Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland.
Sackler Faculty of Medicine, Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Tel-Aviv University, Tel-Aviv, Israel.
Aliment Pharmacol Ther. 2019 Jun;49(11):1376-1384. doi: 10.1111/apt.15267. Epub 2019 Apr 25.
Recently, evidence from a large randomised controlled trial (RCT) negated efficacy of Lactobacillus rhamnosus GG for treating acute gastroenteritis in children.
To review RCTs in which L rhamnosus GG was used to treat acute gastroenteritis in children.
The Cochrane Library, MEDLINE, and EMBASE databases were searched from May 2013 (end of last search) to January 2019. The primary outcomes were stool volume and duration of diarrhoea.
Eighteen RCTs (n = 4208) were included. Compared with placebo or no treatment, L rhamnosus GG use had no effect on stool volume but was associated with a reduced duration of diarrhoea (15 RCTs, n = 3820, mean difference, MD -0.85 day, 95% CI -1.15 to -0.56). L rhamnosus GG was effective when used at a daily dose of ≥10 CFU or <10 CFU; however, the latter produced results of borderline significance. L rhamnosus GG was more effective when used in European countries compared with non-European countries, particularly when considered by region. L rhamnosus GG use was associated with a reduced duration of hospitalisation. One RCT found that L rhamnosus GG had no effect on the total clinical severity score at 14 days after enrolment.
Despite a recent large RCT demonstrating no effect of L rhamnosus GG, current evidence shows that, overall, L rhamnosus GG reduced both the duration of diarrhoea (with a higher impact in European countries) and hospitalisation in inpatients. These findings should be viewed in the context of the high heterogeneity and methodological limitations of the included trials.
最近，一项大型随机对照试验（RCT）的证据否定了鼠李糖乳杆菌 GG 治疗儿童急性肠胃炎的疗效。
综述使用鼠李糖乳杆菌 GG 治疗儿童急性肠胃炎的 RCT。
检索 Cochrane 图书馆、MEDLINE 和 EMBASE 数据库，检索时间截至 2013 年 5 月（最后一次检索结束时间）至 2019 年 1 月。主要结局指标为粪便量和腹泻持续时间。
纳入 18 项 RCT（n=4208）。与安慰剂或不治疗相比，鼠李糖乳杆菌 GG 治疗并未影响粪便量，但与腹泻持续时间缩短有关（15 项 RCT，n=3820，平均差异，MD-0.85 天，95%CI-1.15 至-0.56）。每日剂量≥10 CFU 或<10 CFU 时，鼠李糖乳杆菌 GG 有效；然而，后者的结果具有边缘显著性。与非欧洲国家相比，鼠李糖乳杆菌 GG 在欧洲国家更有效，尤其是按地区考虑时。使用鼠李糖乳杆菌 GG 可缩短住院时间。一项 RCT 发现，鼠李糖乳杆菌 GG 对登记后 14 天的总临床严重程度评分无影响。
尽管最近的一项大型 RCT 表明鼠李糖乳杆菌 GG 没有效果，但目前的证据表明，总体而言，鼠李糖乳杆菌 GG 缩短了腹泻持续时间（在欧洲国家影响更大）和住院时间。这些发现应结合纳入试验的高度异质性和方法学局限性来考虑。
