益生菌和合生菌对营养不良儿童腹泻的影响：系统评价与荟萃分析。
Effects of probiotics and synbiotics on diarrhea in undernourished children: Systematic review with meta-analysis.
机构信息
Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium; Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo; General Pediatrics, Pediatric Department, Hôpital Provincial Général de Référence de Bukavu, Democratic Republic of Congo.
Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo; General Pediatrics, Pediatric Department, Hôpital Provincial Général de Référence de Bukavu, Democratic Republic of Congo.
出版信息
Clin Nutr. 2021 May;40(5):3158-3169. doi: 10.1016/j.clnu.2020.12.026. Epub 2020 Dec 25.
BACKGROUND
Undernutrition predisposes children to a greater incidence and duration of diarrhea. No review and meta-analysis have yet been conducted to assess effectiveness of probiotics and synbiotics in undernourished children.
AIMS
To assess the effectiveness of probiotics and synbiotics on diarrhea in undernourished children.
METHODS
Randomized, double-blind, placebo-controlled trials evaluating the effects of probiotics and synbiotics on diarrhea in undernourished children were searched from 1990 to May 2020. Recommendations of the Cochrane Handbook and the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement were followed.
RESULTS
The systematic review identified 15 trials with 6986 patients. The meta-analysis revealed that treatment with probiotic or synbiotic reduced significantly both the duration of diarrhea [Weighted mean difference (WMD) = -1.05 day, 95% CI (-1.98, -0.11)] and the hospital stay duration [Standard mean difference (SMD) = -2.87 days, 95% CI (-5.33, -0.42)], especially in specific patient subsets. In both groups, similar rates of vomiting and nutritional recovery were observed. No probiotics or synbiotics-related adverse effects were reported. Subgroup analyses showed that probiotic and synbiotic treatment were more effective in reducing risk of diarrhea in outpatients [Risk ratio (RR) = 0.86, 95%CI (0.75-0.98)].
CONCLUSION
This meta-analysis supports the potential beneficial roles of probiotics and synbiotics on diarrhea in undernourished children.
背景
营养不良使儿童更容易发生和持续腹泻。目前尚未有综述和荟萃分析评估益生菌和合生剂在营养不良儿童中的疗效。
目的
评估益生菌和合生剂对营养不良儿童腹泻的疗效。
方法
检索了 1990 年至 2020 年 5 月期间评估益生菌和合生剂对营养不良儿童腹泻影响的随机、双盲、安慰剂对照试验。遵循 Cochrane 手册和系统评价和荟萃分析的 Preferred Reporting Items（PRISMA）声明的建议。
结果
系统评价确定了 15 项试验，涉及 6986 名患者。荟萃分析显示，益生菌或合生剂治疗可显著缩短腹泻持续时间[加权均数差（WMD）=-1.05 天，95%可信区间（CI）（-1.98，-0.11）]和住院时间[标准均数差（SMD）=-2.87 天，95%CI（-5.33，-0.42）]，尤其是在特定的患者亚组中。在这两组中，呕吐和营养恢复的发生率相似。未报告益生菌或合生剂相关的不良反应。亚组分析显示，益生菌和合生剂治疗更能有效降低门诊患者腹泻的风险[风险比（RR）=0.86，95%CI（0.75-0.98）]。
结论
这项荟萃分析支持益生菌和合生剂对营养不良儿童腹泻的潜在有益作用。
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