Wang Feina, Wu Fangru, Chen Hong, Tang Bibo
Department of Pediatrics, People's Hospital of Wanning, Wanning, China.
Department of Pharmacy, The Fourth People's Hospital of Haikou, Haikou, China.
Transl Pediatr. 2023 Apr 29;12(4):731-748. doi: 10.21037/tp-23-200. Epub 2023 Apr 27.
Probiotics have anti-inflammatory effects and can alleviate clinical symptoms of atopic dermatitis (AD) in children. However, the effects of probiotics on AD in children were controversial. This study aimed to evaluate the clinical efficacy of probiotics in the prevention of AD in children by a meta-analysis method.
Randomized controlled trials (RCTs) on probiotics in the prevention of AD in children performed at home and abroad were searched in the PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases using a combination of subject terms and free terms. The retrieval time was from the establishment of the database to November 2022. Meta-analysis was performed by using Stata 14.0 software. The inclusion criteria were based on the Population, Intervention, Comparison, Outcomes and Study (PICOS) framework. (I) Participants: age ≤18; (II) Intervention: the intervention group received probiotics; (III) Control: the control group received placebo; (IV) Outcomes: AD; (V) the type of study: randomized control group. We collected the number of two groups and the number of AD in the included literatures. The I statistic was employed to evaluate heterogeneity.
Thirty-seven RCTs were eventually included, including 2,986 in the experimental group and 3,145 in the control group. The meta-analysis showed that probiotics were superior to placebo in the prevention of AD [risk ratio (RR) (95% confidence interval): 0.83 (0.73, 0.94), I=65.2%]. The sub-group meta-analysis showed that the clinical efficacy of probiotics in the prevention of AD was more significant in the following groups: mothers and infants, before and after childbirth, or mixed probiotics, follow-up time ≤2 years, and conducted in Europe.
Probiotic intervention may provide an effective means of preventing AD in children. However, due to the heterogeneity of the results of this study, the results need confirmation in follow-up studies.
益生菌具有抗炎作用,可缓解儿童特应性皮炎(AD)的临床症状。然而,益生菌对儿童AD的影响存在争议。本研究旨在通过荟萃分析方法评估益生菌预防儿童AD的临床疗效。
使用主题词和自由词相结合的方式,在PubMed、Web of Science、中国知网(CNKI)和万方数据库中检索国内外关于益生菌预防儿童AD的随机对照试验(RCT)。检索时间为数据库建立至2022年11月。使用Stata 14.0软件进行荟萃分析。纳入标准基于人群、干预、对照、结局和研究(PICOS)框架。(I)参与者:年龄≤18岁;(II)干预:干预组接受益生菌;(III)对照:对照组接受安慰剂;(IV)结局:AD;(V)研究类型:随机对照组。我们收集了纳入文献中两组的人数和AD的人数。采用I统计量评估异质性。
最终纳入37项RCT,其中试验组2986例,对照组3145例。荟萃分析表明,益生菌在预防AD方面优于安慰剂[风险比(RR)(95%置信区间):0.83(0.73,0.94),I = 65.2%]。亚组荟萃分析表明,益生菌在预防AD方面的临床疗效在以下组中更显著:母婴、分娩前后、或混合益生菌、随访时间≤2年且在欧洲进行的研究。
益生菌干预可能为预防儿童AD提供一种有效手段。然而,由于本研究结果存在异质性,结果需要在后续研究中得到证实。