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益生菌是治疗细菌性阴道病的一种较好选择:一项随机对照试验的荟萃分析。

Probiotics are a good choice for the treatment of bacterial vaginosis: a meta-analysis of randomized controlled trial.

机构信息

Department of Laboratory Medicine, ZhuJiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.

Microbiome Medicine Center, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.

出版信息

Reprod Health. 2022 Jun 13;19(1):137. doi: 10.1186/s12978-022-01449-z.

Abstract

BACKGROUND

Bacterial vaginosis (BV) is one of the most common vaginal infectious diseases in female reproductive period. Although the existing view is that probiotic treatment may be one of the feasible methods for the treatment of BV, different intervention methods lead to different treatment results. Therefore, up-to-date and comprehensive evidence in this regard is essential for the development of intervention strategies.

OBJECTIVE

This meta-analysis aims to systematically evaluate the role of probiotics in the treatment of BV in adult women.

METHODS

We searched the databases of Embase, Cochrane Library, PubMed, Web of Science and ClinicalTrials.gov for Randomized Controlled Trials published until November 7, 2021. Meta-analysis was performed by Revman5.3 software to systematically evaluate the clinical efficacy of probiotics adjunctive therapy in the treatment of BV. The literatures were screened and evaluated according to the inclusion and exclusion criteria. Chi-square test was used to test the heterogeneity between trials. Random or Fixed effect models were used to analyze the cure rate of BV.

RESULTS

Fourteen randomized controlled trials compared the efficacy of probiotics with antibiotic therapy (probiotics + antibiotics group) versus antibiotics alone or plus placebo (antibiotics (+ placebo) group) for BV [Risk Ratios (RR) = 1.23, 95% CI (1.05, 1.43), P = 0.009]. Three compared the efficacy of probiotics regimen (probiotics group) and antibiotics (antibiotics group) in the treatment of BV [RR = 1.12, 95% CI (0.60, 2.07), P = 0.72]. Another Three compared the efficacy of probiotics regimen (probiotics group) with placebo (placebo group) [RR = 15.20, 95% CI (3.87, 59.64), P < 0.0001].

CONCLUSION

Our meta-analysis suggests probiotics may play a positive role in the treatment of BV, but more strong evidence is needed.

摘要

背景

细菌性阴道病(BV)是女性生殖期最常见的阴道感染性疾病之一。尽管现有的观点认为益生菌治疗可能是治疗 BV 的一种可行方法,但不同的干预方法导致了不同的治疗结果。因此,在这方面需要最新和全面的证据,以制定干预策略。

目的

本荟萃分析旨在系统评价益生菌治疗成年女性 BV 的作用。

方法

我们检索了 Embase、Cochrane 图书馆、PubMed、Web of Science 和 ClinicalTrials.gov 数据库,检索截至 2021 年 11 月 7 日发表的随机对照试验。使用 RevMan5.3 软件对益生菌辅助治疗 BV 的临床疗效进行系统评价。根据纳入和排除标准筛选和评价文献。采用 Chi-square 检验检验试验间的异质性。采用随机或固定效应模型分析 BV 的治愈率。

结果

共有 14 项随机对照试验比较了益生菌与抗生素治疗(益生菌+抗生素组)与抗生素加安慰剂(抗生素(+安慰剂)组)治疗 BV 的疗效[风险比(RR)=1.23,95%可信区间(1.05,1.43),P=0.009]。有 3 项研究比较了益生菌方案(益生菌组)和抗生素(抗生素组)治疗 BV 的疗效[RR=1.12,95%可信区间(0.60,2.07),P=0.72]。另有 3 项研究比较了益生菌方案(益生菌组)与安慰剂(安慰剂组)治疗 BV 的疗效[RR=15.20,95%可信区间(3.87,59.64),P<0.0001]。

结论

我们的荟萃分析表明益生菌可能在治疗 BV 方面发挥积极作用,但需要更多强有力的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0fa/9195231/ca78541fd01c/12978_2022_1449_Fig1_HTML.jpg

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