Gastrointestinal & Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences (GUMS), Rasht, Iran; Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences (GUMS), Rasht, Iran.
Gastrointestinal & Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences (GUMS), Rasht, Iran.
Complement Ther Med. 2019 Apr;43:36-43. doi: 10.1016/j.ctim.2019.01.005. Epub 2019 Jan 9.
Helicobacter pylori is a common human infection, presenting in half of the world's population. The failure of the Helicobacter pylori eradication rate necessitates the assessment of new options. The aim of the present meta-analysis was therefore to assess the role of synbiotics in Helicobacter pylori eradication therapy.
A comprehensive literature search was conducted using PubMed, Google Scholar, Scopus, and Web of Knowledge up to June 2018 to identify all randomized controlled trials assessing the effect of synbiotics on the treatment of Helicobacter pylori. A random-effects model was applied for pooling analysis to compensate for the heterogeneity of included studies. The Cochrane Risk of Bias Tool was applied to assess potential bias risks.
A total of 6 randomized controlled trials were found which assessed the effect of synbiotics on Helicobacter pylori eradication rate. The pooled effect size of the intention-to-treat showed that synbiotics can improve eradication rate (RR: 1.28; 95% CI: 1.15-1.43; I = 0%). Also, common adverse events resulting from antibiotics therapy were significantly reduced by adding synbiotics to conventional antibiotics treatments (RR: 0.47; 95% CI: 0.25-0.90; I = 36%). However, no difference in eradication rate was observed from per-protocol treatment between intervention and control groups (RR: 0.90; 95% CI: 0.69-1.16; I = 88%).
The present systematic review and meta-analysis suggested synbiotics might improve Helicobacter pylori eradication rates, and reduce adverse effects. However, these findings assessed a low number of studies, and further high-quality studies are needed to confirm these results.
幽门螺杆菌是一种常见的人类感染，在世界人口的一半中存在。幽门螺杆菌根除率的失败需要评估新的选择。因此，本荟萃分析的目的是评估共生元在幽门螺杆菌根除治疗中的作用。
使用 PubMed、Google Scholar、Scopus 和 Web of Knowledge 进行了全面的文献检索，截至 2018 年 6 月，以确定所有评估共生元对幽门螺杆菌治疗效果的随机对照试验。应用随机效应模型进行汇总分析，以补偿纳入研究的异质性。应用 Cochrane 偏倚风险工具评估潜在的偏倚风险。
共发现 6 项评估共生元对幽门螺杆菌根除率影响的随机对照试验。意向治疗的汇总效应大小表明，共生元可以提高根除率（RR：1.28；95%CI：1.15-1.43；I=0%）。此外，通过在常规抗生素治疗中添加共生元，显著减少了由抗生素治疗引起的常见不良反应（RR：0.47；95%CI：0.25-0.90；I=36%）。然而，干预组和对照组之间的方案治疗的根除率没有差异（RR：0.90；95%CI：0.69-1.16；I=88%）。
本系统评价和荟萃分析表明，共生元可能提高幽门螺杆菌的根除率，并减少不良反应。然而，这些发现评估了少数研究，需要进一步的高质量研究来证实这些结果。
