Jia Kai, Tong Xin, Wang Rong, Song Xin
Medicine (Baltimore). 2018 Dec;97(51):e13792. doi: 10.1097/MD.0000000000013792.
As the exact pathogenesis of inflammatory bowel disease (IBD) is not known, there is increasing evidence of clinical trials and animal models that indicate the beneficial effects of probiotics.
Multiple databases were adopted to search for the relevant studies involving the comparison between probiotics and control groups. Review Manager 5.0 was used to assess the efficacy among included articles. Risk of bias for the articles included was also conducted.
Finally, 10 studies eventually met the inclusion criteria and 1049 patients were included. The meta-analyses showed that no significant differences of remission, relapse, and complication rate between Escherichia coli Nissle 1917 and mesalazine groups (RR = 0.94, 95%CI [0.86, 1.03], P = .21; RR = 1.04, 95%CI [0.82, 1.31], P = .77; RR = 1.12, 95%CI [0.86, 1.47], P = .39, respectively). Despite the fact that no significant differences of remission, relapse, and complication rate were observed in overall meta-analysis results between probiotics and placebo group, the subgroup analyses suggested that VSL#3 presented a higher remission rate and lower relapse rate (RR = 1.67, 95%CI [1.06, 2.63], P = .03; RR = 0.29, 95%CI [0.10, 0.83], P = .02, respectively).
Some types of probiotics, such as E coli Nissle 1917 and VSL#3, could be used as alternative therapy for patients with IBD.
由于炎症性肠病(IBD)的确切发病机制尚不清楚,越来越多的临床试验和动物模型证据表明益生菌具有有益作用。
采用多个数据库搜索涉及益生菌与对照组比较的相关研究。使用Review Manager 5.0评估纳入文章的疗效。还对纳入文章的偏倚风险进行了评估。
最终,10项研究符合纳入标准,共纳入1049例患者。荟萃分析表明,大肠杆菌Nissle 1917组与美沙拉嗪组在缓解率、复发率和并发症发生率方面无显著差异(相对危险度[RR]=0.94,95%可信区间[CI][0.86, 1.03],P=0.21;RR=1.04,95%CI[0.82, 1.31],P=0.77;RR=1.12,95%CI[0.86, 1.47],P=0.39)。尽管在益生菌与安慰剂组的总体荟萃分析结果中未观察到缓解率、复发率和并发症发生率的显著差异,但亚组分析表明,VSL#3的缓解率较高,复发率较低(RR=1.67,95%CI[1.06, 2.63],P=0.03;RR=0.29,95%CI[0.10, 0.83],P=0.02)。
某些类型的益生菌,如大肠杆菌Nissle 1917和VSL#3,可作为IBD患者的替代治疗方法。