Xie Li, Chen Dongmei, Zhu Xinghui, Cheng Cisong
Department of Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Front Pharmacol. 2023 Jan 10;13:1007654. doi: 10.3389/fphar.2022.1007654. eCollection 2022.
Parkinson's disease (PD) is the most common neurodegenerative disease closely related to the immune system, among whose prodromes constipation is a representative symptom. Recent Randomized Controlled Trials (RCTs) have proved that probiotics can be used to effectively treat PD constipation, but the results are inconsistent. We performed a meta-analysis to assess the efficacy and safety of probiotic therapy on Parkinson's constipation. Questions about the research focus were constructed based on the . We searched electronic databases such as PubMed, Web of Science, EMBASE, Scopus, EBSCO, Cochrane and Google Scholar until March 2022 for eligible literatures. Our primary endpoints were stool frequency, stool consistency, the number of laxatives uses, UPDRS-III scores and adverse events. 12 eligible studies (n = 818 patients) met the inclusion and endpoint criteria. Meta-analysis results showed that constipation symptoms were improved after probiotic treatment, including an increased stool frequency (WMD = 0.94, 95% CI:0.53 to 1.34; OR = 3.22, 95% CI:1.97-5.29), an improved stool consistency (WMD = 1.46, 95% CI:0.54-2.37), a reduced use of laxatives (WMD = -0.72, 95%CI: -1.04 to-0.41), and also a reduced Parkinson's UPDRS-III score (WMD = -6.58, 95%CI: -12.02 to -1.14); there was no significant difference in total adverse events (OR = 0.82, 95%CI:0.39-1.72). Our analysis suggests that probiotics can be used to improve the constipation and motor symptoms for patients with Parkinson's constipation, possibly by reducing the inflammatory response and improving gut-brain axis neuron function, whose safety also proved to be good.
帕金森病(PD)是最常见的与免疫系统密切相关的神经退行性疾病,其前驱症状中便秘是一个典型症状。近期的随机对照试验(RCT)已证明益生菌可有效治疗帕金森病便秘,但结果并不一致。我们进行了一项荟萃分析,以评估益生菌疗法对帕金森病便秘的疗效和安全性。基于该研究重点构建了相关研究问题。我们检索了PubMed、Web of Science、EMBASE、Scopus、EBSCO、Cochrane和谷歌学术等电子数据库,直至2022年3月,以查找符合条件的文献。我们的主要终点指标为大便频率、大便性状、泻药使用次数、帕金森病统一评分量表第三部分(UPDRS-III)评分及不良事件。12项符合条件的研究(n = 818例患者)满足纳入标准和终点指标标准。荟萃分析结果显示,益生菌治疗后便秘症状得到改善,包括大便频率增加(加权均数差[WMD] = 0.94,95%置信区间[CI]:0.53至1.34;比值比[OR] = 3.22,95%CI:1.97 - 5.29)、大便性状改善(WMD = 1.46,95%CI:0.54 - 2.37)、泻药使用减少(WMD = -0.72,95%CI:-1.04至-0.41),以及帕金森病UPDRS-III评分降低(WMD = -6.58,95%CI:-12.02至-1.14);总不良事件无显著差异(OR = 0.82,95%CI:0.39 - 1.72)。我们的分析表明,益生菌可用于改善帕金森病便秘患者的便秘及运动症状,可能是通过减轻炎症反应和改善肠-脑轴神经元功能实现的,其安全性也得到了证实。
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