State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
Department of Orthopedics, Xiaoshan Traditional Chinese Medical Hospital, Hangzhou 310003, Zhejiang Province, China.
World J Gastroenterol. 2019 Sep 7;25(33):4999-5016. doi: 10.3748/wjg.v25.i33.4999.
Diarrhea is a major infectious cause of childhood morbidity and mortality worldwide. In clinical trials, GG ATCC 53013 (LGG) has been used to treat diarrhea. However, recent randomized controlled trials (RCTs) found no evidence of a beneficial effect of LGG treatment.
To evaluate the efficacy of LGG in treating acute diarrhea in children.
The EMBASE, MEDLINE, PubMed, Web of Science databases, and the Cochrane Central Register of Controlled Trials were searched up to April 2019 for meta-analyses and RCTs. The Cochrane Review Manager was used to analyze the relevant data.
Nineteen RCTs met the inclusion criteria and showed that compared with the control group, LGG administration notably reduced the diarrhea duration [mean difference (MD) -24.02 h, 95% confidence interval (CI) (-36.58, -11.45)]. More effective results were detected at a high dose ≥ 10 CFU per day [MD -22.56 h, 95%CI (-36.41, -8.72)] a lower dose. A similar reduction was found in Asian and European patients [MD -24.42 h, 95%CI (-47.01, -1.82); MD -32.02 h, 95%CI (-49.26, -14.79), respectively]. A reduced duration of diarrhea was confirmed in LGG participants with diarrhea for less than 3 d at enrollment [MD -15.83 h, 95%CI (-20.68, -10.98)]. High-dose LGG effectively reduced the duration of rotavirus-induced diarrhea [MD -31.05 h, 95%CI (-50.31, -11.80)] and the stool number per day [MD -1.08, 95%CI (-1.87, -0.28)].
High-dose LGG therapy reduces the duration of diarrhea and the stool number per day. Intervention at the early stage is recommended. Future trials are expected to verify the effectiveness of LGG treatment.
腹泻是全世界儿童发病率和死亡率的主要感染性原因。在临床试验中，已使用 GG ATCC 53013（LGG）来治疗腹泻。但是，最近的随机对照试验（RCT）并未发现 LGG 治疗有益的证据。
评估 LGG 治疗儿童急性腹泻的疗效。
检索 EMBASE、MEDLINE、PubMed、Web of Science 数据库和 Cochrane 对照试验中心注册库，以获取截至 2019 年 4 月的荟萃分析和 RCT。使用 Cochrane 审查经理分析相关数据。
19 项 RCT 符合纳入标准，结果表明与对照组相比，LGG 给药可明显减少腹泻持续时间[均数差（MD）-24.02 h，95%置信区间（CI）（-36.58，-11.45）]。高剂量（≥10 CFU/天）[MD -22.56 h，95%CI（-36.41，-8.72）]和低剂量[MD -32.02 h，95%CI（-49.26，-14.79）]的效果更显著。在亚洲和欧洲患者中也发现了类似的减少[MD -24.42 h，95%CI（-47.01，-1.82）；MD -32.02 h，95%CI（-49.26，-14.79）]。在入组时腹泻持续时间少于 3 d 的 LGG 参与者中，腹泻持续时间也明显缩短[MD -15.83 h，95%CI（-20.68，-10.98）]。高剂量 LGG 可有效减少轮状病毒引起的腹泻持续时间[MD -31.05 h，95%CI（-50.31，-11.80）]和每日粪便量[MD -1.08，95%CI（-1.87，-0.28）]。
高剂量 LGG 治疗可减少腹泻持续时间和每日粪便量。建议在早期阶段进行干预。未来的试验有望验证 LGG 治疗的有效性。
