Tian Chunying, Huang Yang, Wu Xiaoxia, Xu Chuhan, Bu Huaien, Wang Hongwu
Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
Evid Based Complement Alternat Med. 2020 Mar 28;2020:6923609. doi: 10.1155/2020/6923609. eCollection 2020.
To evaluate the efficacy and safety of mesalamine in conjunction with probiotics for ulcerative colitis.
Random controlled trials (RCTs) were searched in PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang, and VIP (VIP Database for Chinese Technical Periodicals) from inception to October 2019. Methodological quality was assessed by the Cochrane Collaboration tool. The quality of evidence was rated by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Data analysis was carried out in Review Manager 5.3.
A total of fifteen studies met the criteria for inclusion. Thirteen studies reported the clinical efficacy, three studies provided data on the clinical symptom scores, two trials reported disease activity index, four studies evaluated endoscopic score, and twelve studies reported adverse events. For ulcerative colitis (UC), mesalamine and probiotics had better clinical efficacy than mesalamine alone (≤8 weeks: RR = 1.12, 95% CI: 1.07-1.18, < 0.0001; >8 weeks: RR = 1.25, 95% CI: 1.11-1.41, =0.0003). On the clinical symptom scores, disease activity index, and endoscopic score, UC patients receiving mesalamine and probiotics had significant difference than patients receiving mesalazine alone (MD = -2.02, 95% CI: -3.28 to -0.76, =0.002; MD = -1.20, 95% CI: -1.76 to -0.65, < 0.001; and MD = -0.42, 95% CI: -0.61 to -0.23, < 0.0001, respectively). There was no statistically significant difference in adverse events between the two groups (RR = 0.88, 95% CI: 0.54 to 1.43, =0.60).
Our meta-analysis results supported that mesalamine and probiotics were effective and safe in treating ulcerative colitis.
评估美沙拉嗪联合益生菌治疗溃疡性结肠炎的疗效和安全性。
检索PubMed、EMBASE、Cochrane图书馆、中国知网、万方和维普数据库（中文科技期刊数据库）中从建库至2019年10月的随机对照试验（RCT）。采用Cochrane协作工具评估方法学质量。证据质量采用推荐分级、评估、制定与评价（GRADE）进行评级。在Review Manager 5.3中进行数据分析。
共有15项研究符合纳入标准。13项研究报告了临床疗效，3项研究提供了临床症状评分数据，2项试验报告了疾病活动指数，4项研究评估了内镜评分，12项研究报告了不良事件。对于溃疡性结肠炎（UC），美沙拉嗪联合益生菌的临床疗效优于单用美沙拉嗪（≤8周：RR = 1.12，95%CI：1.07 - 1.18，<0.0001；>8周：RR = 1.25，95%CI：1.11 - 1.41，=0.0003）。在临床症状评分、疾病活动指数和内镜评分方面，接受美沙拉嗪联合益生菌的UC患者与单用美沙拉嗪的患者有显著差异（MD = -2.02，95%CI：-3.28至-0.76，=0.002；MD = -1.20，95%CI：-1.76至-0.65，<0.001；以及MD = -0.42，95%CI：-0.61至-0.23，<0.0001）。两组不良事件之间无统计学显著差异（RR = 0.88，95%CI：0.54至1.43，=0.60）。
我们的荟萃分析结果支持美沙拉嗪联合益生菌治疗溃疡性结肠炎有效且安全。
