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益生菌预防或治疗犬胃肠道疾病的临床效果:系统评价。

Clinical effect of probiotics in prevention or treatment of gastrointestinal disease in dogs: A systematic review.

机构信息

AniCura Copenhagen Animal Hospital, Copenhagen, Denmark.

Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark.

出版信息

J Vet Intern Med. 2019 Sep;33(5):1849-1864. doi: 10.1111/jvim.15554. Epub 2019 Jul 16.

Abstract

BACKGROUND

Gastrointestinal diseases are prevalent in dogs, and probiotics could provide safe alternatives to conventional treatments.

OBJECTIVE

To evaluate the clinical effects of probiotics when used in the prevention or treatment of gastrointestinal disease in dogs compared with no treatment, only symptomatic treatment, or conventional treatment.

METHODS

A systematic review was preformed searching AGRICOLA, AGRIS, CAB Abstracts, Embase, Ovid MEDLINE, and Web of Science to identify articles published before April 1, 2017. Selection criteria were original research report, those published in peer reviewed journal, and study investigating in vivo use of probiotic for prevention or treatment of gastrointestinal disease in dogs. Studies were rated based on the level of evidence, and methodological quality was evaluated by the following variables: similarities between groups at baseline, risk of bias, and study group size.

RESULTS

One hundred sixty-five studies were identified, of which 17 met the inclusion criteria-12 concerned acute gastrointestinal disease and 5 concerned chronic gastrointestinal disease. The level of evidence ranged between randomized controlled studies and crossover uncontrolled trials; estimated risk of bias was generally moderate to high; and sample sizes were small. Feces consistency was the most frequently evaluated clinical variable.

CONCLUSIONS AND CLINICAL IMPORTANCE

The current data point toward a very limited and possibly clinically unimportant effect for prevention or treatment of acute gastrointestinal disease. For chronic gastrointestinal disease, dietary intervention remains the major key in treatment, whereas probiotic supplement seems not to add significant improvement. However, studies were often underpowered, underscoring the need for future larger, preferably multicenter studies.

摘要

背景

胃肠道疾病在犬中较为常见,益生菌可为常规治疗提供安全的替代方案。

目的

评估益生菌在预防或治疗犬胃肠道疾病方面与不治疗、仅对症治疗或常规治疗相比的临床效果。

方法

系统检索 AGRICOLA、AGRIS、CAB Abstracts、Embase、Ovid MEDLINE 和 Web of Science,查找截至 2017 年 4 月 1 日发表的文章,纳入标准为原始研究报告、同行评议期刊发表的文章、研究益生菌在犬预防或治疗胃肠道疾病中的体内应用的文章。根据证据水平对研究进行评级,并通过以下变量评估方法学质量:基线时组间的相似性、偏倚风险和研究组大小。

结果

共确定了 165 项研究,其中 17 项符合纳入标准,其中 12 项涉及急性胃肠道疾病,5 项涉及慢性胃肠道疾病。证据水平介于随机对照研究和交叉非对照试验之间;估计的偏倚风险通常为中度至高度;样本量较小。粪便稠度是最常评估的临床变量。

结论和临床意义

目前的数据表明,益生菌在预防或治疗急性胃肠道疾病方面的效果非常有限,可能在临床上无重要意义。对于慢性胃肠道疾病,饮食干预仍然是治疗的主要关键,而益生菌补充似乎不能显著改善病情。然而,这些研究往往力不从心,因此需要未来进行更大规模的、最好是多中心的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5de1/6766488/46dbad46e637/JVIM-33-1849-g001.jpg

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