Wang Xia, Tan Xiangsheng, Zhou Jiwei
Department of Pediatrics, The Second Affiliated Hospital of Army Medical University, Army Medical University Xinqiao Hospital, Chongqing, 400037, China.
The First Hospital Affiliated to Army Medical University, Chongqing, 400038, China.
Int J Pediatr Otorhinolaryngol. 2022 Nov;162:111300. doi: 10.1016/j.ijporl.2022.111300. Epub 2022 Sep 5.
This meta-analysis aimed to evaluate the effectiveness and safety of probiotics for allergic rhinitis (AR) management in children.
In total, 6 databases were searched, and 26 randomized controlled trials that compared the effects of probiotics with those not using probiotics in pediatric AR were included. Methodological quality was assessed using the Cochrane risk-of-bias tool. Data for relevant endpoints were extracted and analyzed.
Our meta-analysis of the effectiveness of probiotics for pediatric AR showed that probiotics improved the remission rate of nasal symptoms (risk ratio (RR) 1.21, 95% confidence interval (CI) 1.04 to 1.40; P = 0.01), reduced the Total Nasal Symptoms Scores (TNSS) (weighted mean difference (WMD) -2.58, 95% CI -2.77 to -2.39; P < 0.00001) and the total scores of Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) (for frequency of symptoms: WMD -9.51, 95% CI -10.34 to -8.69; P < 0.00001; and for level of bother: WMD -9.27, 95% CI -10.13 to -8.41; P < 0.00001). Furthermore, they reduced the serum levels of interleukin-4 (IL-4) (WMD -13.86 ng/L, 95% CI -15.92 to -11.81; P < 0.00001), IL-6 (WMD -13.70 pg/mL, 95% CI -16.34 to -11.07; P < 0.00001), and IL-17(WMD -5.41 pg/mL, 95% CI -7.29 to -3.52; P < 0.00001), and significantly elevated the serum levels of interferon-γ (WMD 9.08 ng/L, 95% CI 8.10 to 10.06; P < 0.00001) and IL-10 (WMD 7.82 pg/mL, 95% CI 5.01 to 10.63; P < 0.00001). Probiotics also reduced the duration of cetirizine use in pediatric AR (WMD -2.88 days, 95% CI -4.50 to -1.26; P < 0.0005). No obvious adverse reactions were found to be related to probiotic treatment.
This meta-analysis indicated that probiotic therapy can partially improve pediatric AR outcomes, assisted by modulating immune balance and reducing anti-allergic medication use, without obvious adverse reactions.
本荟萃分析旨在评估益生菌用于儿童过敏性鼻炎（AR）治疗的有效性和安全性。
共检索6个数据库，纳入26项比较益生菌与未使用益生菌对儿童AR疗效的随机对照试验。采用Cochrane偏倚风险工具评估方法学质量。提取并分析相关终点数据。
我们对益生菌治疗儿童AR有效性的荟萃分析表明，益生菌可提高鼻部症状缓解率（风险比（RR）1.21，95%置信区间（CI）1.04至1.40；P = 0.01），降低总鼻症状评分（TNSS）（加权均数差（WMD）-2.58，95%CI -2.77至-2.39；P < 0.00001）以及儿童鼻结膜炎生活质量问卷（PRQLQ）总分（症状频率：WMD -9.51，95%CI -10.34至-8.69；P < 0.00001；困扰程度：WMD -9.27，95%CI -10.13至-8.41；P < 0.00001）。此外，益生菌还可降低血清白细胞介素-4（IL-4）水平（WMD -13.86 ng/L，95%CI -15.92至-11.81；P < 0.00001）、IL-6水平（WMD -13.70 pg/mL，95%CI -16.34至-11.07；P < 0.00001）和IL-17水平（WMD -5.41 pg/mL，95%CI -7.29至-3.52；P < 图00001），并显著提高血清干扰素-γ水平（WMD 9.08 ng/L，95%CI 8.10至10.06；P < 0.00001）和IL-图0水平（WMD 7.82 pg/mL，95%CI 5.01至10.63；P < 0.00001）。益生菌还可缩短儿童AR中使用西替利嗪的持续时间（WMD -2.88天，95%CI -4.50至-1.26；P < 0.000图）。未发现与益生菌治疗相关的明显不良反应。
本荟萃分析表明，益生菌治疗可通过调节免疫平衡和减少抗过敏药物使用，部分改善儿童AR的治疗效果，且无明显不良反应。
