School of Medicine, Federal University of Goiás, Goiânia, Brazil.
Department of Pediatric Gastroenterology, State Hospital for Children and Adolescents, Goiânia, Brazil.
Acta Paediatr. 2024 Feb;113(2):170-182. doi: 10.1111/apa.17036. Epub 2023 Nov 14.
This study is a systematic review and meta-analysis of randomised controlled trials that employed probiotics and symbiotics for treating infantile colic.
We performed electronic systematic literature searches in Embase, PubMed and Web of Science, to identify articles published between 1950 and April 2023. Only RCT involving infants with infantile colic under 3 months were included. The treatment plan comprised 15 probiotics, which included Lactobacillus reuteri DSM 17938 and Bifidobacterium animalis lactis BB-12. The probiotics were administered alone or in combination with a prebiotic, vs. no intervention or a placebo.
Probiotics resulted in an average reduction of 51 min of crying per day (p = 0.001). Further analysis of subgroups showed that the reduction was -39.30 min for vaginal delivery (p = 0.003), -64.66 min for Lactobacillus reuteri DSM 17938 (p = 0.03), -40.45 min for other strains (p < 0.00001), -74.28 min for exclusively breastfed infants (p = 0.0003) and -48.04 min for mixed feeding (p < 0.00001).
All probiotic strains seem effective in treating infantile colic. Exclusively breastfed infants have demonstrated more significant reduction in crying time. However, the available evidence on the effectiveness of probiotics in formula-fed and caesarean-born infants is limited.
本研究对使用益生菌和合生剂治疗婴儿绞痛的随机对照试验进行了系统评价和荟萃分析。
我们在 Embase、PubMed 和 Web of Science 中进行了电子系统文献检索，以确定 1950 年至 2023 年 4 月期间发表的文章。仅纳入涉及 3 个月以下婴儿绞痛的 RCT。治疗方案包括 15 种益生菌，包括雷特氏乳杆菌 DSM 17938 和动物双歧杆菌 lactis BB-12。益生菌单独或与益生元联合使用，与无干预或安慰剂相比。
益生菌使每天哭泣的平均时间减少了 51 分钟（p=0.001）。进一步的亚组分析表明，阴道分娩的减少为-39.30 分钟（p=0.003），雷特氏乳杆菌 DSM 17938 为-64.66 分钟（p=0.03），其他菌株为-40.45 分钟（p<0.00001），纯母乳喂养的婴儿为-74.28 分钟（p=0.0003），混合喂养的婴儿为-48.04 分钟（p<0.00001）。
所有益生菌株似乎都能有效治疗婴儿绞痛。纯母乳喂养的婴儿在哭泣时间减少方面表现出更显著的效果。然而，关于配方奶喂养和剖宫产婴儿中益生菌有效性的证据有限。
