c0d/5643593/07182b7f4dfb/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c0d/5643593/1467c76e716d/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c0d/5643593/6cb46908bd7f/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c0d/5643593/ae67039ae367/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c0d/5643593/12f4551ceed6/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c0d/5643593/07182b7f4dfb/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c0d/5643593/1467c76e716d/gr5.jpg

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本文引用的文献

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Probiotic treatments for induction and maintenance of remission in inflammatory bowel diseases: a meta-analysis of randomized controlled trials.益生菌治疗对炎症性肠病缓解的诱导和维持作用:一项随机对照试验的荟萃分析。
Clin J Gastroenterol. 2014 Feb;7(1):1-13. doi: 10.1007/s12328-013-0440-8. Epub 2013 Dec 28.
2
Protective effect of Lactobacillus plantarum 21, a probiotic on trinitrobenzenesulfonic acid-induced ulcerative colitis in rats.植物乳杆菌21(一种益生菌)对三硝基苯磺酸诱导的大鼠溃疡性结肠炎的保护作用。
Int Immunopharmacol. 2015 Apr;25(2):504-10. doi: 10.1016/j.intimp.2015.02.026. Epub 2015 Feb 27.
3
The probiotic mixture VSL#3 dampens LPS-induced chemokine expression in human dendritic cells by inhibition of STAT-1 phosphorylation.
益生菌联合氨基水杨酸制剂治疗溃疡性结肠炎缓解期的疗效:一项随机对照试验的荟萃分析。
Biosci Rep. 2019 Jan 18;39(1). doi: 10.1042/BSR20180943. Print 2019 Jan 31.
益生菌混合物VSL#3通过抑制STAT-1磷酸化来减轻脂多糖诱导的人树突状细胞趋化因子表达。
PLoS One. 2014 Dec 29;9(12):e115676. doi: 10.1371/journal.pone.0115676. eCollection 2014.
4
The probiotic mixture VSL#3 mediates both pro- and anti-inflammatory responses in bone marrow-derived dendritic cells from C57BL/6 and BALB/c mice.益生菌混合物VSL#3在C57BL/6和BALB/c小鼠的骨髓来源树突状细胞中介导促炎和抗炎反应。
Br J Nutr. 2014 Oct 14;112(7):1088-97. doi: 10.1017/S000711451400169X. Epub 2014 Sep 2.
5
Probiotic mix VSL#3 is effective adjunctive therapy for mild to moderately active ulcerative colitis: a meta-analysis.益生菌组合VSL#3是轻至中度活动性溃疡性结肠炎的有效辅助治疗方法:一项荟萃分析。
Inflamm Bowel Dis. 2014 Sep;20(9):1562-7. doi: 10.1097/MIB.0000000000000084.
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Anti-TNF alpha in the treatment of ulcerative colitis: a valid approach for organ-sparing or an expensive option to delay surgery?抗肿瘤坏死因子α治疗溃疡性结肠炎:保留器官的有效方法还是延迟手术的昂贵选择?
World J Gastroenterol. 2014 May 7;20(17):4839-45. doi: 10.3748/wjg.v20.i17.4839.
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Effect of probiotics on inducing remission and maintaining therapy in ulcerative colitis, Crohn's disease, and pouchitis: meta-analysis of randomized controlled trials.益生菌对诱导溃疡性结肠炎、克罗恩病和 pouchitis 缓解和维持治疗的影响:随机对照试验的荟萃分析。
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The effects of probiotics on barrier function and mucosal pouch microbiota during maintenance treatment for severe pouchitis in patients with ulcerative colitis.益生菌对溃疡性结肠炎患者维持治疗期间 pouchitis 严重程度和 pouch 黏膜微生物群的屏障功能的影响。
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Gut microbiota imbalance and chaperoning system malfunction are central to ulcerative colitis pathogenesis and can be counteracted with specifically designed probiotics: a working hypothesis.肠道微生物群落失衡和分子伴侣系统功能障碍是溃疡性结肠炎发病机制的核心,可以用专门设计的益生菌来对抗:一个工作假说。
Med Microbiol Immunol. 2013 Dec;202(6):393-406. doi: 10.1007/s00430-013-0305-2. Epub 2013 Jul 18.
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VSL#3 probiotics exerts the anti-inflammatory activity via PI3k/Akt and NF-κB pathway in rat model of DSS-induced colitis.VSL#3 益生菌通过 PI3k/Akt 和 NF-κB 通路在 DSS 诱导的结肠炎大鼠模型中发挥抗炎活性。
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