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益生菌对婴儿腹绞痛症状、肠道微生物群和炎症标志物的影响:一项随机对照试验的系统评价、荟萃分析和荟萃回归

The Effect of Probiotics on Symptoms, Gut Microbiota and Inflammatory Markers in Infantile Colic: A Systematic Review, Meta-Analysis and Meta-Regression of Randomized Controlled Trials.

作者信息

Skonieczna-Żydecka Karolina, Janda Katarzyna, Kaczmarczyk Mariusz, Marlicz Wojciech, Łoniewski Igor, Łoniewska Beata

机构信息

Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland.

Department of Clinical and Molecular Biochemistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland.

出版信息

J Clin Med. 2020 Apr 2;9(4):999. doi: 10.3390/jcm9040999.

Abstract

Immaturity in digestive-tract motor function and altered intestinal microbiome may play roles in pathogenesis of infantile colic. We assessed the impact of probiotic therapy on crying duration day, in newborns experiencing colic attacks. The PubMed, Embase, Cinnahl, Web of Science databases, and a clinical trials registry (ClinicalTrials.gov) were searched from inception until 12/02/2020. Random-effects meta-analyses were used to derive standardized mean differences/differences in means and risk ratios. We included 16 studies, which involved 1319 newborns aged up to 6 months. strain DSM17938 was administered predominantly ( = 10). Probiotic intervention reduced the duration of crying (standardized mean difference = -2.012, 95% confidence interval: -2.763 to -1.261, z = -5.25, < 0.0001). The probability of at least a 50% reduction in crying duration was at least 1.98 times higher in the intervention group than in controls (Z = 4.80, < 0.0001). The effects of the intervention were not significantly affected by the risk of bias assessment, percentage of breastfed infants, and duration of the study. In 11 studies, data concerning gut microbiota composition and function and/or immunological markers were given. Probiotics significantly shortened the crying duration, but a causal relationship between the modulatory effect of probiotics on microbiota and the immune system has not been confirmed.

摘要

消化道运动功能不成熟和肠道微生物群改变可能在婴儿腹绞痛的发病机制中起作用。我们评估了益生菌疗法对患有腹绞痛发作的新生儿每日哭闹时长的影响。检索了PubMed、Embase、Cinnahl、Web of Science数据库以及一个临床试验注册库(ClinicalTrials.gov),检索时间从建库至2020年2月12日。采用随机效应荟萃分析得出标准化均值差/均值差和风险比。我们纳入了16项研究,涉及1319名6个月及以下的新生儿。主要使用了DSM17938菌株(n = 10)。益生菌干预缩短了哭闹时长(标准化均值差 = -2.012,95%置信区间:-2.763至-1.261,z = -5.25,P < 0.0001)。干预组哭闹时长至少减少50%的概率比对照组至少高1.98倍(Z = 4.80,P < 0.0001)。干预效果不受偏倚风险评估、母乳喂养婴儿百分比和研究时长的显著影响。在11项研究中,给出了关于肠道微生物群组成和功能及/或免疫标志物的数据。益生菌显著缩短了哭闹时长,但益生菌对微生物群和免疫系统的调节作用之间的因果关系尚未得到证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6f5/7231167/8be540743364/jcm-09-00999-g001.jpg

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