益生菌治疗酒精性肝病的临床疗效：系统评价和荟萃分析。
Clinical efficacy of probiotics in the treatment of alcoholic liver disease: a systematic review and meta-analysis.
机构信息
State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macao, Macao SAR, China.
Integrated Traditional Chinese and Western Medicine Department, Yibin Sixth People's Hospital, Yibin, Sichuan, China.
出版信息
Front Cell Infect Microbiol. 2024 Mar 12;14:1358063. doi: 10.3389/fcimb.2024.1358063. eCollection 2024.
OBJECTIVE
Alcoholic liver disease (ALD) is a liver damage disease caused by long-term heavy drinking. Currently, there is no targeted pharmaceutical intervention available for the treatment of this disease. To address this, this paper evaluates the efficacy and safety of probiotic preparation in treating ALD through conducting a meta-analysis, and provides a valuable insight for clinical decision-making.
METHODS
A systematic search was conducted across databases, including PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP, Wanfang, and CBM from the inception dates to October 15, 2023, to identify clinical randomized controlled trials on probiotic preparations in the treatment of ALD. After the literature underwent screening, data extraction, and quality assessment, RevMan 5.3 and Stata 14.2 were employed for data analysis and processing.
RESULTS
A total of 9 randomized controlled trials fulfilled the inclusion criteria. The results of the meta-analysis showed that probiotic preparation could significantly improve the liver function of patients with alcoholic liver disease compared with the control group. Probiotic intervention led to a significant reduction in the levels of alanine aminotransferase (MD=-13.36,95%CI:-15.80,-10.91;<0.00001),aspartate aminotransferase (MD=-16.99,95%CI:-20.38,-13.59;<0.00001),γ-glutamyl transpeptidase (MD=-18.79,95% CI:-28.23,-9.34; <0.0001). Concurrently, the level of serum albumin (MD=0.19,95% CI:0.02,0.36;=0.03) was increased. Furthermore, probiotic intervention could also modulate the composition of intestinal flora in patients with alcoholic liver disease, leading to an augmentation in and a reduction in However, in patients with alcoholic liver disease, probiotic intervention showed no significant effects on total bilirubin (MD=-0.01,95% CI:-0.17,0.15;=0.91), tumor necrosis factor-α (MD=0.03,95% CI:-0.86,0.92;=0.94) and interleukin-6 (MD=-5.3,95% CI:-16.04,5.45;=0.33).
CONCLUSION
The meta-analysis indicates that probiotics can improve liver function in alcoholic liver disease, reduce inflammatory responses, regulate intestinal flora, which have potential value in the treatment of alcoholic liver disease.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier CRD42023472527.
目的
酒精性肝病（ALD）是一种由长期大量饮酒引起的肝损伤疾病。目前，尚无针对该疾病的靶向药物干预措施。为了解决这个问题，本文通过荟萃分析评估益生菌制剂治疗 ALD 的疗效和安全性，为临床决策提供有价值的参考。
方法
系统检索了从数据库成立日期到 2023 年 10 月 15 日的 PubMed、Embase、Web of Science、Cochrane 图书馆、CNKI、VIP、Wanfang 和 CBM 中的临床试验，以确定益生菌制剂治疗 ALD 的随机对照试验。文献经过筛选、数据提取和质量评估后，采用 RevMan 5.3 和 Stata 14.2 进行数据分析和处理。
结果
共纳入 9 项随机对照试验。荟萃分析结果表明，益生菌制剂可显著改善酒精性肝病患者的肝功能，与对照组相比，丙氨酸氨基转移酶（MD=-13.36，95%CI：-15.80，-10.91；<0.00001）、天冬氨酸氨基转移酶（MD=-16.99，95%CI：-20.38，-13.59；<0.00001）、γ-谷氨酰转肽酶（MD=-18.79，95%CI：-28.23，-9.34；<0.0001）水平显著降低，血清白蛋白（MD=0.19，95%CI：0.02，0.36；=0.03）水平升高。此外，益生菌干预还可以调节酒精性肝病患者的肠道菌群组成，增加 ，减少 。然而，在酒精性肝病患者中，益生菌干预对总胆红素（MD=-0.01，95%CI：-0.17，0.15；=0.91）、肿瘤坏死因子-α（MD=0.03，95%CI：-0.86，0.92；=0.94）和白细胞介素-6（MD=-5.3，95%CI：-16.04，5.45；=0.33）无显著影响。
结论
荟萃分析表明，益生菌可改善酒精性肝病患者的肝功能，减轻炎症反应，调节肠道菌群，在酒精性肝病的治疗中具有潜在价值。
系统评价注册
https://www.crd.york.ac.uk/prospero/，标识符 CRD42023472527。
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