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益生菌或合生元补充剂对胃肠道癌化疗引起的并发症和肠道微生物群失调的疗效:系统评价和荟萃分析

Efficacy of probiotics or synbiotics supplementation on chemotherapy-induced complications and gut microbiota dysbiosis in gastrointestinal cancer: a systematic review and meta-analysis.

作者信息

Yao Bei, Wei Wei, Zhang Huiping

机构信息

First school of clinical medicine, Shandong Traditional Chinese Medicine University, Jinan Shandong, 250014, China.

Acupuncture rehabilitation Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, GuangDong, 510006, China.

出版信息

Eur J Clin Nutr. 2024 Nov 19. doi: 10.1038/s41430-024-01542-5.

Abstract

This study aimed to systematically review the clinical efficacy of probiotics or synbiotics supplementation in the treatment of chemotherapy-induced complications and gut microbiota dysbiosis in patients with gastrointestinal cancer. A literature search was performed systematically using PubMed, Embase, Cochrane, Web of Science, Wanfang Data, and CNKI for randomized controlled trials of probiotics or synthetic supplementation on chemotherapy-induced complications and gut microbiota dysbiosis in gastrointestinal cancer up to December 2023. The outcome measures included chemotherapy-related complications and the the incidence of gut microbiotas. Fifteen studies were finally eligible for meta-analysis, involving 1356 patients. Meta-analysis results showed that the the incidence rates of chemotherapy-related complications such as nausea and vomiting [RR = 0.61, 95% CI (0.46,0.82), P = 0.0008] and diarrhea [RR = 0.47, 95% CI (0.32,0.68), P < 0.001] were significantly reduced after probiotic intervention. The number of intestinal flora changed significantly after intervention, such as bifidobacterium [SMD = 1.33, 95% CI (0.52,2.31), P = 0.001], Escherichia coli [SMD = -0.82, 95% CI (-1.26, -0.38), P = 0.0003], and the difference was statistically significant. Probiotics or synbiotics supplementation can reduce chemotherapy-induced complications in patients with gastrointestinal cancer and regulate the number of gut microbiotas to balance the intestinal microecology of the body.

摘要

本研究旨在系统评价补充益生菌或合生元在治疗胃肠道癌患者化疗引起的并发症及肠道微生物群失调方面的临床疗效。截至2023年12月,使用PubMed、Embase、Cochrane、Web of Science、万方数据和中国知网系统检索了关于益生菌或合成制剂补充对胃肠道癌化疗引起的并发症及肠道微生物群失调的随机对照试验。结局指标包括化疗相关并发症和肠道微生物群的发生率。最终有15项研究符合荟萃分析的条件,涉及1356例患者。荟萃分析结果显示,益生菌干预后,恶心、呕吐等化疗相关并发症的发生率[RR = 0.61,95%CI(0.46,0.82),P = 0.0008]和腹泻的发生率[RR = 0.47,95%CI(0.32,0.68),P < 0.001]显著降低。干预后肠道菌群数量发生显著变化,如双歧杆菌[SMD = 1.33,95%CI(0.52,2.31),P = 0.001]、大肠杆菌[SMD = -0.82,95%CI(-1.26, -0.38),P = 0.0003],差异具有统计学意义。补充益生菌或合生元可降低胃肠道癌患者化疗引起的并发症,并调节肠道微生物群数量,以平衡机体肠道微生态。

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