益生菌联合曲美布汀治疗肠易激综合征患者：一项系统评价与Meta分析

Probiotics Combined With Trimebutine for the Treatment of Irritable Bowel Syndrome Patients: A Systematic Review and Meta-Analysis.

作者信息

Yu Qiu-Xiang, Wang Dong-Dong, Dong Peng-Ju, Zheng Li-Hua

机构信息

Department of Proctology, China-Japan Friendship Hospital, Beijing, China.

Department of Surgical, Tumote Right Banner Hospital, Baotou, Inner Mongolia, China.

出版信息

J Gastroenterol Hepatol. 2025 Mar;40(3):677-691. doi: 10.1111/jgh.16858. Epub 2025 Jan 8.

DOI:10.1111/jgh.16858

PMID:39780334

Abstract

OBJECTIVE

This study aimed to assess the efficacy and safety of probiotics combined with trimebutine in the treatment of irritable bowel syndrome (IBS), addressing an important gap in current treatment strategies.

METHODS

Randomized controlled trials (RCTs) of trimebutine combined with probiotics for the treatment of IBS were collected from various databases. All retrieved articles were screened and assessed for quality. The methodological quality of the included studies was assessed following the guidelines recommended by the Cochrane Collaboration. The meta-analysis of the included studies was conducted using RevMan 5.3 software.

RESULTS

A total of 37 RCTs involving 4360 participants were included in this study. Among them, the treatment group consisted of 2177 participants, and the control group consisted of 2183 participants. The results showed that the overall efficacy of trimebutine combined with probiotics in the treatment of IBS was significantly higher than that of trimebutine alone (odds ratio [OR] = 5.09, 95 % confidence interval [CI] [4.19, 6.20], p < 0.00001). The effective rate in the combination therapy group was 93.5 % compared with 73.8 % in the trimebutine alone group. The safety profile was favorable, with adverse event rates of 1.75 % and 1.69 % in the combination and monotherapy groups, respectively. The most common adverse events were mild and included dry mouth, nausea and dizziness. No serious adverse events were reported in either group. Subgroup analysis based on the type of probiotic intervention showed that combination use was better than trimebutine alone, and the differences between each subgroup were statistically significant. Combination use of compound Lactobacillus capsules had the best effect (OR = 16.03, 95 % CI [4.57, 56.21], p < 0.0001]. These results highlight the potential role of strain-specific benefits in IBS treatment and suggest that probiotic strain selection may significantly influence treatment outcomes.

CONCLUSIONS

The combination of trimebutine and probiotics is more effective in the treatment of IBS compared with trimebutine alone.

CLINICAL TRIAL REGISTRATION

https://www.crd.york.ac.uk/prospero/, identifier: CRD42024516044.

摘要

目的

本研究旨在评估益生菌联合曲美布汀治疗肠易激综合征（IBS）的疗效和安全性，以填补当前治疗策略中的一项重要空白。

方法

从多个数据库收集曲美布汀联合益生菌治疗IBS的随机对照试验（RCT）。对所有检索到的文章进行筛选和质量评估。按照Cochrane协作网推荐的指南评估纳入研究的方法学质量。使用RevMan 5.3软件对纳入研究进行荟萃分析。

结果

本研究共纳入37项RCT，涉及4360名参与者。其中，治疗组有2177名参与者，对照组有2183名参与者。结果显示，曲美布汀联合益生菌治疗IBS的总体疗效显著高于单用曲美布汀（优势比[OR]=5.09，95%置信区间[CI][4.19，6.20]，p<0.00001）。联合治疗组的有效率为93.5%，而单用曲美布汀组为73.8%。安全性良好，联合治疗组和单药治疗组的不良事件发生率分别为1.75%和1.69%。最常见的不良事件为轻度，包括口干、恶心和头晕。两组均未报告严重不良事件。基于益生菌干预类型的亚组分析表明，联合使用优于单用曲美布汀，各亚组之间的差异具有统计学意义。复合乳酸菌胶囊联合使用效果最佳（OR=16.03，95%CI[4.57，56.21]，p<0.0001）。这些结果突出了特定菌株益处在IBS治疗中的潜在作用，并表明益生菌菌株的选择可能显著影响治疗结果。