Department of Gastroenterology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
Department of Gastroenterology, Affiliated Baoan Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Shenzhen, 515000, China.
Complement Ther Clin Pract. 2021 May;43:101370. doi: 10.1016/j.ctcp.2021.101370. Epub 2021 Apr 1.
In 1954, the term "probiotics" was coined by Ferdinand Vergin in his article. Although there are many clinical reports on the use of pro/synbiotics and other microbial preparations to prevent postoperative infections and related complications in patients with Colorectal cancer (CRC), their effectiveness remains divided. Therefore, we collected relevant high-quality randomized controlled trial (RCT) studies and conducted systematic review and meta-analysis. We electronically searched online databases (the PubMed, EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Allied and Alternative Medieine (AMED), China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu) for literature published until December 2020. These reports were rigorously screened, and the data extracted, assessed for risk of bias (ROB), and subjected to meta-analysis and subgroup analysis. Postoperative infections were the main criteria for outcomes. Nineteen high-quality articles were included, involving 1975 patients. Compared with the control group, the pro/synbiotics group had reduced total postoperative infections ((odds ratio)OR = 0.28, 95% (confidence interval)CI: 0.20; 0.39, p < 0.0001), which included surgical site infections (SSI) (OR = 0.43, 95% CI: 0.31; 0.58, p < 0.0001) and non-surgical site infections (non-SSI) (OR = 0.28 95% CI: 0.20; 0.39, p < 0.0001).What is more, in aspects of inflammatory factors, intestinal dysbiosis, non-infectious complications, and systemic symptoms, the treatment group was better than the control group. However, there were no differences in perineal infections (OR = 0.45, 95% CI: 0.13; 1.50, p = 0.1933), celiac infections (OR = 0.54, 95% CI: 0.11; 2.66, p = 0.4471), or systemic inflammatory response syndrome (SIRS) incidence (OR = 0.63, 95% CI: 0.31; 1.30, p = 0.2139), etc. There were no differences in intervention (probiotics or synbiotics), strain type (multistrain or non-multistrain probiotics), and intervention time (administration preoperatively or pre-and-postoperatively). Pro/synbiotics can effectively prevent postoperative infections and related complications in patients with CRC. The strain type and intervention time did not affect the treatment effects.
在 1954 年，Ferdinand Vergin 在他的文章中创造了“益生菌”一词。虽然有许多关于使用益生菌/合生菌和其他微生物制剂预防结直肠癌（CRC）患者术后感染和相关并发症的临床报告，但它们的疗效仍存在分歧。因此，我们收集了相关的高质量随机对照试验（RCT）研究，并进行了系统评价和荟萃分析。我们通过电子方式在在线数据库（PubMed、EMBASE、MEDLINE、Cochrane 对照试验中心注册库（CENTRAL）、辅助和替代医学（AMED）、中国知网（CNKI）、万方和维普）中检索截至 2020 年 12 月发表的文献。这些报告经过严格筛选，提取数据，并进行了风险偏倚（ROB）评估，以及进行荟萃分析和亚组分析。术后感染是主要的结果标准。纳入了 19 篇高质量的文章，涉及 1975 名患者。与对照组相比，益生菌/合生菌组术后总感染率降低（（优势比）OR=0.28，95%置信区间（CI）：0.20；0.39，p<0.0001），包括手术部位感染（SSI）（OR=0.43，95%CI：0.31；0.58，p<0.0001）和非手术部位感染（非 SSI）（OR=0.28 95%CI：0.20；0.39，p<0.0001）。更重要的是，在炎症因子、肠道菌群失调、非感染性并发症和全身症状方面，治疗组优于对照组。然而，在会阴感染（OR=0.45，95%CI：0.13；1.50，p=0.1933）、腹腔感染（OR=0.54，95%CI：0.11；2.66，p=0.4471）或全身炎症反应综合征（SIRS）发生率（OR=0.63，95%CI：0.31；1.30，p=0.2139）等方面，两组间没有差异。干预措施（益生菌或合生菌）、菌株类型（多菌株或非多菌株益生菌）和干预时间（术前或术前和术后）没有差异。益生菌/合生菌可有效预防 CRC 患者术后感染和相关并发症。菌株类型和干预时间不影响治疗效果。
