Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland.
Aliment Pharmacol Ther. 2020 Apr;51(7):678-688. doi: 10.1111/apt.15659. Epub 2020 Feb 13.
There is still controversy with regard to the efficacy of individual probiotic strains for the management of acute gastroenteritis.
To update evidence on use of Saccharomyces boulardii for treating acute gastroenteritis in children.
The Cochrane Library, MEDLINE and EMBASE databases were searched from inception to December 2019 for randomised controlled trials (RCTs) that compared use of S boulardii with no S boulardii (defined as placebo or no treatment). The grey literature was searched through Google search. Authors of the original papers and S boulardii manufacturers were contacted for additional data.
Twenty-nine RCTs (among them, 20 newly identified trials) were included. Only 38% of trials adequately generated their randomisation sequence, only 17% adequately concealed allocation and only one trial adequately blinded participants, study personnel and outcome assessors. However, 83% provided complete outcome data. None of the trials evaluated the effect of S boulardii on stool volume. Compared with placebo or no treatment, S boulardii use reduced the duration of diarrhoea (23 RCTs, n = 3450, mean difference -1.06 day, 95% CI -1.32 to -0.79; high heterogeneity [I = 90%]) (very low quality of evidence). S boulardii use was also associated with a reduced duration of hospitalisation (8 RCTs, n = 999, mean difference -0.85 day, 95% CI -1.35 to -0.34; I = 91%) (very low quality of evidence). S boulardii reduced the risk of diarrhoea on day 2 to day 7 (low quality of evidence).
In children with acute gastroenteritis, low- to very low-quality evidence suggests that S boulardii confers a benefit for several diarrhoeal outcomes.
对于特定益生菌菌株在急性胃肠炎治疗中的疗效仍存在争议。
更新使用布拉氏酵母菌治疗儿童急性胃肠炎的证据。
从建库至 2019 年 12 月，我们检索了 Cochrane 图书馆、MEDLINE 和 EMBASE 数据库，以寻找比较使用布拉氏酵母菌与不使用布拉氏酵母菌（定义为安慰剂或无治疗）的随机对照试验（RCT）。通过 Google 搜索检索灰色文献。我们联系了原始论文的作者和布拉氏酵母菌制造商以获取额外数据。
共纳入 29 项 RCT（其中包括 20 项新发现的试验）。只有 38%的试验充分产生了随机序列，只有 17%充分隐藏了分配，只有 1 项试验充分对参与者、研究人员和结果评估者进行了盲法。然而，83%的试验提供了完整的结局数据。没有一项试验评估了布拉氏酵母菌对粪便量的影响。与安慰剂或无治疗相比，布拉氏酵母菌的使用减少了腹泻持续时间（23 项 RCT，n=3450，平均差-1.06 天，95%CI-1.32 至-0.79；高度异质性[I²=90%]）（极低质量证据）。布拉氏酵母菌的使用也与住院时间的缩短相关（8 项 RCT，n=999，平均差-0.85 天，95%CI-1.35 至-0.34；I²=91%）（极低质量证据）。布拉氏酵母菌降低了第 2 天至第 7 天腹泻的风险（低质量证据）。
在患有急性胃肠炎的儿童中，低至极低质量证据表明，布拉氏酵母菌对多种腹泻结局有益。
